Health workers race to contain Congo's fast-spreading Ebola outbreak

Medical personnel were rushing on Monday to the frontlines of a new Ebola outbreak in eastern Democratic Republic of ​Congo (DRC), whose late detection and quick spread have alarmed health experts.

The World Health Organisation (WHO) on Sunday declared the outbreak a public health emergency of international concern because ‌of the high risk the disease could spread further beyond DRC's borders after two cases were confirmed in Kampala, the capital of neighbouring Uganda.

There have been 105 suspected Ebola deaths and 393 suspected Ebola cases across nine health zones in Ituri province, with eight cases confirmed by laboratory testing, the Congo Health Cluster said on Monday.

Another case was confirmed in neighbouring North Kivu province's capital, Goma, according to the M23 rebels who control the ​city. The US Centres for Disease Control and Prevention (CDC) also said on Sunday that it was supporting partners in withdrawing a small number of directly affected Americans.

A delegation led by ​DRC Health Minister Samuel Roger Kamba arrived in Ituri's capital, Bunia, on Sunday with tents to set up treatment centres to support strained local ⁠hospitals.

"This is not a mystical disease," he told Reuters. "Make yourself known so that you can be taken care of and so that we can prevent the disease from spreading."

WHO's representative in ​DRC, Anne Ancia, said WHO had emptied its stocks of protective equipment in the capital, Kinshasa, and was now preparing a cargo plane to bring additional supplies from a depot in Kenya.

The ​European Centre for Disease Prevention and Control said on Monday it was deploying an expert to its African counterpart's headquarters in Ethiopia to support operational planning, and the US CDC said it planned to send more people to its offices in the DRC and Uganda.

On Monday, the US embassy in Uganda said it had temporarily paused all visa services in Uganda in light of the Ebola virus outbreak in the East African ​nation, effectively restricting travel. And a Reuters witness said Congolese people trying to cross into Rwanda from Bukavu were stopped by authorities at the border.

A map of Ituri Province and Goma in the Democratic Republic of the Congo.

Previous outbreak response was complicated by insecurity

The ​current outbreak is caused by the Bundibugyo virus, which, unlike the more common Zaire strain of Ebola, has no approved virus-specific therapeutics or vaccine.

An outbreak of the Zaire strain from 2018-2020 in North Kivu and ‌Ituri provinces was ⁠the second deadliest on record, killing nearly 2,300 people. The response to that outbreak was complicated by widespread armed violence in eastern Congo that continues today.

Jean Pierre Badombo, the former mayor of Mongbwalu, a mining town in Ituri at the epicentre of the outbreak, said people started falling ill in April after a large open-casket funeral procession arrived from Bunia.

"After that, we experienced a cascade of deaths," he said.

The WHO has said it was informed of an unknown illness with high mortality in Mongbwalu on May 5, including four health workers who had died within four days, ​and dispatched a rapid response team.

Several subsequent ​missteps, including an initial failure by personnel ⁠in Bunia to escalate samples for further testing after they came back negative for the Zaire strain, meant the virus was not detected until May 14, Congolese health officials told Reuters. An outbreak was declared the next day.

Lievin Bangali, IRC's senior health coordinator in DRC, said declining funding ​from international donors had also weakened disease detection.

"When surveillance networks break down, dangerous diseases like Ebola are able to spread further and faster ​before communities and health ⁠workers can respond," he said.

Uganda postpones Martyrs' Day holiday

Congo has experienced 17 outbreaks of Ebola since the virus was first identified in the country in 1976. The disease spreads through direct contact with the bodily fluids of infected persons or contaminated materials.

According to WHO, the average fatality rate from Ebola is around 50%, varying from 25% to 90% in past outbreaks.

Uganda on Sunday postponed next month's celebrations of ⁠Martyrs' Day, a ​national holiday that typically attracts thousands of pilgrims from eastern DRC, because of the outbreak.

Kithula Haggai Sunday, a ​doctor at Uganda's health ministry, told an online briefing that several people from western Uganda who had recently gone to a burial in eastern Congo and then returned home were under observation, with some who developed symptoms taken to the ​city of Fort Portal.