The grim threshold has been crossed. According to Congolese Health Ministry data released on Saturday 31 October, the Ebola outbreak has claimed 5,026 lives in the Democratic Republic of the Congo, out of a total of 10,351 infections. Compiled up to 29 October by the National Institute of Public Health, these figures point to a case fatality rate of 48.6%. A further 2,788 people have recovered, while 1,101 remain in hospital or in isolation.
The acceleration is clear. In early October, the toll still stood at 4,018 deaths and 8,300 cases across seven provinces. Eight of the country’s 26 provinces are now affected, covering 67 of its 178 health zones, 50 of which have active cases. Ituri, in the north-east, remains the epicentre: as of 28 October, the WHO counted more than 7,300 cases and more than 3,400 deaths there. This is the DRC’s 17th Ebola outbreak, the deadliest the country has ever known and the second worst in the world after the one that killed around 11,000 people in West Africa between 2014 and 2016. The real toll could be even higher, as experts believe the virus was circulating undetected since at least February, well before the official declaration on 15 May.
The strain involved makes the response far harder. Unlike the Zaire strain, Bundibugyo has no approved vaccine or treatment, and health workers can only treat symptoms. Contact tracing is also falling short. According to Africa CDC, around 80% of new cases come from unmonitored chains of transmission. Patrick Otim, a programme manager at the WHO, points out that a third of deaths have occurred outside treatment centres, before any testing.
On the ground, teams are stretched to breaking point. Two young Congolese doctors died of the virus this week in North Kivu and Ituri, prompting Africa CDC to call for better protection for health workers. On Friday, staff at the Tchomia treatment centre in Ituri downed tools to demand four months of unpaid wages. In Beni, a local elected official blamed the surge in cases on a lack of fuel and funding from Kinshasa. In these eastern provinces, insecurity linked to armed groups is also hampering the deployment of health teams.
The threat now extends beyond Congo’s borders. After Uganda, Kenya confirmed eight cases in October, two of them fatal, according to the Associated Press. Nigeria recorded its first case last week in Abuja, a woman who had arrived from Uganda and has since been evacuated to Switzerland. It is the first time an Ebola outbreak has reached Central, East and West Africa at once. Travel restrictions are multiplying: Saudi Arabia, which suspended travel to and from the DRC, Uganda and South Sudan in June, is now also barring travellers coming from Kenya.