KINSHASA, June 14 (Xinhua) -- At Lwiro Hospital in South Kivu Province, eastern Democratic Republic of the Congo (DRC), the fight against Ebola has narrowed to a ward, a mobile laboratory and a fragile line of surveillance around one of the country's less noticed fronts of the outbreak.
The village of Lwiro, in Kabare territory, lies in the Miti-Murhesa health zone north of Bukavu, the provincial capital of South Kivu. While most attention has focused on Ituri province, the epicenter of the current Ebola outbreak, health workers here say the virus has already forced them into maximum alert.
As of June 12, the DRC had reported 710 confirmed cases, including 149 deaths, across Ituri, North Kivu and South Kivu provinces, said the DRC health ministry late Saturday.
According to the DRC health ministry, three Ebola cases have been confirmed in South Kivu, including one death. Several suspected cases are being monitored at Lwiro Hospital, where the first confirmed case linked to the area was recorded, local sources told Xinhua.
"We have already recorded two confirmed cases and two suspected cases," said Rene Mbiye, medical director of Lwiro Hospital. He said six patients were currently under care, including children.
"We have a newborn who is almost two weeks old, as well as another child aged one year and three months," Mbiye said. "We are monitoring them closely. They have been separated from their mothers, and we have made a nurse available to take care of them."
For doctors in Lwiro, the small number of confirmed cases does not mean the danger is small. The zone sits along important routes linking Bukavu, Kavumu and areas farther north, in a province already weakened by conflict, displacement and limited health services.
The area is also under the control of the March 23 Movement (M23) rebel group, whose control over parts of North Kivu and South Kivu has complicated normal administration, humanitarian access and public health coordination.
The World Health Organization (WHO) said on Saturday in its latest disease outbreak update that the Ebola outbreak in the DRC continues to evolve rapidly, with rising case numbers and geographic spread.
Although South Kivu accounted for only one affected health zone in that WHO update, the province had already listed more than 200 contacts under follow-up, underscoring the risk of silent transmission in an area far from the main epicenter.
WHO has assessed the risk in the DRC as "very high", citing ongoing transmission and the continued expansion of the outbreak into new health zones. It also warned that security incidents affecting health facilities were constraining access, disrupting surveillance and response activities, and increasing the risk of undetected transmission.
Those warnings have special resonance in South Kivu.
Earlier this month, an Ebola safe and dignified burial team was attacked in Katana, about 30 km north of Bukavu, in an area controlled by the M23 rebels, according to local media. The team was forced to abandon a coffin, and the body was later handled by community members, a high-risk practice that can fuel new chains of infection.
For Ebola responders, burial practices, contact tracing and early isolation are not technical details. They are the difference between a contained cluster and a spreading outbreak.
In Miti-Murhesa health zone, health teams are trying to detect symptoms early, isolate suspected cases and prevent the virus from moving quietly through families, clinics or crowded communities.
To shorten the time between suspicion and confirmation, a mobile molecular biology laboratory has been deployed near the outbreak's local epicenter. Inside the mobile unit, laboratory specialists analyze samples taken from suspected cases and people considered at high risk. Results that previously had to wait for samples to be sent to Kinshasa can now be obtained within hours.
Noella Mukana, a medical biologist with the National Institute for Biomedical Research (INRB), said the mobile laboratory is equipped for testing hemorrhagic fevers and includes biosafety level-3 facilities, sample incubation areas, manual extraction units and dedicated workstations for sample processing, analysis and archiving.
"We have put in place the necessary means to respond to the situation," Mukana said. "They chose to deploy a mobile laboratory directly at the epicenter of the outbreak. This considerably reduces the time between sample collection, transport and the obtaining of results. It is the best solution."
The role of the laboratory has become even more important because Bundibugyo Ebola virus disease, the strain responsible for the current outbreak, can initially resemble other common febrile illnesses, including malaria.
WHO says there is currently no approved vaccine or specific treatment for this strain, making rapid detection, isolation, supportive care, contact tracing, safe burials and community engagement central to controlling transmission.
The memory of previous Ebola outbreaks remains strong in eastern DRC. But in South Kivu, the current outbreak has arrived in a place already burdened by armed conflict and displacement. The province may not yet have the highest number of cases, but health workers say that is precisely why speed matters.
"While attention has focused on Ituri province, which accounts for more than 90 percent of the caseload, we are concerned about the lack of resources and attention given to North Kivu and South Kivu, especially in areas where armed conflict is hampering humanitarian and medical assistance," a staff member of the International Federation of Red Cross and Red Crescent Societies (IFRC) told Xinhua.
As eastern DRC confronts a widening outbreak, South Kivu has become a quieter test of whether Ebola can be stopped before it gains a stronger foothold in a province where conflict, mobility and mistrust already make every delay dangerous. ■
