The deadliest Ebola outbreak since west Africa’s 2014 epidemic, which claimed over 11,000 lives, continues to worsen in northeastern Democratic Republic of Congo.
The spread of the viral disease was first confirmed in August 2018. Earlier this month, the country’s health ministry reported a total of 1,600 suspected Ebola cases, of which 1,534 were confirmed and 66 were likely, according to Voice of America.
So far, more than 1,000 people have died from the disease, a large percentage of whom were women and children, the Guardian reported. The fatality rate is 67%, which is greater than outbreaks in the past.
“Whether it gets to the absolute scale of west Africa or not, none of us know, but this is massive in comparison with any other outbreak in the history of Ebola and it is still expanding,” Jeremy Farrar, the head of the Wellcome Trust, told the Guardian. “It’s remarkable it hasn’t spread more geographically but the numbers are frightening and the fact that they are going up is terrifying.”
Whitney Elmer, a country director for Mercy Corps, working to contain the outbreak, told the Guardian that there were around 400 new cases in the last month, the highest monthly number since the beginning of the outbreak.
Ebola is contracted through contact with the bodily fluids of an infected person. The virus was named after the Ebola River in the Congo, where it was first discovered in 1976, according to VOA, and can cause severe internal and external bleeding.
The disease has been nearly impossible to contain for a number of reasons, including violent conflict making it difficult for health workers to deliver care, unstable health systems, misinformation about the disease and its treatment, and more demand for treatment than the World Health Organization has funding to supply.
The most pressing issue hindering treatment in the Congo is the violence in the region, which has caused people either to flee or go into hiding, preventing responders from administering treatment and monitoring the disease’s spread.
“There was violence in west Africa, in Freetown and Monrovia, but this is on a different scale and it is coming from multiple sources,” Farrar said.
In May alone, there have been several politically motivated attacks. Members of the Mai-Mai rebel group attacked a treatment center in Butembo, the Guardian reported. During another attack on a treatment center in Katwa, two patients were fatally injured. According to VOA, Richard Valery Mouzoko Kiboung, a Cameroonian epidemiologist in his early forties, was killed on April 19 while working at Butembo University Hospital. The installation of armed police and election cancellation continue to fed the political tensions.
A VOA correspondent reportedly also saw letters from Mai-Mai rebels on the streets of Butembo threatening police, soldiers, and the people of the Congo if they work with or show support for health workers battling to contain or treat the disease.
“Cases are increasing because of violent acts that set us back each time,” said Dr. Tedros Adhanom Ghebreyesus, WHO director general, who originally believed that the outbreak would be eradicated by September.
Another major factor in the quick spread of the disease is lack of community involvement, according to Kate White, an emergency manager for Médecins Sans Frontières — also known as Doctors Without Borders.
Many diagnosed individuals contracted the disease as a result of deaths in their area, she said, highlighting the lack of awareness and active work by local communities to eradicate the disease. The WHO has seen some improvements by increasing “community dialogue, outreach initiatives, and restoration of access to certain hotspot areas,” it said in a news update earlier this month, but more work is still needed.
In the news release, the WHO also emphasized the increased risk the spread of the virus poses to neighboring countries due to high population movement and density. During a congressional testimony on the Ebola crisis in March, Robert R. Redfield, director of the Centers for Disease Control and Prevention, said that the organization had deployed staff to offices in Uganda, Rwanda, and South Sudan in preparation for the disease’s potential spread.
“The situation is far more dangerous than the statistic of 1,000 deaths, itself the second largest in history, suggests and the suspension of key services threatens to create a lethal inflection point in the trajectory of the disease,” said David Miliband, the head of the International Rescue Committee.
"The danger is that the number of cases spirals out of control, despite a proven vaccine and treatment,” he added.