Congo Ebola outbreak in Ituri has killed scores, raising alarm over cross-border spread, virus strain concerns and urgent containment efforts.
Congo Ebola outbreak fears have intensified after Africa’s top public health body confirmed a new crisis in Ituri province, where scores have already died.
The outbreak is the 17th recorded in Congo since the disease first emerged in the country in 1976.
A total of 246 suspected cases and 65 deaths have already been recorded in the new outbreak, the Africa Centres for Disease Control and Prevention said in a statement on Friday.
In neighbouring Uganda, an Ebola case has also been confirmed in a man from Congo who died in a hospital in the capital, Kampala. Ugandan officials said the man was tested after his death.
Here’s what to know about the health crisis:
The outbreak is in a remote part of Congo
The suspected Ebola cases have mainly been recorded in Ituri’s Mongwalu and Rwampara health zones. Suspected cases have also been reported in Bunia, the capital of Ituri province.
So far, only four of the reported deaths are laboratory-confirmed cases, but the new outbreak was confirmed after many suspected infections were detected.
Ituri is located in a remote eastern part of Congo with poor road networks. It is more than 1,000 kilometres, or 620 miles, from the national capital, Kinshasa.
One major concern, according to the Africa CDC, is the proximity of the affected areas to Uganda and South Sudan.
Bunia, Ituri’s main city, lies near the border with Uganda.
The agency said there is also a risk of further spread because of intense population movement and attacks by armed groups. Those attacks have killed dozens and displaced thousands in parts of Ituri province over the past year.
There are also gaps in contact tracing, the Africa CDC said, as local authorities rush to locate people who may have been exposed to the virus.
An unusual strain raises questions
Africa CDC said results so far suggest a variant of illness other than the Ebola virus, also known as the Ebola Zaire strain.
The agency said sequencing is still ongoing to further identify the strain, with results expected within the next 24 hours.
The Ebola Zaire strain was prominent in Congo’s previous outbreaks, including the 2018 to 2020 outbreak in the eastern region that killed more than 1,000 people.
The World Health Organization says Ebola disease is caused by a group of viruses. Three of them are known to cause large outbreaks: Ebola virus, Sudan virus and Bundibugyo virus.
During Congo’s Ebola outbreak last year, WHO said the country had a stockpile of treatments and around 2,000 vaccine doses.
However, that vaccine is designed for the Ebola virus, not the Sudan or Bundibugyo viruses.
Dr. Gabriel Nsakala, a professor of public health who has been involved in previous Ebola outbreak responses in Congo, said treatments for viral infections such as Ebola are often focused on symptoms.
He added that plans regarding vaccines would become clearer once the strain behind the new outbreak is confirmed.
In Uganda, authorities said the confirmed case there was linked to the Bundibugyo virus, a strain that has been endemic to that country.
However, health officials said the case was “imported” from Congo and that no local cases had been detected.
Ugandan health officials said contacts linked to that case have been quarantined. They include a high-risk contact who is a close relative of the deceased.
Urgent containment efforts begin
The Africa CDC convened an urgent high-level coordination meeting on Friday with health authorities from Congo, Uganda and South Sudan.
Key partners, including United Nations agencies and other countries, also joined the meeting.
The agency said the meeting was expected to focus on immediate response priorities, cross-border coordination, surveillance, safe and dignified burials, and resource mobilisation, among other areas.
Congo and health workers on the ground have a high level of experience from past outbreaks, Nsakala said.
The country also has existing infrastructure, including laboratories.
“Now, the expertise and equipment need to be delivered quickly,” he added.
Logistical challenges may slow response
Congo is Africa’s second-largest country by land area and often faces serious logistical problems when responding to disease outbreaks.
Bad roads and long distances frequently slow the delivery of medical supplies and response teams.
During last year’s outbreak, which lasted three months, the WHO initially faced major challenges in delivering vaccines.
The vaccines arrived a week after the outbreak was confirmed.
Funding has also been a problem.
During last year’s outbreak, health officials raised concerns about the impact of recent U.S. funding cuts.
The United States had supported the response to Congo’s past Ebola outbreaks.
In 2021, the U.S. Agency for International Development provided up to $11.5 million to support Ebola response efforts across Africa.
How Ebola spreads
The Ebola virus is highly contagious and can be transmitted to people from wild animals.
It then spreads among humans through contact with bodily fluids such as vomit, blood or semen.
It can also spread through surfaces and materials, including bedding and clothing, contaminated with those fluids.
The disease caused by the virus is rare but severe. It is often fatal.
Symptoms include fever, vomiting, diarrhoea, muscle pain and, in some cases, internal and external bleeding.
The virus was first discovered in 1976 near the Ebola River in what is now Congo.
The first outbreaks occurred in remote villages in Central Africa, near tropical rainforests.
