Congo Ebola Deaths Pass 5,000 as Africa CDC Chief Says Continent Is 'Not Winning'

Since Congo declared its Bundibugyo Ebola outbreak on May 15, the numbers have kept climbing. Government data now shows more than 10,300 confirmed cases and more than 5,000 deaths, with eight of the country's 26 provinces affected. The current case fatality rate is 48.6%.

That puts this outbreak well past Congo's previous worst. The 2018-2020 outbreak killed 2,299 people, according to the United Nations. Only the West Africa epidemic of 2014-2016, with more than 11,325 deaths according to the World Health Organization, was deadlier. The UN says the current outbreak is "taking lives at a much faster rate."

The latest numbers

The WHO's tally as of Oct. 26 was 10,172 confirmed cases and 4,932 deaths across five countries: Congo, Uganda, France, Kenya and Nigeria. Congo accounted for 10,141 of those cases and 4,928 of the deaths.

Congo's Ministry of Public Health reported 96 new confirmed cases and 46 deaths in the 24 hours before its Oct. 26 update. New cases came from North Kivu, Ituri and Tshopo provinces.

Ituri, a conflict zone in the northeast, accounts for 71.7% of confirmed cases, the ministry said. Dieudonne Mwamba Kazadi, director general of the National Institute of Public Health, said about five health zones hold more than 80% of all cases: Mambasa, Beni, Katwa, Bunia and Rwampara. Response teams are being concentrated there.

Kazadi also said more than 2,500 people have recovered and that contact tracing follow-up is running at about 87%. A mid-term review of the response was scheduled to take place in Tshopo Province this week.

"We are not winning"

Dr. Jean Kaseya, director-general of the Africa Centres for Disease Control and Prevention, put it bluntly to more than 40 African health ministers at an extraordinary meeting this week. "We are not winning so far. 10,172 confirmed cases. 4,932 people are gone," he said.

In an interview with CBC News from Addis Ababa on Friday, Kaseya warned there could be "massive" cross-border spread, possibly to other continents. "No one is safe today," he said. He asked Western countries, Canada in particular, for more support.

Kaseya also pointed to what an uncontrolled outbreak costs. In West Africa, he said, about five million children were kept out of school, about 23,000 children lost their parents, and nearly $3 billion in GDP was lost.

Borders: open or restricted

The ministers agreed to prepare every country for possible cases, coordinate across borders, and keep borders open while strengthening surveillance, Kaseya said.

Not every country is taking that approach. Uganda, which recorded 20 confirmed cases and two deaths shortly after the outbreak began and has reported no new cases since August, still keeps travel restrictions on people arriving from Congo. It has also imposed a quarantine on those who visited Congo.

Spread beyond Congo

Kenya has nine confirmed cases and two deaths. The U.S. CDC says the first, reported Oct. 6, was a man who traveled from Congo through Uganda to Nairobi and died in an isolation unit. The rest were relatives and health workers in close contact, all already in quarantine when diagnosed. Kenya's Ministry of Health has reported no community transmission.

Nigeria confirmed its first case on Oct. 20, a traveler with a history of travel to Uganda. The patient was evacuated to Switzerland. Nigeria's disease control centre said 54 contacts were under follow-up as of Oct. 26.

Nigeria's Ministry of Health said in an Oct. 23 update that genetic analysis showed the virus was related to one identified in Kenya. It said further investigation was needed to determine whether the two cases are directly linked. France has recorded one imported case with no deaths.

Violence against responders

The outbreak is also killing the people trying to stop it. In recent days, a nurse was killed and a teacher serving as a community health worker was seriously injured in Bafwasende, in Tshopo Province, when a mob attacked them. Local residents accused the pair of spreading the virus through water sources and toilets, according to local officials and UN-backed Radio Okapi.

A local health official said doctors and nurses in Bafwasende are now sheltering at the hospital under police guard. Another community worker in the area escaped a separate mob days earlier, though his house was burned.

In late September, politician Marie-Celestin Karondwa was beaten to death after promoting Ebola prevention measures on the radio. In August, the Red Cross said its volunteers had been injured and an ambulance burned in 11 violent incidents during the outbreak's first 100 days.

WHO Director-General Tedros Adhanom Ghebreyesus said, "Everyone working to protect communities from this deadly disease must be able to work in dignity and safety." UN Ebola coordinator Julien Harneis called the nurse's killing "a loss to the Ebola response and an even greater loss to patients."

No approved vaccine or treatment

Bundibugyo is a different species from the Ebola strain behind earlier outbreaks, and no approved treatment or vaccine exists for it. Testing and treatment are under way, along with clinical trials of vaccines, the WHO's Africa office said. It says the response needs "continued scale-up of key control measures, greater access to affected areas, and community outreach."

Scientists suspect the virus spread undetected for months in some of Congo's most remote regions before the May declaration.

Two questions remain open: whether the concentrated push in the five Ituri and North Kivu health zones can slow case growth, and whether Nigeria's investigation links its case to Kenya's. Results from the Tshopo mid-term review are expected to shape the next phase of the response.