Ebola: DRC cases surpass 11,000; insecurity hampers response

Health workers wearing protective equipment.

Insecurity has been identified as one of the “greatest obstacles” to containing the Ebola outbreak in the Democratic Republic of the Congo (DRC), where more than 11,000 cases and 5,400 deaths have been reported.

The World Health Organisation (WHO), in a news release published on 15 November, said attacks on health workers and facilities, displacement and difficulties reaching remote communities were disrupting efforts to contain the outbreak.

The outbreak, caused by the Bundibugyo virus, has spread to 67 health zones across eight provinces, with between 400 and 500 new cases reported weekly.

“Children account for more than a quarter of confirmed cases and one third of deaths. Seven in 10 children under five with confirmed Ebola have died,” it noted.

According to the WHO, a recent armed attack in Cantine-Aloya killed 66 civilians, including three health workers, while three health facilities were looted.

The attack also resulted in more than 1,000 contacts being lost to follow-up, with three confirmed cases still unaccounted for. Another attack on the town was reported on 11 November.

According to WHO, more than 80 attacks on healthcare have been recorded since the outbreak was declared.

“A halt in hostilities is urgently needed to protect communities and health workers, and to safeguard the progress made over the past six months,” it noted.

The WHO said about two-thirds of confirmed deaths occurred in communities, suggesting that many infections were being identified too late for patients to receive timely treatment.

WHO also highlighted the risk of the outbreak spreading beyond the DRC, following recent imported cases in Kenya and Nigeria.

The agency said cross-border collaboration has strengthened surveillance, information-sharing and coordination among affected and at-risk countries.

“Recent imported cases in Kenya and Nigeria underscore the continuing risk of spread beyond national borders. Delays in paying frontline health workers and responders create tension and slow the response,” it said.

WHO said the developments underscored the need for neighbouring countries to maintain surveillance and preparedness, particularly around high-risk border areas.

Despite the challenges, WHO said efforts had slowed transmission in some of the outbreak’s initial hotspots, including Mongbwalu, Nyankunde, Nizi, Rwampara and Butembo.

Diagnostic capacity has expanded from two laboratories to more than two dozen, while nearly 2,000 treatment beds are available across 104 treatment and transit centres.

About 3,000 people have recovered from the disease, while more than 17,000 community health workers and 46,000 community actors have been trained to support the response.

WHO said sustained funding, safe access for health workers and greater community participation would be essential to reaching areas that remain difficult to access and bringing the outbreak under control.

In Nigeria, the index patient evacuated to Switzerland has recovered and been discharged from hospital. At the same time, all 62 people identified as contacts have completed the mandatory 21-day monitoring period without any secondary infection.

The Nigeria Centre for Disease Control and Prevention (NCDC) disclosed this on 13 November, saying the patient tested negative for the virus after receiving further treatment in Switzerland.

NCDC Director-General, Jide Idris, said 13 of the 62 contacts developed fever or other symptoms during monitoring, but all tested negative. Seven suspected Ebola cases reported in five states were also investigated, with none testing positive.

“However, it is important to note that the completion of contact monitoring does not, by itself, constitute a formal declaration that an outbreak is over. Such a determination must be based on the applicable public health criteria and the findings of ongoing surveillance,” it noted.

“Nigeria therefore remains vigilant, particularly given the continued occurrence of Ebola virus disease in the DRC.”