Ebola

DAKAR: Health officials battling the Ebola outbreak in eastern Democratic Republic of Congo are using anonymised mobile-phone ​data to map population movements and identify areas where the virus could spread next, according to the World Health Organization and researchers working with it. 

The approach, which has not been used before in an Ebola response, comes as authorities struggle to contain what the WHO has described as the fastest-growing Ebola outbreak on record. Cases have been confirmed in six provinces, with more than 6,250 people infected and 3,039 killed since the outbreak was declared on May 15, according to the latest government data. 

The outbreak, Congo’s 17th, is caused by the Bundibugyo species of Ebola, for which there are no approved vaccines or treatments. 

As the virus spreads, health officials are looking for ways to anticipate where cases could emerge next and direct limited surveillance and response resources. 

“Population movements have always been a factor in outbreaks, but they are particularly important in the ‌current epidemic,” said Olivier ‌Le Polain, head of epidemiology and analytics for response at the WHO Health Emergencies Programme. 

Traditional ​risk ‌assessments focus ⁠on outbreak ​hotspots ⁠and assume the virus is most likely to spread to surrounding areas.Analizing mobility data allows responders to identify risks in places that may be geographically distant but closely connectedthrough travel patterns. 

“It gives us a more nuanced understanding of risk,” Le Polainsaid, citing the example of Ituri province, in the northeast, where the virus is believed to have started circulating. 

“There are very significant population movements in Ituri linked to mining activities and trade. Understanding those movements is crucial to understanding how the outbreak spreads.” 

The analysis is produced by Swedish non-profit Flowminder, using anonymised records generated when mobile phone users connect to telecommunications networks. As people move around the country, their phones connect to different antennas on the network, generating records that show where those connections took place. Researchers use ⁠those records to estimate how people travel between different areas. 

The data is provided free of charge by ‌Vodacom, Congo’s largest operator. Vodacom did not respond to a request for comment. 

Flowminder says it ‌receives aggregated and anonymised records and does not have access to information identifying individual subscribers. 

“We seek ​to provide estimates of how people move, which in turn is ‌a predictor of how infectious people move,” Flowminderfounder Linus Bengtsson said. 

Flowminder’s first analysis, published in early June, focused on the three ‌areas where the outbreak is believed to have started: Bunia, Mongbwalu and Rwampara. Researchers tracked where people who had spent time in those areas between April 3 and April 23 later traveled. 

The largest flows were to nearby areas in Ituri province and North Kivu province. By the end of June, all 10 of the destinations receiving the largest flows of travelers from the original outbreak areas had reported confirmed Ebola cases. 

DRC detected the outbreak of the rare Bundibugyo virus in mid-May; nearly 3,400 people have since died.

More than 7,000 Ebola cases have been recorded in the Democratic Republic of the Congo’s (DRC) worst outbreak of the deadly disease, according to figures from Congolese authorities.

The DRC officially detected the latest outbreak in mid-May, but experts suspect it had been spreading under the radar for weeks before.

Of the 7,022 registered cases, 3,398 people have died, according to DRC authorities. Currently, 837 people are in isolation or receiving treatment.

The outbreak of the rare Bundibugyo virus, DRC’s 17th Ebola epidemic, began in the northeastern Ituri province.

It has since spread across conflict-plagued, remote eastern and northern regions where armed groups have roamed for decades, the presence of the state is weak and health infrastructure is largely lacking.

Earlier this week, one case of the disease was confirmed in a seventh province, South-Ubangi, which is in the northwest of the country bordering the Central African Republic and Congo-Brazzaville.

Most of the recorded cases remain in Ituri, where Ebola has been detected in schools in the days after the post-summer holiday return to classes, causing alarm among parents and health workers.

“We are very worried because we don’t know which child comes from which family or what the health status of the members of that family is,” Angele Magani, a mother of a schoolboy in Bunia, Ituri’s provincial capital, told the AFP news agency.

“We are so scared, even though the school authorities reassure us about the health measures that have been put in place,” she added.

Bunia school official Roger Mungimbo told AFP that “there is a mandatory hand-washing system with soap, and we have also done everything possible to have a maximum of 30 pupils per classroom”.

“We regularly make the children aware that they must not touch each other, must not greet each other and must wash their hands regularly,” he added.

