‘This is a fire’: DRC Ebola outbreak is fastest-growing ever, warns WHO

This article is published in association with United Nations.

Infections of the Bundibugyo species of Ebola in the Democratic Republic of the Congo (DRC) have reached record highs and a majority of new cases are coming from “unknown chains of transmission”, the UN World Health Organization (WHO) warned on Tuesday.

Why this matters

• Third-largest Ebola outbreak ever recorded.
• Most new infections come from unknown transmission chains.
• Virus has spread beyond the original outbreak area.
• Early detection and global support are critical.

Speaking to reporters in Geneva after returning from Bunia in eastern DRC’s Ituri Province, at the heart of the outbreak, Dr Chikwe Ihekweazu, Executive Director of WHO’s Health Emergencies Programme, said that with close to 2,000 confirmed cases and more than 700 deaths across five provinces as of 11 July, the current outbreak is the third-largest ever.

“We’ve seen the fastest growth in a single month since the outbreak started and of all the Ebola outbreaks that we have managed,” he said.

“Over the last few days, we’ve seen some of the highest numbers of new infections in a single day,” Dr Ihekweazu added, including over 80 cases confirmed in 24 hours. 

Known unknowns

Many of the newly reported deaths are people who died in their communities without ever reaching a health facility or receiving care – which is what the WHO official described as “the most alarming finding”.

Despite progress on diagnostics and high contact follow-up rates, “80 per cent of new cases are outside our contact lists and so are coming to us from unknown chains of transmission,” Dr Ihekweazu warned.

The current outbreak was declared two months ago almost to the day and WHO’s modelling indicates that its scale could be “at least two to four times” the number of reported cases.

“You have to imagine that this is a fire,” Dr Ihekweazu said. “There’s something driving the fire in its heart, and it’s also expanding at the same time.”

While up to 95 per cent of all new Ebola cases come from Ituri Province where the outbreak started, the virus has very recently spread to two new provinces, Haut-Uele and Tshopo.

The WHO official outlined a two-pronged strategy for the response: continue pushing at the heart of the outbreak in Ituri and at the same time, “understand the travel routes… and really map out where the risks are of new cases coming up”.

Urging the international community not to be “despondent” in the face of the disease’s rapid spread, the WHO official insisted that the work was bringing results.

“Now is not the time to drop the ball,” he warned.

Therapeutic trials ongoing

Several therapeutics are undergoing clinical trials but there is no approved treatment for patients with the Bundibugyo species of Ebola yet. Still, chances of survival increase significantly with early supportive care.

“We must find the cases earlier, bring them into care as soon as possible” to reduce transmission in the community and avoid staying behind the curve, Dr Ihekweazu said.

Asked about recent attacks on healthcare workers and facilities he explained that the solution lies in “being open and transparent” about the care being provided. 

“Before any new centre is opened, we invite leaders of the community to see what is being done” and to speak with the health care providers who have left their homes to support the response, he said.

Preventing attacks on healthcare relies on building community confidence in the new facilities and showing people that “they’re not going to be left alone – they’ll not only be treated, they’ll be offered food, they’ll have access to their families”.

As the struggle continues to stop the spread of Ebola in DRC, Dr Ihekweazu spoke of “cognitivedissonance between the threats facing us and the efforts that we’re making to respond.” 

“We need the world to come together, not just out of charity or out of support for the DRC, but in our own enlightened best interest. The more we do right now, the better placed we will be in the future,” he stressed.

The WHO official mentioned that at WHO headquarters in Geneva, Member States are negotiating the key part of the WHO Pandemic Agreement, the Pathogen Access and Benefit Sharing (PABS) annexe, which aims to ensure that genetic information on dangerous pathogens with pandemic potential is rapidly shared and vaccines and treatments are made available to developing countries.