KINSHASA, Aug. 15 (Xinhua) -- The ongoing Ebola outbreak in the Democratic Republic of the Congo (DRC) has spread to a sixth province, with confirmed cases rising to 4,727 and deaths to 2,214, according to the latest report released on Friday by the DRC's health authorities.
The report said the outbreak has affected 55 health zones across Bas-Uele, Haut-Uele, Ituri, North Kivu, South Kivu and Tshopo provinces, with Ituri remaining the epicenter.
Buta health zone in Bas-Uele was newly affected. Africa Centers for Disease Control and Prevention (Africa CDC) Director-General Jean Kaseya said Thursday that one person had travelled from Isiro in neighboring Haut-Uele to Buta, and died there later.
A total of 976 people have recovered since the start of the epidemic. Health authorities, however, warned that persistent community transmission and gaps in contact tracing could prolong what is already the world's second-largest Ebola epidemic on record.
COMMUNITY TRANSMISSION CONTINUES
Kaseya said more than 63 percent of Ebola deaths were currently occurring in communities rather than treatment centers or hospitals.
Community deaths further complicate response efforts because health authorities may not know who came into contact with infected people before or after death, making contact tracing and safe and dignified burials more difficult, he said.
The latest government report put the contact follow-up rate at 82.6 percent. Africa CDC, however, said the proportion of registered contacts being followed does not by itself reflect the effectiveness of contact tracing if many contacts are never identified in the first place. The figures indicated that community-based surveillance and contact identification needed to be strengthened, Kaseya said.
World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus said Wednesday that a high proportion of deaths continued to occur in communities, while many new cases were being detected among people who were not on existing contact lists, indicating that some transmission chains had yet to be identified.
"It's already the second-biggest Ebola epidemic on record, and it's moving faster than any previous Ebola outbreak," Tedros told a press briefing in Geneva.
"At its current pace, it's on track to eclipse the West African Ebola outbreak of 2014 to 2016," he warned.
The 2014-2016 West Africa epidemic, the largest Ebola outbreak ever recorded, infected more than 28,600 people.
TRUE SCALE UNCLEAR
The DRC formally declared the outbreak on May 15, but Kaseya said studies examined by Africa CDC suggested that transmission may have begun around February.
"We have no clue about what happened from February to May," he said, adding that figures collected since the declaration should not necessarily be regarded as a complete picture of the epidemic.
Africa CDC is now pushing for a more village-based response that would also seek to reconstruct the early stages of the outbreak.
Kaseya said communities would be asked to help identify people who died or fell ill with Ebola-like symptoms between January and May. Where laboratory confirmation is no longer possible, such information could still help authorities estimate the extent of transmission before the outbreak was formally detected.
Chikwe Ihekweazu, executive director of the WHO Health Emergencies Program, also said investigations so far suggest the virus may have been circulating for two to three months before the outbreak was formally detected, although the exact start of transmission remains under investigation.
OUTBREAK COULD LAST A YEAR
Abdirahman Mahamud, WHO director for health emergency alert and response operations, said Wednesday that response planning is currently based on a moderate scenario under which the outbreak could continue for about six months.
"There's a worst-case scenario where this outbreak may last nine months to 12 months," Mahamud said, adding that efforts were underway to shorten the duration of the epidemic.
Africa CDC has issued an even stronger conditional warning. "If we don't stop this outbreak," Kaseya warned, "it could last more than a year and ultimately become the largest Ebola epidemic ever recorded."
Kaseya said reversing the trajectory would require a combination of measures, including shifting more responsibility for surveillance and response to villages, ensuring access to essential health services, strengthening the referral of suspected cases, deploying additional medical tools and improving the coordination of response resources. ■