Ebola, which has killed more than 15,000 people in Africa over the last 50 years, is transmitted through contact with bodily fluids and can cause severe internal and external bleeding and organ failure.

The world’s deadliest outbreak in West Africa in 2014-2016 was the Zaire Ebola virus. That epidemic killed more than 11,325 people, mainly in Guinea, Liberia and Sierra Leone.

The Bundibugyo strain currently seen in DRC has no approved vaccine or treatment currently, although several potential treatments and vaccines are being tested.

DRC’s is the fastest-spreading Ebola outbreak ever recorded, with 5,794 confirmed cases and 2,786 deaths.

The fastest-spreading Ebola outbreak in history has reached two new health zones in eastern Democratic Republic of the Congo (DRC), with a total of 60 areas now affected, according to the latest government figures.

The two new zones affected are Biena and Manguredjipa in DRC’s North Kivu province, where the fatality rate is much higher than the overall rate of 48 percent, partly due to delayed response efforts, according to data by the Ministry of Health released on Friday.

The ministry said the outbreak in DRC has recorded 5,794 confirmed cases, including 2,786 deaths, and is spreading at an unprecedented speed – faster than efforts to track and slow it.

Efforts to contain the outbreak have been hampered by armed conflict in the affected provinces, displacement, attacks on medical personnel and facilities, a mobile working population, and a lack of critical infrastructure.

The outbreak is now on track to surpass the deadliest Ebola epidemic on record – the 2014 to 2016 outbreak in West Africa that killed more than 11,000 people.

Meanwhile, aid group Doctors Without Borders – known by its French acronym MSF – said on Friday it had opened a new treatment centre in Beni in North Kivu in the country’s northeast to enable a faster response in what it said was one of the hardest-hit areas.

Beni has recorded 122 confirmed cases and 87 deaths since the start of the outbreak in mid-May, with an Ebola fatality rate of close to 69 percent, one of the highest in the country, according to the latest government figures.

Aid workers have said that a shortage of bed capacity is one of the factors hampering the response to the outbreak. The new centre “enables the rapid treatment of patients, strengthens contact tracing and supports the health authorities in their efforts to contain the spread of the virus,” MSF said in a statement.

There is no approved vaccine or treatment for this particular strain of Ebola, known as Bundibugyo, which is rarer than the virus type behind most past outbreaks. This means that relief workers are more reliant on traditional methods like tracing contacts and ⁠isolating patients to try to control ⁠its spread.

MSF currently has 1,400 staff in DRC supporting the response, ‌and operates ‌treatment centres with a total of 400 beds.

“Early diagnosis and treatment as soon as the first symptoms appear significantly increase people’s chances of survival, whilst reducing the risk of transmission ‌ within families and communities,” MSF emergency coordinator Albert Stern said.

UN Secretary-General Antonio Guterres warned on Thursday that Ebola is spreading faster than efforts to contain it.

“The Ebola outbreak in the Democratic Republic of the Congo is the fastest-spreading Ebola epidemic ever recorded,” he said in a post on US social media company X. “It’s growing faster and wider than the response to contain it.

“We know how to contain Ebola and save lives. The world must urgently step up action to get it under control.”

Trials for a vaccine for the Bundibugyo strain are ongoing, as DRC authorities try to control the Ebola outbreak.

The Democratic Republic of Congo (DRC) has begun vaccinating people against Ebola, with health workers and other front-line workers being prioritised.

However, the vaccine being distributed this week is licensed for another strain, and its effectiveness against the Bundibugyo strain of Ebola has not been determined.

There is currently no approved vaccine or treatment for the new strain, and clinical trials are ongoing to find a suitable vaccine for the Bundibugyo strain.

The first injections are being given to health workers in the Congolese city of Kisangani.

More than 50,000 doses of the vaccine have been received, according to the Congolese health minister, Samuel Roger Kamba.

The outbreak is concentrated in the Ituri province, which borders Uganda.

Kamba said: “We will cover all the provinces that are around Ituri, moving in the ring towards the centre of the outbreak.”

The World Health Organization (WHO) said last week that 70,000 doses of the Ervebo vaccine had been approved for use in the DRC.

About 20,000 of the doses allocated to the DRC will be used in a clinical trial to test its effectiveness against the latest strain. Health workers are calling for more doses.

