The Ebola outbreak affecting the Democratic Republic of Congo (DRC) and Uganda has resulted in over 200 fatalities, and the confirmed case count has jumped by 38% in just a week, according to the Africa Centers for Disease Control (Africa CDC) on Thursday.
The Africa CDC reported a total of 894 confirmed cases, predominantly located in eastern DRC. This current Bundibugyo outbreak is proving to be much more severe than the earlier outbreak first identified in Uganda, which, while serious, lacked the devastating impact of the major DRC outbreaks of 2014 and 2018.
There are concerns among health professionals that the actual scale of the outbreak may be significantly larger than the confirmed figures suggest. Epidemiologists are finding it challenging to determine when the outbreak began, and tracing the vast number of individuals who had contact with confirmed Ebola patients is proving to be complex.
Wessam Mankoula, an epidemiologist at the Africa CDC, remarked that the 894 confirmed cases could have between 17,000 and 35,000 contacts, yet only around 4,000—about 15%—have been traced so far.
“We are still far from controlling this epidemic situation,” he cautioned.
Mankoula pointed out that a shortage of funding and personnel is hindering effective contact tracing. He noted that only 10% of international funds pledged to combat the outbreak have been made available thus far. The Africa CDC estimates that at least 540 personnel are necessary to effectively respond, but currently, they only have 84 staff members.
Africa CDC Executive Director Jean Kaseya mentioned that it was indicated earlier in the week that for each confirmed Ebola case, about 40 contacts in densely populated areas need to be traced.
Kaseya also highlighted concerns regarding contact with deceased Ebola patients, emphasizing the urgent need for quick and safe burials to limit exposure to healthy individuals. Some of the additional staff Mankoula hopes to recruit would be tasked with managing the safe handling of infectious bodies.
Bruno Michon, an Operations Manager for the International Federation of the Red Cross (IFRC), shared a caution on Tuesday that the outbreak has not yet reached its peak. He noted, “I’m worried that this will last a year before we can end this disease.”
Michon stated that one of the most significant challenges for health workers is the prevailing mistrust and hostility from communities in eastern Congo. He mentioned that IFRC teams have faced “verbal abuse, intimidation, and attacks” while attempting to engage with remote communities and oversee the safe burial of Ebola victims.
Kate White, Emergency Medical Coordinator for Médecins Sans Frontières (MSF), observed that most of the new patients entering already “overwhelmed” treatment facilities were not previously identified as contacts. This raises the concern that for every new case, there are likely many more contacts that require tracing.
Another considerable hurdle is the large population of internally displaced persons (IDPs) residing in the affected regions. Over 2 million individuals displaced by ongoing violence from jihadists and rebel groups find themselves at risk of contracting Ebola.
According to the United Nations refugee agency UNHCR, approximately 320,000 of these displaced people live in unsanitary camps, while others are on the move, potentially spreading the disease further throughout DRC and neighboring regions.
UNHCR reported a concerning event on June 7th, where 2,250 individuals were evacuated from Mbau, which is near the outbreak’s epicenter, to Oicha in North Kivu province after armed attacks triggered panic. This kind of chaotic movement heightens the risk of Ebola spreading and complicates contact tracing for those involved.
“Refugees and internally displaced persons already face trauma, insecurity, and inadequate humanitarian aid, and the outbreak is exacerbating fear and misinformation, undermining trust in response teams, and delaying access to critical care,” the UNHCR added.
