DR Congo Ebola Deaths Near 5,000 as Three Doctors Die in Beni

Since the Bundibugyo Ebola outbreak was declared in the Democratic Republic of the Congo on May 15, the toll has climbed to the edge of a threshold that only one outbreak in history has exceeded. The country's National Institute of Public Health (INSP) situation report, released Friday, put the count at 10,274 confirmed cases and 4,992 deaths as of Oct. 28, a case fatality rate of 48.6%.

That is 8 deaths short of 5,000 on the INSP's Oct. 28 cutoff. Deaths were running at 46 over the previous 24 hours in the ministry's Oct. 26 update, so a crossing within a day or two is consistent with the numbers. Reuters and Al Jazeera, citing government data released Friday, reported that the toll has surpassed 5,000; the INSP figure through Oct. 28 stands at 4,992.

Only the 2014-2016 West African epidemic was larger. That one infected more than 28,600 people and killed more than 11,000 across Guinea, Liberia and Sierra Leone.

A spread the response has not caught

The World Health Organization says 50 to 80 new cases are still recorded each day across eight affected provinces. WHO officials also say 80% of cases are coming from outside known transmission chains. That means most new patients were not on anyone's contact list.

The outbreak covers 67 health zones. Ituri is the hardest hit, accounting for 71.7% of confirmed cases, the health ministry said. INSP director general Dieudonne Mwamba Kazadi said response teams are concentrating on about five health zones that account for more than 80% of cases: Mambasa, Beni, Katwa, Bunia and Rwampara. He said the contact tracing follow-up rate was about 87% and that more than 2,500 people have recovered.

North Kivu looks worse on the monitoring numbers. The INSP report shows only 82.2% of identified contacts there are being monitored, against a 95% target. Treatment facilities in the province are running at 86.3% capacity. Reuters reported that many deaths are occurring outside treatment centers.

There are no approved treatments or vaccines for the Bundibugyo strain. Delayed detection, conflict in the east and strained health services have let it spread faster than in earlier outbreaks, according to Reuters.

Doctors dying in Beni

Africa CDC paid tribute on X to Dr. Marie-France Shogogo, who died of Ebola in Beni. "Protect those who protect us," the agency said. Local health sources said three doctors died of Ebola within less than 72 hours at an Ebola treatment center in Beni.

The Beni health zone has recorded 661 cases and 443 deaths, a fatality rate of 67.0%. North Kivu as a whole has 2,391 confirmed cases and 1,341 deaths.

Nigeria and Kenya

Nigeria became the fourth African country to report an Ebola case last week, extending the outbreak to West Africa. Kenya and Uganda have also reported cases. Kenya has confirmed nine cases and two deaths, according to CIDRAP. Nigeria has identified one patient and no more since.

Genomic results released this week place both the Nigerian and Kenyan cases in the same genetic group as the DRC outbreak. Neither sample carries markers of the Ugandan cases reported in May and June, which eliminates the suggestion of underreported spread in Uganda, according to CIDRAP's account of the testing. How the Nigerian patient was infected is still not understood. The patient visited Uganda from Sept. 15 to Oct. 3.

Kenya's first patient traveled from the DRC through Uganda between Oct. 1 and Oct. 3 and later died in an isolation unit in Nairobi. Both index patients were at Entebbe airport on Oct. 3. The U.S. Centers for Disease Control and Prevention said the man did not contract the virus in Kenya. The remaining Kenyan cases are relatives and health workers who had close contact with him, and all were already in quarantine when diagnosed. Kenya's Ministry of Health has reported no community transmission. Nigeria's Ministry of Health said genetic analysis showed its case was related to the virus identified in Kenya, but that further investigation is needed to determine whether the two cases are directly linked.

Borders and travel

Saudi Arabia on Friday suspended travel to and entry from Kenya, according to the Saudi Press Agency. The measures include suspending travel by Saudi citizens to Kenya, a pause on issuing all types of visas to travelers from the country, and a ban on entry for travelers arriving from Kenya, including those transiting through third countries who stayed in Kenya or other Ebola-affected countries within the previous 21 days. In June, the kingdom suspended travel to and entry from the DRC, Uganda and South Sudan.

The CDC says Americans face low risk, but it announced a rule requiring all passengers boarding an international flight to the United States to attest in a signed statement that they have not been in the DRC during the previous 21 days. The attestation begins Nov. 3 and lasts through Dec. 18. Travelers, including U.S. citizens and U.S. nationals, who have been in the DRC within 21 days before their flight will not be allowed to board flights with U.S. destinations, including passengers transiting through the DRC on a connecting flight. About 500 people at the CDC are involved in the response, including more than 120 deployed to affected countries.

Africa CDC Director-General Jean Kaseya warned that the outbreak could spread to the United Kingdom and other European countries. "It is the first time three African regions have been affected," he said. "The geographic extension of this outbreak is unprecedented."

Kazadi said a mid-term review of the response would take place in Tshopo Province to assess progress and guide the next phase. The share of new cases outside known transmission chains, now 80% by WHO's count, is the number to watch.