Congo Ebola outbreak passes 2,000 deaths as WHO says response is “playing catch-up”

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An Ebola outbreak in the eastern Democratic Republic of the Congo has passed 2,000 deaths and is expanding faster than any previous outbreak, the World Health Organization warned in a briefing on August 12.

Director-General Tedros Adhanom Ghebreyesus told reporters that 4,449 confirmed cases and 2,061 deaths have been reported across five provinces and 53 health zones. About 90 percent of cases and 80 percent of deaths are concentrated in Ituri province in the country's northeast.

"At its current pace, it is on track to eclipse the West African Ebola outbreak of 2014 to 2016," Tedros said. That epidemic killed more than 11,000 people across Guinea, Sierra Leone and Liberia and remains the deadliest in recorded history.

Tedros said the outbreak "had a big head start" and that responders are still "playing catch-up," with sustained transmission reported in the towns of Bunia, Rwampara, Nizi and Lita.

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A rare strain with no approved vaccine

The virus behind the outbreak is Bundibugyo, a rare species of Ebola for which no vaccines or treatments have been approved. That is a critical difference from earlier outbreaks in Congo and West Africa, which were caused by the more common Zaire species.

Two experimental vaccines built specifically against Bundibugyo have now entered Phase 1 safety trials in humans for the first time, Tedros said. A WHO-sponsored treatment trial called PARTNERS has reached the milestone of 100 patients enrolled.

The WHO is also pushing to launch a Phase 3 efficacy trial of Merck's Ervebo, a vaccine approved in 2019 against the Zaire strain. Animal studies suggest it may offer some cross-protection against Bundibugyo, but this has not been shown in people.

"WHO has recommended inclusion of the vaccine in a Phase 3 trial, which we hope to start as soon as possible," Tedros said. According to STAT News reporting, the WHO is preparing to submit the trial protocol to DRC regulators and ethics officials for approval; if approved, contacts of confirmed cases would be randomized to receive Ervebo or a placebo.

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Why the response is falling behind

Ebola thrives when health systems fracture, and eastern Congo has several fractures at once. A joint mission by WHO and Africa CDC in early August described insecurity, poor road access, misinformation and severe pressure on services, plus armed conflict in eastern DRC.

Contact tracing stood at about 80 percent as of the August 12 briefing, still well below the 95 percent target, and treatment-centre occupancy in North Kivu was reported at 139 percent at the start of the month. A total of 886 patients have recovered, Tedros said, even without specific vaccines or drugs.

Ituri borders Uganda and lies close to South Sudan. Uganda contained a smaller cross-border outbreak of 20 confirmed cases and two deaths, which the WHO declared over on July 28. Neighboring countries have been urged to keep surveillance and laboratory capacity ready.

What the risk looks like in the US

For Americans, the immediate risk remains low. The US Centers for Disease Control and Prevention says no cases linked to this outbreak have been reported in the United States and the overall likelihood of spread to the country is very low.

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The agency has issued a Level 3 notice urging travelers to reconsider nonessential trips to Ituri, North Kivu, Haut-Uélé and Tshopo provinces, and a Level 2 notice for the rest of the DRC. Travelers who have been in the DRC within 21 days of a US-bound flight are subject to entry restrictions.

Ebola spreads through direct contact with the bodily fluids of a sick or deceased person, not through casual contact, and standard airport screening plus contact tracing have contained past imported cases. Anyone returning from the region who develops fever, unexplained bleeding or severe fatigue within three weeks should contact a doctor before visiting a clinic.

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This article is made and published by Jesper Bengtson, who may have used AI in the preparation.

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