KINSHASA, Oct. 27 (Xinhua) -- Ebola cases in the Democratic Republic of the Congo (DRC) have surpassed 10,000, marking a grim milestone in what has become the world's second-largest recorded Ebola outbreak.
The latest figures released Tuesday by the country's health authorities showed that the country had recorded a total of 10,060 confirmed cases, including 4,887 deaths, as of Oct. 25, with the fatality rate at 48.6 percent.
PERSISTENT TRANSMISSION AT EPICENTER
In the DRC, a brief decline in Ebola infections has given way to another rise.
A report released last Wednesday by the World Health Organization (WHO) Regional Office for Africa found that infections rebounded in early October after falling in late September, with recent epidemic evolution suggesting "renewed intensification of transmission."
According to DRC health authorities, the outbreak, which has become the largest and deadliest Ebola outbreak ever recorded in the country, has spread to eight of the country's 26 provinces and 66 health zones, with the eastern province of Ituri remaining the epicenter, accounting for more than 70 percent of confirmed cases.
The outbreak has unfolded against the backdrop of a protracted armed conflict in eastern DRC, where years of violence and mass displacement have already strained an overstretched healthcare system.
The WHO warned that escalating insecurity, continued population displacement and restricted humanitarian access are further disrupting disease surveillance and response operations, raising the risk of infections going undetected.
Health authorities identified persistent weaknesses in early detection, contact tracing and access to treatment as major obstacles to controlling the outbreak.
Only about 12 percent of confirmed cases in the DRC have been identified among previously known contacts, indicating that some chains of transmission remain undetected, Wessam Mankoula, an official with the Africa Centers for Disease Control and Prevention (Africa CDC), warned at an online press briefing last Thursday.
VIRUS CROSSING BORDERS
The difficulties in containing Ebola at its source have increasingly become a concern beyond the DRC. Since May, cases linked to the outbreak have been reported in Uganda, France, Kenya and Nigeria, extending the epidemic across three regions of Africa.
In Kenya, 20 contacts of the country's first imported Ebola patient were released from quarantine Monday after completing 21 days of monitoring without developing symptoms. The initial patient, a Kenyan national who had been living in the DRC, traveled to Nairobi via Uganda and died on Oct. 5.
Kenya has since recorded eight additional cases, all linked to the imported patient and detected among people already in quarantine. As of Monday, the country had reported nine confirmed cases, including two deaths, with another 98 contacts remaining under monitoring.
Further afield in West Africa, Nigeria's first Ebola patient was medically evacuated to Switzerland on Monday and was in stable condition, according to Nigeria's Coordinating Minister of Health and Social Welfare Muhammad Ali Pate.
The index patient, who traveled from Uganda to Nigeria on Oct. 3, developed symptoms four days later and was confirmed infected on Oct. 20.
Nigeria currently has no confirmed Ebola patient within its borders, as 52 contacts remain under monitoring, said the WHO on Monday, stressing that the country has not been declared Ebola-free.
The source of the Nigerian patient's infection, however, remains unclear, prompting a joint investigation with Uganda.
Ugandan Health Minister Chris Baryomunsi said on Sunday in a statement that authorities are working with Nigeria and international partners to review genomic sequencing findings and verify the patient's travel history, contacts and movements in Uganda and en route to Abuja.
Uganda, which recorded 20 confirmed cases, including two deaths, before declaring its outbreak over in July, reaffirmed Sunday that it remained Ebola-free. On Friday, the country announced additional precautionary measures, including reinstating mandatory traveler locator forms, tightening border screening, and restricting transit for travelers with a history of travel to the DRC.
Africa CDC Director-General Jean Kaseya on Sunday welcomed Uganda's continued vigilance and cooperation with Nigeria in investigating the source of its imported case, warning that the risk of further cross-border spread persists.
RACE FOR VACCINES
As health authorities struggle to interrupt transmission, scientists are seeking a longer-term weapon against the outbreak.
On Friday, the first participant received a dose of a candidate vaccine in Bunia, the capital of the DRC's hardest-hit Ituri, marking the launch of a pivotal Phase 2/3 clinical trial known as Tumaini, or "hope" in Swahili.
The trial aims to evaluate whether candidate vaccines can safely and effectively protect people against the Bundibugyo virus, for which no vaccine has yet been licensed.
The first candidate being evaluated is Ervebo, a vaccine already approved against a different Ebola virus species. Preparations are underway to include two Bundibugyo-specific vaccine candidates developed by Moderna and by the University of Oxford in collaboration with the Serum Institute of India.
"If successful, this would be the first time we have clear evidence of vaccine efficacy against Bundibugyo virus," said Chikwe Ihekweazu, executive director of WHO's Health Emergencies Program, describing the prospect as "a major advance" that could transform responses to current and future outbreaks. ■
