The Ebola outbreak in the Democratic Republic of the Congo may have begun as early as January, World Health Organization director-general Dr Tedros Adhanom Ghebreyesus said, giving the virus what he described as a ‘‘big head start.’’ He warned that the response is still catching up and highlighted several obstacles hampering control efforts.
Since identification in mid-May, the Bundibugyo strain has been linked to 344 confirmed Ebola cases and 60 deaths in the DRC, and to 15 confirmed cases with one death in neighbouring Uganda. Treatment centres have now been set up across Ituri province, the area worst affected by the outbreak.
Tedros urged countries that imposed blanket travel restrictions, including the US, to lift them, saying such measures are disrupting supply chains and hindering the response. He also pointed to high levels of community mistrust and weak contact tracing as major concerns.
Only about 45% of identified contacts are currently being followed up, he said, a figure he urged to be raised to above 90% to get ahead of transmission. Contact tracing in Ituri is being made particularly difficult by insecurity and population displacement.
Officials reported a sudden fall in the number of suspected cases in the DRC, from more than 1,000 to 116, after teams worked through a backlog of tests to confirm or rule out infections. Tedros said scaling up laboratory and diagnostic capacity in the most affected areas and neighbouring provinces and countries remains a key priority.
The first identified case in the outbreak was a nurse who sought care at a health centre on 24 April, but Tedros said earlier transmission remains possible, with January through April all plausible start dates. He stressed that the immediate focus should be on strengthening the response.
Mistrust is a serious barrier: Tedros reported that some community leaders told him they did not believe Ebola was real and feared response activities would divert resources from other essential services. There is currently no licensed vaccine or specific treatment for the Bundibugyo strain, but recoveries reported so far — six in the DRC and two in Uganda — show that patients can survive when they receive prompt care at health facilities.
The UK Foreign, Commonwealth and Development Office has announced a new multi-hazard research network to provide rapid expert advice and evidence on emerging infectious diseases and other crises, including the ongoing Ebola outbreak.
