As the Ebola outbreak in the Democratic Republic of the Congo (DRC) reaches 194 cases and deaths hit 122, a humanitarian group today added a new concern—the virus has now spread within a school. The group also said response efforts were again interrupted by regional violence.
DRC health officials yesterday confirmed 6 new Ebola cases in the latest hot spot of Beni, including 3 deaths, as the number of suspected cases continues to pile up. Of the 194 total cases, 159 are confirmed and 35 are listed as probable.
In addition, a World Health Organization (WHO) official says the epidemic will likely carry well into 2019.
Officials probe 25 suspected cases
The DRC's health ministry said the 6 new cases in Beni include 3 deaths in the community, a concerning report because it means high levels of exposure to people who cared for the dead. The ministry also noted a death in a previously reported patient.
Health officials are following up on 25 suspected cases, which is up from 20 the day before. The DRC has now reported 29 new cases in just 6 days, or 15% of the total cases in the entire outbreak, which began in August.
The event already ranks as the seventh-largest Ebola outbreak ever. Everyone remembers the colossal 2014-16 outbreak in West Africa, which grew to almost 29,000 cases. But only five other outbreaks have surpassed 200 infections, and they ranged from 224 to 425 cases.
Among them are the very first known Ebola outbreaks. In separate epidemics in 1976, the virus infected at least 284 people in Sudan and 318 in Zaire, which is now the DRC.
The vast majority of new cases in the current DRC outbreak have been in Beni, an area of rebel violence and community resistance to vaccine efforts. Yesterday DRC officials implemented new measures to help slow the outbreak in the region, including making it illegal to harbor suspected Ebola patients and keep them away from Ebola treatment centers.
New York City–based humanitarian nonprofit the International Rescue Committee (IRC) said today that the disease has now spread in a DRC school. The IRC also noted in a news release that the number of new cases each day has more than doubled since Oct 1, likely spurred by a suspension of response activities late last month in Beni because of rebel violence.
"This is a sign not only that the outbreak is not under control, but that without full engagement from the community, things could get a lot worse," said Michelle Gayer, the IRC's senior director of emergency health.
Gayer added, "We have recently seen the transmission of Ebola within a school, opening up a new front in the fight against the disease." She expressed deep concern over interruptions in response efforts in Beni.
"We are operating within a highly volatile environment where the security situation continues to deteriorate, threatening the lives and livelihoods of the community and disrupting the response. Programs are again suspended today due to unrest and violence. Each time the Ebola response is interrupted lives are at risk. Teams are not able to trace the contacts of patients, vaccinate those in need and ensure safe burial practices," she said.
"We are at a critical moment in the response and our teams are highly concerned that the number of new cases could continue to escalate," Geyer said. "It's vital that over the coming days organizations continue to work alongside the local community to strengthen the relationship and work to increase access to people in need."
No quick end in sight
Peter Salama, MD, the WHO director of emergency response, told Reuters today that he sees no quick solution to ending the DRC epidemic.
"We anticipate that now we'll be looking at least another 3-4 months in order to really stem this outbreak, with a strong focus in Beni and surrounding areas," he said. "I'd say that's the best case scenario."
Salama added that the next few days will reveal whether the latest wave in Beni is over, and much depends on the security of responders in the region and the level of community resistance.
"If, however, this peak is accompanied by a peak in insecurity which limits our ability to get to all these cases and their contacts, then we could see a much larger wave building. A lot is depending on that security situation," he added.
Oct 11 IRC news release
Oct 10 DRC health ministry update
Oct 11 Reuters story
Oct 10 CIDRAP News story "Officials confirm 7 more Ebola cases in DRC"