The whereabouts of nearly 300 individuals who tested positive for Ebola in the Democratic Republic of Congo remain unknown, according to Africa’s top health official. A humanitarian crisis amid ongoing conflict in the affected areas has left over 1 million people living in camps that medical workers cannot access, said Dr. Jean Kaseya, director general of the Africa Centres for Disease Control and Prevention (Africa CDC), on Thursday.
His comments followed the release of forecasts by the African regional office of the World Health Organization (WHO) in the journal The Lancet Infectious Diseases, predicting approximately 8,210 cases and 1,420 deaths by mid-September. The modeling indicated a 70% chance that the outbreak could spread to neighboring South Sudan in the coming weeks. To date, the DRC has reported 1,118 confirmed cases and 291 deaths, along with 20 cases and two deaths in neighboring Uganda.
Challenges in contact tracing and scale of the outbreak
On Wednesday, France announced that a doctor who had worked in the DRC tested positive after returning home. His employer, the medical NGO Alima, stated they were “working to understand how the infection could have occurred”.
Data on the number of patients who have recovered, those currently under treatment, and deaths reveal that 297 individuals who tested positive are unaccounted for. “This is concerning to us. Where are these people?” asked Kaseya.
The DRC authorities announced on Thursday that anyone who had been in the affected provinces would need to wait 21 days before traveling further. The outbreak, caused by the Bundibugyo strain of the virus, is the largest in five weeks since the declaration. At the same stage during the West Africa outbreak from 2014–2016, which infected more than 28,000 people and resulted in over 11,000 deaths, there were 239 cases and 160 deaths.
Outbreak development forecasts and virus control funding
The WHO employed computer models to simulate three potential trajectories—low, central, or high transmissibility. The authors noted signs that the DRC’s response is effectively slowing transmission, with current figures aligning most closely with the central scenario, which predicts between 6,636 and 10,287 cases by September 16.
The worst-case scenario anticipates 66,000 confirmed cases by September. Kaseya indicated that 30% of new cases are among known contacts of confirmed cases, suggesting “huge, huge community transmission.” Authorities plan to recruit 20,000 community health workers from local areas to enhance contact tracing efforts, he added. Bed occupancy in Ebola treatment centers is currently at 95%, and “we have not yet reached the peak.”
He noted that in the camps where displaced people reside, “there are cases, and because we do not have access to these camps, we cannot trace contacts. We cannot have a clear picture of what is happening there. We cannot stop this outbreak without addressing the humanitarian problem.”
The Africa CDC and WHO previously stated that $518 million (£392 million) is needed for health care to combat the outbreak. Including humanitarian needs, the total rises to $1.4 billion, according to Kaseya. He noted that only about 13% of the $910 million pledged by international governments and organizations for the response has been provided so far. The first trial of drugs that could treat the Bundibugyo virus is set to begin in the DRC next week, while a trial of an antiviral drug aimed at preventing the disease in contacts will also start in a week.
Source: The Guardian