A Congolese health worker in full personal protective equipment carries a child who has been cleared of Ebola at an orphanage in Hoho commune, Bunia, Ituri province, DRC. This image captures the heartbreaking reality of an outbreak that is rapidly escalating.
One Month On: Will the Latest Outbreak Become the Deadliest Yet?
With more than 670 confirmed cases and over 135 deaths, the disease remains uncontained amid funding shortfalls, fear, and disinformation. When an orphanage in Bunia took in a newborn baby after his mother died from Ebola, the nuns hoped to give the infant a chance at life. The baby survived only two more weeks. Now, four of the nuns who cared for him have fallen sick with the deadly virus.
This snapshot highlights the tragedies at the center of an outbreak where the number of victims roughly doubles every week, according to the World Health Organization (WHO).
“It’s really, really devastating,” says Dr. Babou Rukengeza, Save the Children’s Ebola response lead in the Democratic Republic of the Congo (DRC). All children and staff at the orphanage are now being monitored for symptoms.
One month after the latest Ebola outbreak, caused by the Bundibugyo virus, was first identified in the DRC, UN figures show 676 confirmed cases and 136 deaths, the overwhelming majority in Ituri province.
Frontline Challenges
Frontline workers report ongoing shortages of essential supplies, including personal protective equipment and vehicles to transport dead bodies. Testing has improved but needs to be faster and closer to patients. In neighboring Uganda, which has reported 19 cases and two deaths, intensive contact tracing has brought the outbreak under control, according to health officials.
Despite the global risk remaining low, 22 countries, including the US, have imposed travel restrictions on people from the DRC, Uganda, or South Sudan, according to Africa CDC, the African Union’s health agency. These restrictions have been criticized for impeding the health response. Experts say the DRC urgently needs flexible funding from the international community to gain control.
Reasons for Hope
Scientists are rapidly working to test and produce vaccines against Bundibugyo, and recent research suggests existing antivirals may be effective. In Ituri, response organizations meet daily to coordinate plans, and African leaders will meet virtually on Tuesday to discuss the outbreak and make funding commitments.
Obstacles to Containment
Strong headwinds slow the response: conflict persists in the worst-hit areas, misinformation is rampant, leading people to avoid hospitals, and there have been attacks on aid workers and treatment centers. Gratien Iracan, the local MP for Bunia, noted on social media: “Despite the millions of dollars announced by the international community to support the Ebola response, these resources are not yet sufficiently visible on the ground in Ituri.” He highlighted a doctor’s death from Ebola, with messages complaining of poor care, and an incident where a community reported a suspected case but promised support never arrived, sparking “incomprehension, anger and concern.”
According to Africa CDC, community trust is “a critical challenge.” CNN video from Bunia’s central market shows people denying the virus exists and blaming Red Cross workers for spreading it. The health watchdog cited “reports of resistance to hygiene measures and decontamination in some communities, as well as incidents of mob violence.”
A key reason is people’s reluctance to let sick relatives be cared for by strangers in isolation units, and the importance of funeral rites. For some, fear of displeasing God over improper burial outweighs fear of the virus. A study after the 2016 outbreak found that exposure to body fluids during each “unsafe” funeral created an average of 2.58 secondary cases.
Informing people about symptoms and risks through mass media and face-to-face contact is crucial, says Rukengeza. “We are working with community leaders, religious leaders, and others to let them know this is really Ebola virus, and they have to pay attention.”
Alarming Statistics
With about 600 confirmed cases in one area, health experts would expect about 24,000 contacts to monitor. On Thursday, Dr. Jean Kaseya, director general of Africa CDC, said there are 4,955 listed, with 57% being monitored. “It means there is a huge risk of sustained transmission in the community. We still have some confirmed cases not admitted to hospital. They are somewhere in the community.”
A joint response plan by Africa CDC and WHO estimates $518 million needed over six months. Kaseya says early pledges “were not real,” but about $212 million, including in-kind support, is “almost there.”
Many infected are healthcare workers. Ebola spreads via body fluids, and caregivers are most exposed. Dr. Salim Abdool Karim, an epidemiologist chairing the Africa CDC emergency consultative group, visited a treatment center in Bunia: “There were 22 patients, five of whom were healthcare workers, two doctors and an anaesthetist.”
Even before Ebola, Ituri faced a humanitarian crisis with tens of thousands displaced by years of conflict. WHO has registered over 520 security incidents affecting their teams. The outbreak is now the third largest on record. Modeling by the US CDC suggests it could match the 2014-16 west Africa outbreak that killed over 11,000 people. “We hope we can stop that,” says Kaseya, “and it won’t move from third to second, even first.”
