The Democratic Republic of the Congo’s Ebola outbreak has become the fastest-spreading on record, with the death toll surpassing 2,000 as the rare Bundibugyo strain outpaces the response. Here are eight notes:
1. The toll. As of Aug. 11, the outbreak had reached 4,381 confirmed cases and 2,011 deaths, with deaths doubling from about 1,000 to more than 2,000 in less than three weeks. Congo’s National Institute of Public Health put the crude case-fatality ratio at 45.5%, Bloomberg reported Aug. 10.
By cumulative cases at 12 weeks, the outbreak has outpaced both the 2018-2020 Congo epidemic and the 2014-2016 West Africa epidemic — the fastest growth on record, according to CBS News.
2. Largest in Congo, second-largest ever. It is the largest Ebola outbreak Congo has recorded (its 17th) and the second-largest in history, behind only the 2014-16 West Africa epidemic, which infected more than 28,000 people and killed more than 11,000.
3. Origins and reach. The World Health Organization declared the outbreak May 15 in Bunia, in eastern Congo’s Ituri province, though officials believe it began in February. Early cases were misattributed to malaria and typhoid. It has since spread across five provinces and into neighboring Uganda.
4. Children are dying at the highest rates. As of Aug. 2, 743 children had been confirmed infected and 330 had died, according to Bloomberg. This represents nearly one-third of all Ebola deaths, though children account for about one-fourth of confirmed cases.
More than 60% of infected children younger than 5 have died, compared with fewer than 30% of adults, according to UNICEF. The Africa Centres for Disease Control and Prevention is deploying pediatricians to treatment centers after finding unusually rapid progression from symptom onset to death in young children.
5. A new variant and a repurposed drug. Researchers at Dalhousie University in Halifax, Nova Scotia, working with teams in Uganda and Congo, identified the virus driving the outbreak as a genetically distinct variant of Bundibugyo ebolavirus, according to a study published in The Lancet.
A second study, published in the Journal of Infection, used computer modeling to show that remdesivir triphosphate — the active form of the antiviral used during COVID-19 — targets a viral replication site unchanged in the new variant. The drug is now in a clinical trial in Africa. No vaccine or therapy is approved specifically for Bundibugyo.
“There are currently no good diagnostic tools available to catch cases in the early stages,” David Kelvin, PhD, who directs Dalhousie’s Laboratory of Emerging Infectious Diseases, told Medical Xpress on Aug. 10.
6. Why it is outpacing responders. Local conflict, poor road infrastructure and health worker strikes over unpaid wages have hampered containment. More than 70% of new infections are being detected in people who were not already monitored as contacts, and only 68.8% of suspected-case alerts were investigated as of Aug. 7, according to Bloomberg.
7. The surveillance overhaul. Bloomberg reported that Africa CDC is shifting from conventional contact tracing to door-to-door case finding and has warned that daily case counts will climb as hidden infections surface. Roughly 17,000 contacts are listed, against an expected 160,000 to 200,000.
The agency aims to mobilize 25,000 to 30,000 community health workers — about 2,000 are deployed, with 4,000 more planned — and is extending Starlink connectivity to villages to accelerate reporting.
The WHO plans to add 400 Ebola beds and decentralize care away from Bunia, the agency said Aug. 10.
8. A suspected case reaches Israel. A man who recently returned from Congo was hospitalized in isolation at Soroka Medical Center in Beersheba, Israel, on suspicion of having contracted Ebola, the country’s Health Ministry said Aug. 11, with test results expected within 24 hours.
The ministry, which had prepared its health systems for the outbreak to reach Israel, urged the public to avoid nonessential travel to Congo and Uganda.
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