KINSHASA, June 15 (Xinhua) -- One month after the Democratic Republic of the Congo (DRC) declared its latest Ebola outbreak, health authorities and aid agencies are warning that the disease remains in an active phase, with rising cases, gaps in testing and contact tracing, community resistance, insecurity and a mounting toll on children complicating efforts to contain it.
The outbreak, declared on May 15 and caused by the Bundibugyo Ebola virus, has rapidly become one of the largest Ebola outbreaks recorded in the DRC. According to the latest figures from the health ministry on Sunday, the number of confirmed Ebola cases has risen to 782, including 178 deaths, with 359 patients in isolation or hospitalized and 40 recoveries.
The outbreak has mainly affected Ituri Province, with cases also reported in North Kivu and South Kivu, three eastern provinces already struggling with armed violence, displacement and weak health services.
RISING CASES, LIMITED TREATMENT CAPACITY
Dieudonne Mwamba Kazadi, head of the DRC National Institute of Public Health (INSP), told Xinhua in an interview on Monday in Bunia, capital of Ituri and the epicenter of the outbreak, that the epidemic was still moving upward.
"We are still in the midst of the epidemic. I would say we are in the upward phase of the outbreak, the active phase," Kazadi said.
He said health authorities expected more confirmed cases in the coming days, making it urgent to expand treatment capacity and position new Ebola treatment centers in affected areas.
"The perspective is really to increase capacity and already have treatment centers positioned to receive the future suspected and confirmed cases that we will identify in the coming days and weeks," Kazadi said.
Kazadi said the response strategies were moving "on the right track," but that some measures still needed to be strengthened, including community engagement, treatment capacity and safe and dignified burials.
"We must continue engaging communities further," he said. "All our interventions must be carried out with the community."
Medical charity Medecins Sans Frontieres (MSF) warned on Monday that despite the recent scale-up in the response, major gaps in surveillance, diagnosis, contact tracing and community engagement continued to undermine efforts to bring the outbreak under control.
"One month on, the Ebola disease outbreak is outpacing the response effort," said Kate White, MSF emergency medical coordinator in the DRC.
"No one knows the true scale or exactly where the disease is spreading in DRC," White said. "What we do know is that most treatment centres in Ituri province are overwhelmed; many of our patients arrive at a late stage of the disease, and the majority were never identified or monitored as contacts before seeking care."
"Many communities, especially those affected by ongoing insecurity, still have limited access to these kits, while treatment centres continue to face significant delays in receiving laboratory results," White said. "Without faster and more widely available testing, we will struggle to detect cases early enough to contain the outbreak."
The INSP chief said controlling the outbreak would depend heavily on surveillance and contact tracing.
"Once we follow all our contacts, and all new cases come from contacts being followed and are isolated, then we can be sure we are on the path toward controlling the epidemic," he said.
The latest INSP assessment report released on Sunday said confirmed cases have been increasing from week to week, indicating continued community transmission. It warned that a sudden geographic expansion of the outbreak is feared if public health measures are not implemented quickly.
CHILDREN HIT HARD AS OUTBREAK DEEPENS SOCIAL CRISIS
Global charity Save the Children said Monday that at least 52 children, including 16 toddlers and infants, had contracted Ebola in the month since the outbreak was declared, with 19 of them confirmed dead.
The aid agency said young children represented a smaller share of cases than other age groups but were dying at a far higher rate.
Citing figures from the Africa Centers for Disease Control and Prevention, Save the Children said children aged 14 or under were more than twice as likely to die after contracting Ebola as patients aged 15 to 44.
Greg Ramm, Save the Children's country director in the DRC, said the outbreak was "more than a health emergency" and had become a wider social crisis for children, caregivers and communities.
Save the Children said the current outbreak is unfolding on top of a wider humanitarian crisis in the DRC, where about 15 million people, nearly one in seven, need humanitarian assistance.
INSECURITY, MISINFORMATION AND BURIAL RISKS UNDERMINE RESPONSE
The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) warned that escalating violence in eastern DRC was undermining efforts to contain the outbreak and raising the risk of further spread.
In North Kivu, OCHA said a recent armed attack in Beni territory killed at least five civilians, citing local civil society. Renewed clashes in Masisi territory triggered further displacement and forced humanitarian organizations to restrict movements in several areas, limiting access to people in need and disrupting Ebola response activities.
In South Kivu, hostilities in Kabare territory caused civilian casualties and new displacement, forcing the World Food Program and partners to delay planned food distributions, OCHA said.
In Ituri, a health worker in Mongbwalu health zone, which is at the center of the outbreak, was taken by armed group elements on June 8 and forced to perform a post-mortem procedure without protective equipment, according to OCHA. The incident highlighted the serious risks faced by frontline health workers.
The UN agency said surveillance, contact tracing, transport of laboratory samples, medical referrals, emergency deployments and safe and dignified burials must be able to continue without interruption.
Kazadi also said some communities still did not believe Ebola exists, with rumors and misinformation spreading since the start of the outbreak.
"Some communities did not believe it was Ebola. They thought it was witchcraft or a mystical phenomenon," he said.
"This outbreak can still be brought under control, but the window for action is narrowing," said Frederic Lai Manantsoa, emergency coordinator for MSF in DRC. "Diagnostics, surveillance, access to care, and community engagement must be urgently strengthened."
At Bunia Airport, where flights have been disrupted by the outbreak, slowing down the arrival of health experts from the international community, Kazadi said response teams and the International Organization for Migration had carried out several assessments. The latest report showed about 98 percent of required preventive measures had been put in place, he said.
"We are sufficiently ready," Kazadi said, adding that any decision to reopen or close the airport rests with civil aviation authorities and other relevant agencies, not the Ebola response team. ■