Congo's Ebola outbreak reaches an eighth province as recorded deaths top 4,500
Congo's Ebola outbreak has spread to an eighth province, Nord-Ubangi in the country's north. The National Institute for Biomedical Research confirmed two infections there, including one death. Both patients were men in their 20s living in the Wapinda health zone, which borders Bas-Uele province, where cases had already been recorded, according to the Health Ministry. Nord-Ubangi sits between Sud-Ubangi and Bas-Uele, along the border with the Central African Republic. Reuters first reported the two cases on 15 October, citing two health officials, before authorities confirmed them on Sunday.
Congo's latest situation report logged 67 new confirmed cases and 26 new deaths in the 24 hours to 16 October, bringing the cumulative total to 9,415 cases and 4,536 deaths since the outbreak began. Xinhua, citing the same ministry report, put the case fatality rate at 48.2 percent and noted that the report did not say how the two men were infected. Nord-Ubangi joins Ituri, North Kivu, South Kivu, Haut-Uele, Bas-Uele, Tshopo and Sud-Ubangi. The Associated Press, using a slightly broader count, reported at least 9,400 cases and more than 4,500 deaths, making this the deadliest outbreak in the country's history.
Ituri province in the east still accounts for almost three quarters of confirmed cases, and 66 health zones have been affected nationwide, according to government data cited by the Associated Press. Ituri supplied 44 of the 67 new cases reported in the 24 hours to 16 October. The World Health Organization's 6 October update noted that 264 of the previous 372 deaths occurred in the community rather than in treatment centres — a sign that patients are still being identified and brought to care too late. North Kivu has the highest fatality rate of any affected province.
Nord-Ubangi borders the Central African Republic, where recurring armed violence has forced thousands to flee into Congolese border communities, and poor roads and limited communications make contact tracing harder. The European Centre for Disease Prevention and Control said testing in the province was triggered by a series of suspected deaths in a mining area of the Wapinda health zone. An earlier cross-country jump followed a similar route: the imported case in Sud-Ubangi involved a patient who left South Kivu, transited Rwanda and Uganda, and re-entered Congo through Ituri, Kisangani and Lisala.
The outbreak is caused by Bundibugyo virus, for which no vaccine or specific treatment is licensed. WHO experts say the first clinical trial of an Ebola vaccine is expected to begin in Congo by the end of October. Medecins Sans Frontieres launched a study of about 20,000 frontline health workers in Ituri and North Kivu on 19 September, running nine to 12 months. The vaccine used, Ervebo, is the only one licensed for use in Bundibugyo outbreaks; Congo received 70,000 doses from the global stockpile for a Phase 3 trial.
The spread is no longer confined to Congo. Kenya's confirmed total has risen to seven, including three health workers infected while caring for the country's first patient — a 40-year-old Kenyan man who died in Nairobi on 5 October. About 130 contacts were identified. Uganda recorded 20 cases and two deaths between May and July and declared its outbreak over on 28 July, while the Netherlands evacuated an infected health worker on 1 October.
In Bunia, health workers protesting unpaid wages carried placards reading "No money, no data!", and front-line staff have gone on strike several times since the outbreak began; a patient transit camp was burned down. Africa CDC says donor commitments have reached $2.9 billion, with Prime Minister Judith Suminwa Tuluka pressing for rapid disbursement.
Africa CDC Director-General Jean Kaseya said in Kinshasa on 14 October that cases had declined over the previous two weeks, but that the epidemic's centres were shifting from Ituri to Beni and Butembo in North Kivu. With eight of Congo's 26 provinces now affected, the response hinges on surveillance in border provinces, community cooperation, and whether vaccine trials and promised money arrive on schedule.