Congo's Ebola Outbreak Is Now the Worst Ever Recorded

The Democratic Republic of the Congo is facing the largest Ebola outbreak ever recorded, after confirmed cases passed 8,000 for the first time, the World Health Organization warned on Tuesday.

Congolese health authorities reported 8,067 confirmed infections and 3,901 deaths, a case fatality rate above 48 per cent, across 63 health zones in seven of the country's 26 provinces, according to the UN agency. The outbreak, caused by the Bundibugyo strain of the virus, was declared in May and has since spread from its original focus in Ituri province to become the biggest Ebola epidemic the country has seen.

Speaking to reporters in Geneva, Dr Janet Diaz of WHO's Health Emergencies Programme said transmission was easing in some areas, but warned that "the number of cases remains high for this outbreak."

The toll behind the milestone

Ituri remains the centre of the epidemic, with its capital, Bunia, the worst-hit city. The virus has also taken hold in North Kivu, where Butembo, a city of around two million people, has emerged as a major hotspot. Health officials recorded a substantial rise in infections there through September, though the most recent days show some decline, WHO said. By 23 September, the agency had recorded 1,480 confirmed cases in North Kivu alone, with a provincial fatality ratio of nearly 60 per cent.

What sets this outbreak apart is the strain itself. Bundibugyo is the member of the Ebola virus family for which no approved vaccine or treatment exists. Trials are underway, and last week WHO said 20,000 doses of the Ervebo vaccine, which has proved effective against the Zaire strain in past outbreaks, had been allocated for a research vaccination programme in Ituri province.

Early treatment saves lives, but a large share of patients never reach it. "Delays in seeking care, together with challenges in access and referral, continue to complicate the response," Diaz said. People frequently die at home or in their communities because they cannot reach a health facility in time, according to the agency. Oxygen, described as essential for severe cases, is "unavailable or unreliable in many health facilities, especially in emergency settings," WHO said.

Why the response keeps falling short

The epidemic is unfolding in some of the most unstable parts of eastern Congo. Violence around displacement camps near Bunia has forced thousands of people to flee in recent days, breaking surveillance and contact tracing, according to the UN. In Butembo, health workers are treating patients in communities where they may also be caring for neighbours and relatives, while running short of protective equipment, Médecins Sans Frontières project coordinator Stephanie Hoffmann told France 24.

Public mistrust has become a second obstacle. Anger at government policy has hardened into a major barrier to containing the virus, Al Jazeera reported, and a senior member of the ruling UDPS party was beaten to death in Butembo on Sunday after raising awareness about the epidemic on local radio. Africa's health agency says case numbers have levelled off after a rapid rise, but still judges the outbreak "not under control."

The race to scale up care

WHO and its partners have expanded treatment capacity from a handful of beds at the start of the outbreak to more than 1,600 beds across 50 treatment centres in the seven affected provinces, with plans to go beyond 2,000. Nearly 400 health workers have been trained at a new hub in Bunia, and the agency says the focus now is on early recognition of illness, faster referrals, and a dependable supply of oxygen.

Diaz recently returned from her second visit to the DRC since the ebola outbreak was declared in May, including a stop at treatment centres in Bunia, the capital of Ituri province, according to the UN report.

For people in the affected zones, speed is the decisive factor. Patients who reach a treatment centre early stand a far better chance of surviving than those who wait, WHO said. But with violence cutting off roads and clinics, and trust in short supply, getting people through the door in time remains the response's central challenge. The UN report notes that without earlier oxygen scale-up work in Ebola and Marburg responses, outcomes today would be worse.