The Ebola outbreak affecting both Congo and Uganda has resulted in over 200 deaths within its first month, making it the most severe outbreak recorded at this early stage, according to the Africa Centres for Disease Control and Prevention. As of now, there are 894 confirmed cases, a figure that is reportedly three times higher than that during Uganda’s previous outbreak in 2000, which recorded 281 cases at a similar point in time. Dr Wessam Mankoula, a medical epidemiologist at Africa CDC, indicated that the true number of cases is likely higher, as the outbreak was officially confirmed on May 15, several weeks after its suspected onset.

Since last week, reported cases have increased by 38 per cent. The outbreak has expanded into 32 health zones across eastern Congo, predominantly due to the rare Bundibugyo virus. This strain lacks approved vaccines or treatments and was not initially tested for. In contrast, past Ebola outbreaks in Congo have primarily involved the Zaire virus, for which vaccines do exist.

While 74 individuals have recovered in the affected regions of eastern Congo and Uganda, there is ongoing research into experimental treatments, such as monoclonal antibodies, specifically targeting the Bundibugyo strain. Most cases are centred in Ituri province, accounting for over 90 per cent of reported instances. North Kivu and South Kivu have also seen cases, and 19 confirmed cases along with two fatalities have been recorded in Uganda.

Challenges in Containing the Outbreak

Contact tracing is proving to be a significant hurdle in stopping the outbreak due to the area’s remoteness and ongoing insecurity within Ituri province. According to Dr Mankoula, for the 800 confirmed cases, it is estimated that there should be between 17,000 and 35,000 individuals identified as contacts. However, as of now, only around 4,000 contacts have been tracked and evaluated, representing less than 15 per cent of the necessary contacts.

Dr Mankoula emphasised that significant challenges remain in controlling the situation. The United Nations humanitarian office reports that nearly one million individuals have been displaced due to prolonged conflict in Ituri province, which complicates contact tracing efforts as people are forced to flee from attacks or move frequently. The difficult terrain, with dense forests and poor road infrastructure, further complicates the situation.

Additionally, there are thousands of mobile miners operating within the mineral-rich region, making it increasingly difficult to manage contact tracing effectively. The area’s complexity makes reaching some villages take several days, exacerbating the situation.

Funding and Resource Constraints

Regarding funding for the outbreak response, Dr Mankoula noted that of the more than $900 million committed to combat the outbreak, only $90 million has been disbursed thus far. The Africa CDC has stated that a workforce of 540 personnel is essential for an effective response, yet only 84 individuals are currently deployed. This discrepancy raises concerns about the capacity to manage the outbreak adequately.

Dr Mankoula expressed hope that the remaining pledges would be fast-tracked and emphasised the importance of following up with various member states and partners to convert those commitments into actual financial support for the affected countries. Delayed detection and development of response measures, along with weak contact tracing efforts, insecurity, displacement, and insufficient funding and personnel, are all hindering the overall containment of the outbreak.

As the situation evolves, health authorities continue to adapt their strategies to combat the widespread impact of the outbreak across eastern Congo and into Uganda, aiming for effective containment and support for affected communities.

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