As of Tuesday, the DRC had recorded 5,713 confirmed cases of Ebola, including 2,744 deaths, according to government figures. The outbreak is the deadliest of all past Ebola outbreaks that have hit the DRC.

The outbreak is spreading under extremely difficult conditions, fuelled by insecurity, displacement, a health workers’ strike and intense population movements.

The WHO has said it remains out of control and is on track to surpass the 2014-2016 West Africa Ebola outbreak, the deadliest on record, which killed more than 11,000 people, primarily in Guinea, Liberia and Sierra Leone.

The international body declared Uganda Ebola-free after 42 days without any new transmission, though cases are rising in DR Congo.

Uganda has been declared free of Ebola, with the World Health Organization (WHO) confirming that the East African country had passed the mandatory 42-day monitoring period without any new cases.

WHO made the announcement at a joint news conference on Tuesday with Uganda’s Ministry of Health.

But the declaration came roughly a month after Uganda had declared that the local outbreak was over, based on its own analysis of the virus’s spread.

“We had assessed the risk, we had assessed the whole chain of transmission and the dynamics of importation of the virus in the country, and we knew that we were free from Ebola,” Diana Atwine, the permanent secretary for Uganda’s Health Ministry, told national broadcaster NTV.

“However, WHO had to wait because that’s the process. That’s the guideline.”

Atwine called on countries that had imposed travel restrictions on Uganda during the outbreak to lift them.

“Unless they have other reasons, they should definitely lift the restrictions off the country, and Ugandans should be free to travel to any country,” she said.

Uganda reported 20 Ebola infections in total, with its last confirmed case recorded on June 21. Two people died from the virus during the outbreak.

The last patient was discharged from Mulago National Referral Isolation Centre on July 16, and the Health Ministry formally declared the outbreak over on July 28.

The outbreak in the Democratic Republic of the Congo (DRC), by contrast, is accelerating.

Confirmed cases in the DRC reached 5,656 as of August 25, an increase of 72 from a report released one day prior. A total of 2,715 deaths have been recorded, according to the latest government data cited by the European Centre for Disease Prevention and Control.

Ituri province, in the northeast of the country, remains the epicentre of the outbreak, with more than 4,700 people infected.

Uganda shares a border with the northeast part of the DRC, stretching more than 877km (500 miles).

Kasonde Mwinga, the WHO’s representative for Uganda, said in Wednesday’s news conference that the country was supporting treatment and laboratory capacity at two sites across the border, in Aru and Kasenyi, both part of the Ituri province.

Mwinga added that the model for cross-border collaboration could be expanded regionally.

Already, Uganda has announced it would open two additional Ebola treatment centres in the DRC, bringing the total to four.

On Monday, Ugandan and Congolese officials also met in Kampala to review a bilateral memorandum of understanding on cross-border health security.

Kenneth Akiiri, the undersecretary for Uganda’s Health Ministry, called for the WHO and the Africa Centres for Disease Control and Prevention (CDC) to mobilise further resources.

“When you are vulnerable and you have littler resources, you are supposed to raise an alarm for help,” Akiiri said in a joint statement.

For his part, DRC delegation head Adelard Lufungula urged strong action to combat the virus. “We want to fight Ebola like a war,” he said.

Case fatality rate climbs to nearly 48 percent in the DRC, meaning almost one in two people infected with Ebola are dying.

The Ebola outbreak in the Democratic Republic of the Congo (DRC) has reached  5,515 confirmed cases of infection and killed 2,642 people, with 51 new cases detected in Ituri and North Kivu provinces, according to the latest government figures.

The update on Sunday came as Pope Leo called for ⁠international action to help contain the epidemic, which is now the deadliest Ebola outbreak in the DRC’s history.

Declared in mid-May, it is the DRC’s 17th Ebola epidemic and was designated a Public Health Emergency of International Concern by the World Health Organization (WHO), its highest alert level, also covering neighbouring Uganda.

The outbreak is now on track to surpass the deadliest Ebola epidemic on record, which was the 2014–2016 outbreak in West Africa that killed more than 11,000 people.

According to government figures, the case fatality rate in the DRC has climbed from about 20 percent in early June to nearly 48 percent now, meaning almost one in two people infected are dying.

