Five months after it was declared, the epidemic in eastern Congo has become the largest Ebola event the country has ever recorded. Health ministry data showed over 10,000 confirmed cases on Tuesday, nearly half of them fatal, with the outbreak producing surpassing the number of cases and deaths of the 2014-2016 West African epidemic over the same span after declaration, the AP reported. That West African outbreak remains the largest in total numbers. Earlier epidemics took years to reach totals Congo has logged in months.
The pathogen itself limits what responders can do. The strain is the Bundibugyo virus, a rarer form of Ebola with no approved vaccine or treatment, although a pivotal trial of candidate vaccines began enrolling participants in Bunia last week, the World Health Organization said. Previous Bundibugyo outbreaks in Uganda and Congo were small by comparison. Geography and history work against the response as well. Much of the affected territory is contested by armed groups and poorly served by roads, and residents who have lived through chronic insecurity and one epidemic after another are often reluctant to engage with outsiders. The response is also losing people to violence and to pay disputes: a nurse died and a second health worker was badly hurt during a Saturday callout in Tshopo province, and responders in some localities have downed tools over bonuses unpaid since late August, according to the AP.
Crossing borders has turned a national emergency into a continental one. With Kenya and Nigeria reporting cases and the virus present in three regions of Africa, health ministers will meet virtually on Wednesday, and Africa CDC head Jean Kaseya said "Ebola is crossing borders" and the response "must move faster," the agency said in a statement. Earlier cases in Uganda and France have since cleared. Containing the new clusters depends on the same contact tracing that has proved so difficult inside Congo.