outbreak

Health workers struggle as new Ebola cases are found in border regions of South Ubangi and Haut-Uele.

The Ebola virus caused by the Bundibugyo strain has spread to two new health zones in the Democratic Republic of the Congo, according to the World Health Organization (WHO).

New cases were found in Bulu in South Ubangi governorate on the border with the Central African Republic and Dungu in Haut-Uele province on the border with South Sudan, the WHO said on Friday.

The additional cases bring the number of health zones affected to 63 across seven provinces as authorities struggle to control the outbreak.

As of September 23, the Democratic Republic of the Congo, or DRC, has reported 7,890 confirmed cases and 3,799 deaths, according to the WHO. That means that almost half the people who contracted the infection have died.

WHO Director-General Tedros Adhanom Ghebreyesus said conflict and population displacement were making it more difficult for health workers to reach ‌‌affected communities and trace people who may have been exposed to the virus.

“It’s very difficult to see Ebola in isolation because even our response to Ebola is affected by the conflict, because there is displacement and there is an access problem to some areas,” Tedros said.

The Bundibugyo strain is difficult to treat because there are no approved vaccines, Tedros said, adding that the WHO is accelerating clinical trials of vaccines and treatments.

Contact tracing falling short

Meanwhile, health workers looking for people who may have been exposed to the Bundibugyo strain are falling short of their targets.

According to Dr Jean Kaseya, the director-general of the Africa Centres for Disease Control and Prevention (Africa CDC), the more than 7,000 confirmed cases should translate to about 420,000 contacts.

“But currently, we have just 30,000 people in the contact list,” Kaseya said.

“When the outbreak is at community level, we cannot talk about control,” he added.

Ituri province in northeastern DRC continues to be the epicentre of the outbreak, accounting for 6,032 confirmed cases since the start of the epidemic in May, including 868 new confirmed cases reported in the last 21 days.

North Kivu is the second most affected province, with 1,480 new cases, including 567 reported in the last 21 days. The province now accounts for around a third of newly confirmed cases and deaths, the WHO said in a report on Sunday.

Nearly 60 percent of people diagnosed in North Kivu died, significantly higher than the national average of 48 percent, the data show.

Medical staff say patients are avoiding health facilities until it is too late.

“Patients think that if they arrive at the hospital, they will be immediately sent to the treatment centre to die,” said Dr Michel Paluku Mukuloli, who works at a hospital in North Kivu’s Butembo.

That complicates efforts to identify cases and start treatment before the disease reaches its most dangerous stages.

North Kivu was the epicentre of three previous Ebola outbreaks, including one in 2018-2020, which until this year was the DRC’s largest and deadliest. Those outbreaks, however, were caused by a different type of Ebola virus, known as the Zaire strain.

Much less is known about the Bundibugyo strain. But responders say in the early stages of infection, patients often experience milder symptoms easily mistaken for more common diseases such as malaria and typhoid fever.

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.