Ebola outbreak 'likely far worse' than reports... as cases surge

The Ebola crisis sweeping across several African nations is likely far more severe than official figures indicate, health specialists caution.

On Monday, the International Rescue Committee (IRC), an aid organization based in New York, highlighted the challenges faced in the Democratic Republic of the Congo (DRC). The DRC is at the center of a growing Ebola outbreak, where efforts to control the virus are hampered by delays in detection and insufficient contact tracing.

This outbreak, attributed to the rare and untreatable Bundibugyo variant, has led to over 1,000 suspected cases and more than 200 suspected deaths in the DRC, as reported by the country’s Ministry of Health. Out of these, 282 cases and 42 deaths have been confirmed.

The virus is not confined to the DRC alone. Neighboring Uganda and South Sudan have reported rising numbers of cases, while patients in Italy and Brazil are being closely monitored. Additionally, an American who contracted the virus was transported to Germany for treatment.

The Bundibugyo variant poses a significant threat, with a mortality rate of up to 50% among those infected, and currently, there are no available treatments or vaccines to combat it.

Initial cases of Ebola in this outbreak were verified in late April, yet the IRC suspects the virus might have been circulating undetected as early as March, possibly even three months prior to the official declaration of the epidemic in mid-May.

Rachel Howard, senior technical emergency health advisor at the IRC, estimated only about 20 percent of contacts are currently being traced, which means health authorities are struggling to find new sources of transmission. 

The IRC notes that cases may spread to other countries neighboring the DRC such as Burundi.  

Officials have warned the Ebola outbreak surging in the Democratic Republic of the Congo (DRC) is ‘likely far worse’ than current estimates state. Pictured above are physicians with Doctors Without Borders providing medical care to a patient in the DRC

‘IRC teams warn that shortages of diagnostic cartridges and testing backlogs are slowing confirmation of cases, further obscuring the true spread of the outbreak,’ Howard said in a statement.

She notes at least six healthcare workers have died, including two doctors in recent days, and many residents are avoiding health facilities. This raises fears that those infected with Ebola are remaining in vulnerable communities rather than seeking treatment.

‘As a result, transmission is spreading across multiple areas, and communities are losing trust in the response,’ she said. ‘Strengthening local, community-based prevention and infection control should be the immediate priority to control the outbreak at the source. 

‘Without urgent funding, the situation could deteriorate rapidly.’

As the outbreak surges, the US is requiring Americans arriving from the DRC, Uganda or South Sudan to reroute their travel to arrive in one of four airports for enhanced screening: John F Kennedy International Airport in New York City, Washington Dulles International Airport outside of Washington DC, Hartsfield-Jackson Atlanta International Airport and George Bush Intercontinental Airport in Houston.

Last week, health officials in Kenya shot down the White House’s plan to quarantine Americans exposed to Ebola in the country, stating the plans could not continue until petitions against them were heard. Hearings are scheduled for Tuesday.

Estimates suggest that up to 5,000 Americans are in the DRC, although it is not clear how many are in Uganda and South Sudan. 

Health workers are pictured putting on protective equipment at the Evangelical Medical Center in Bunia, Ituri province, DRC (file photo)

Dr Peter Stafford, an American medical missionary doctor, became infected with the Bundibugyo virus while stationed in the DRC and was evacuated to Charité Hospital in Germany.

During a press conference last week, health officials said Stafford is weak but is not critically ill. Officials said he has not required intensive care and has not suffered organ failure, and his viral counts are decreasing with antiviral medications. 

Stafford is being treated in a fully isolated ward and can see his family only through a window. The officials added that his wife, Dr Rebekah Stafford, has tested negative for Ebola and remains symptom-free, but the family is being quarantined in a separate section of the unit.

The CDC has a level 3 travel advisory in place for the DRC, which advises Americans to ‘reconsider nonessential travel’ to the country’s Ituri, Nord-Kivu, and Sud-Kivu provinces. 

Ebola spreads through contact with the blood or body fluids of an infected person, as well as contact with contaminated objects or infected animals such as bats or primates. 

A child from the DRC returning from school is pictured looking at awareness illustrations outside the Ebola Treatment Center in Munigi

Health workers from the International Medical Action (ALIMA) are seen putting on protective equipment in Rwampara outside Bunia, Ituri province, DRC (file photo)

Agency officials note if travel is absolutely necessary, Americans should consider getting travel insurance. They should also avoid contact with individuals showing Ebola symptoms as well as blood or other bodily fluids or objects contaminated with them. 

Travelers should also avoid contact with bats, forest antelopes, primates and blood, fluids or meat from these animals.

The CDC urges travelers to watch for symptoms of Ebola for 21 days after leaving the DRC. 

The agency has a level 2 travel advisory in place for Uganda and South Sudan, which urges travelers to ‘practice enhanced precautions.’ 

Ebola’s presence in the DRC dates back to 1976, and the latest outbreak is the 17th in the country since. 

Previous outbreaks in 2018 and 2020 in eastern Congo killed more than 1,000 people each. The largest Ebola outbreak occurred in 2014 to 2016 in West Africa when more than 28,600 cases were reported.   

The World Health Organization (WHO) has said the current outbreak does not meet the criteria of a pandemic emergency, but countries sharing borders with DRC, such as Uganda and Rwanda, are at an increased risk of further spread. 

Medical staff are pictured carrying an Ebola patient at a hospital in the DRC

A physician with Doctors Without Borders is seen during the contamination process in the DRC

A physician with Doctors Without Borders is seen during the contamination process in the DRC

Ebola symptoms include fever, headache, muscle pain and weakness, diarrhea, vomiting, abdominal pain and unexplained bleeding or bruising. 

The virus can cause serious disease and has a mortality rate as high as 90 percent without treatment. 

The current outbreak is caused by the Bundibugyo virus, a rare strain of Ebola that has no approved treatments or vaccines. The strain has only been implicated in two other previous outbreaks, in 2007 and 2012. 

The mortality rate for the Bundibugyo virus ranges from 25 to 50 percent.  

The Zaire strain, which is the most common form of Ebola, can be treated with the drugs Inmazeb and Ebanga and the Ervebo vaccine, which is administered only during outbreaks. 

‘Unfortunately, Bundibugyo has fewer proven countermeasures than Zaire ebolavirus, where vaccines have been highly effective in controlling outbreaks,’ Amanda Rojek, Associate Professor of Health Emergencies, Pandemic Sciences Institute at the University of Oxford, said in a statement. 

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