Contact tracing, however, has improved sharply, from 30 percent in June to more than 85 percent.

The disease has also proved deadly for those fighting it. About 160 health workers have been infected, and about 45 have died, according to the WHO.

Efforts to contain the outbreak, however, have been hampered by armed conflict in the affected provinces, displacement, attacks on medical personnel and facilities, a mobile working population and a lack of critical infrastructure.

Vaccines arrive in DRC

There is no approved vaccine or treatment for this particular strain of Ebola, known as Bundibugyo, which is rarer than the virus type behind most past outbreaks.

The WHO has pledged 70,000 doses of the Ervebo vaccine, which is licensed for Ebola and has been effective in past outbreaks. According to the global body, early data from animal trials suggest it may offer some protection against Bundibugyo.

Some 16,250 doses of the vaccine arrived in the DRC on Friday.

WHO Director-General Tedros Adhanom Ghebreyesus and other officials said the response in the DRC needs to be scaled up two to threefold to contain the outbreak and reach every affected area.

They also called for more support and protection for front-line health workers, including protective equipment, timely payment, and access to rapid diagnosis and high-quality supportive care if they fall ill.

Abdulsalami Nasidi, a public health consultant who helped establish the Africa Centres for Disease Control and Prevention, told Al Jazeera that the outbreak was “getting out of hand”.

He blamed weak infection control measures and a lack of trust between authorities and affected communities for the continued transmission.

“This is no longer just a national or regional issue; it is a global issue. If it spreads to neighbouring places with lower immunity, it will be a disaster,” Nasidi added.

The WHO currently rates the risk to the global public as low, but warns that the danger inside the DRC remains very high.

Despite the surging cases, Uganda and several health zones in DRC’s Ituri and South Kivu have interrupted transmission, which the WHO said is evidence that rapid detection, decisive leadership, and community cooperation can break the chain of transmission.

At the Vatican on Sunday, Pope Leo offered prayers for the DRC, “in light of the spread of the Ebola epidemic, which is sadly ⁠claiming many lives”.

The pontiff also called for global action to help save lives.

“I urge the international community to ⁠respond in a way that also involves local communities ⁠in prevention efforts to save ⁠as many lives as possible,” he said.

Each time we travel to the Democratic Republic of the Congo (DRC), we first go to listen.

In Bunia, we have met dozens of community representatives: survivors, women, young people, local organisations, health workers and leaders from affected areas. Their message is direct: involve us. We know our communities. We know where families seek care, how information moves and why trust is breaking down. Give us the means to help drive the response. They are right.

Ebola spreads through communities and communities hold the knowledge required to stop it. They can identify illness early, alert health teams, help identify and trace contacts, challenge dangerous rumours and support families through access to treatment and safe, dignified burials. The response always moves faster when communities lead alongside national authorities and health workers.

One hundred days ago, the government of the DRC declared the country’s 17th Ebola outbreak, following confirmation of the Bundibugyo virus. WHO subsequently declared a Public Health Emergency of International Concern, followed by Africa CDC’s declaration of a Public Health Emergency of Continental Security.

The scale of the emergency is immense. As of August 21, the DRC has reported 5,290 confirmed cases and 2,516 deaths across 56 health zones. This is now the second-largest Ebola outbreak ever recorded and it is moving faster than any previous one. It is being fuelled by insecurity caused by decades of armed conflict that have undermined law, order and social services, and displaced more than a million people.

At the centre of the response are the people who show up every day. Health workers care for patients. Laboratory teams identify the virus. Contact tracers follow its path. Community health workers build trust where fear and misinformation have taken hold. Burial teams help families honour their loved ones safely and with dignity.

They are working under extraordinary pressure, often in insecure and hard-to-reach areas. Some have contracted Ebola in the line of duty.

Their service must be met with action: safety, protective equipment, training, sufficient medical supplies, timely payment, psychosocial support and access to rapid diagnosis and high-quality supportive care if they fall ill. The safety of frontline workers is central to stopping transmission.

The response has made progress. Under the leadership of national authorities, Congolese responders, WHO, Africa CDC and partners have expanded surveillance, deployed laboratories, supported treatment centres, reinforced infection prevention and delivered essential supplies.

