GENEVA, Aug. 13 (Xinhua) -- The Ebola outbreak in the Democratic Republic of the Congo (DRC) has become the second-largest on record and is moving faster than previous ones, pushing health officials into a race to keep it from becoming the deadliest.
The latest official count showed 4,449 confirmed cases and 2,061 deaths across five provinces and 53 health zones, World Health Organization Director-General Tedros Adhanom Ghebreyesus told a media briefing Wednesday. That means about 46 percent of known patients have died. The toll is approaching the 2,299 deaths recorded during the DRC's deadliest outbreak, from 2018 to 2020.
The WHO cautions that some reported jumps reflect more testing and the clearing of backlogs, though it says most of the increase represents wider transmission.
The global record remains the 2014-2016 epidemic in West Africa, which caused more than 28,600 reported cases and 11,325 deaths, according to the WHO. Tedros warned that the DRC outbreak could eclipse it at its current pace.
"The outbreak had a big head start. It is still way ahead of us, and we are playing catch-up," the WHO chief said.
WHY IT SPREADS FAST
The outbreak was declared May 15, but genetic sequencing now indicates that it began in February. Some of the first cases were mistaken for malaria or typhoid, which can also begin with fever, weakness and body aches. Early tests were aimed at a more common type of Ebola, adding to the delay, WHO officials told a press conference earlier this week.
The outbreak is caused by Bundibugyo virus, a rare type of Ebola. A study of samples from 22 patients, published this week in Nature Medicine, found that the outbreak strain was genetically distinct from previous Bundibugyo viruses associated with outbreaks in 2007 and 2012. The findings point to a fresh jump from an infected animal to a person, followed by person-to-person spread.
Ebola does not spread through the air. People are infected through direct contact with the bodily fluids of someone who is sick or has died, or with contaminated items such as bedding and clothing. Risk is greatest late in the illness when patients need care and during burial practices that involve touching the body.
That makes quick diagnosis, isolation, care and safe burials essential. Yet many patients are dying at home or in communities rather than in treatment centers. Many new infections also occur among people who were not on contact lists, a sign that health teams do not know every chain of transmission.
WHY CONTAINMENT IS DIFFICULT
Nearly 90 percent of the DRC's cases are in Ituri, a northeastern province affected by armed conflict, displacement and poor roads. Some communities are difficult or unsafe for response teams to reach. Health centers lack beds and supplies, while misinformation and fear have kept some patients away.
Unpaid or underpaid health workers have also staged strikes. Those stoppages have weakened care and contact tracing just as increases in cases have accelerated. Treatment centers in neighboring North Kivu province were at 139 percent of capacity by Aug. 4, the WHO and Africa CDC said.
Contact tracing remains a major gap. Tedros said that about 80 percent of listed contacts were being followed, short of the 95 percent target needed to stop hidden spread.
Money is another constraint. Only 264 million U.S. dollars of the 518 million dollars sought under a regional response plan has been disbursed, the WHO head said.
EFFECTIVE VACCINES ON THE WAY?
There is no approved vaccine or specific drug for the Bundibugyo strain. Patients can still survive with early care, including fluids and treatment for pain and other symptoms. The WHO said 886 people had recovered by Wednesday.
For the first time, two vaccines designed specifically for Bundibugyo virus have entered early safety trials in people. The WHO also wants to test whether an existing vaccine for the more common Zaire Ebola virus can protect against Bundibugyo after animal studies showed encouraging results. A separate trial is testing possible treatments, but none has yet been proved effective.
Meanwhile, the WHO plans to triple treatment capacity to 3,000 beds within 12 weeks and says thousands more health workers are needed. More than 21,000 community health workers have already been trained.
Uganda offers evidence that the virus can be contained. It declared an end to local transmission on July 28, bringing infections under control quickly after the virus killed two and infected 20. Continued transmission in the DRC, however, means Uganda and other neighboring countries remain at risk of imported cases.
Abdirahman Mahamud, WHO director for health emergency alert and response operations, said a moderate scenario could see the outbreak peak in about six months. A worse course could last nine months to a year, he added. ■