Neighbouring Uganda has interrupted locally acquired transmission of the virus. Several health zones in northern Ituri and South Kivu provinces in the DRC have also interrupted transmission. These experiences prove that the outbreak can be stopped more quickly when rapid detection, decisive national leadership and close cooperation with communities break the chains of transmission.

But the continued emergency in the rest of Ituri province and five other provinces demands urgently scaled-up action.

To turn the corner, surveillance teams are being expanded and equipped to detect cases early and rapidly identify contacts. Safe clinical care and infection prevention measures are being increased wherever people seek treatment.

More risk communication and community engagement teams are being deployed to reach out to communities to empower them to participate in the response and address barriers to care. More safe and dignified burial teams are working to prevent transmission associated with deaths. Special efforts are being made to reach vulnerable populations and communities in insecure and hard-to-reach areas.

But despite all these efforts, more is needed. We need to scale our response by two to three times current capacities, across all the response pillars.

Health facilities also require urgent protection from infection. As of August 20, 158 health workers have been infected and 45 have died. Every facility in an affected or high-risk area needs trained staff, protective equipment, clean water, sanitation and functioning infection-prevention systems.

National and local teams need predictable funding for surveillance, laboratories, treatment, logistics, infection prevention and community engagement. Frontline workers must be paid on time. Local organisations need direct support to work consistently with communities. Supplies must arrive before stocks run out.

Delayed financing costs lives. Fragmented financing leaves gaps. Ebola exploits both. On the ground, we at WHO and Africa CDC have established tight integration among health and relief organisations working with the government. Donors therefore need to support and enhance that integration, rather than back siloed and disconnected efforts.

Cross-border coordination also must remain strong. People move within and between countries to trade, work, study, seek care and support their families. Borders must serve as bridges for coordinated public health action. This does not require closing borders or imposing blanket travel and trade restrictions. Such measures can disrupt response operations and livelihoods without stopping transmission. The priority is coordinated surveillance, rapid information-sharing and prepared health services along movement routes.

The first 100 days have made the priorities clear.

Find every case. Follow every contact. Break every chain of transmission, protect every health and frontline worker, save lives and ensure that no community is left behind. Bring testing and treatment closer to every affected community. Bolster cross-border coordination. Scale up international support. Turn every pledge into action.

WHO and Africa CDC will continue working with the DRC, neighbouring countries, communities and partners to deliver on these priorities. Our responsibility is to bring the full strength of international and continental cooperation behind the nationally-led response.

Uganda and areas in DRC have shown how the course of the outbreak can be turned, through rapid detection, decisive action and close cooperation with communities. But these measures must be delivered at scale. Success depends on sustained national leadership, continental solidarity and international support. We must rise to this challenge, together.

The views expressed in this article are the authors’ own and do not necessarily reflect Al Jazeera’s editorial stance.

The doses are the first of 70,000 allocated for Kinshasa as experts warn of the virus’s exponential spread.

The Democratic Republic of the Congo (DRC) has received more than 16,000 doses of the Ervebo vaccine as the country faces its deadliest-ever Ebola outbreak.

The 16,250 doses arrived in the capital, Kinshasa, late on Friday evening, comprising the first of 70,000 that the World Health Organization (WHO) and partners pledged to provide on Thursday.

More doses are set to arrive next week.

Although the vaccine is approved against the Zaire strain of the virus, the Bundibugyo strain currently circulating in the country has no approved vaccine or treatment.

Early data from animal trials show it may offer some protection, according to the WHO.

Samuel Roger Kamba, the DRC’s health minister, told reporters Ervebo had been used several times in the past, including “on a very large scale” during the 2018 to 2020 outbreak.

Of the 70,000 doses intended for the DRC, 20,000 will be part of a late-stage clinical trial to test its effect on the Bundibugyo strain, the WHO said. The remainder is allocated to front-line and health workers.

The outbreak has killed more than 2,500 people out of nearly 5,300 confirmed cases, with the United Nations warning this week that infections continue to spread “exponentially”.

Although the outbreak was declared in mid-May, it is believed to have started weeks beforehand. Data from the Africa Centres for Disease Control and Prevention, meanwhile, shows that transmission has not yet peaked and could reach three times its known rate.

Efforts to contain the virus have been stymied by ongoing armed conflict, delays in identifying cases and a lack of infrastructure in eastern DRC, experts say.