The Ebola epidemic in the Democratic Republic of Congo has tragically claimed the lives of at least 2,011 individuals this year, according to the latest figures released by authorities. Health officials warn that this outbreak could escalate to become the most severe in the nation’s history. Government data published recently revealed a total of 4,381 confirmed cases.

The rapid acceleration of the health crisis is starkly evident in the fatality rates. While it took approximately nine weeks to record the first 1,000 deaths, the subsequent 1,000 fatalities occurred in just about three weeks. This alarming trend underscores how the epidemic is progressing much faster than current monitoring and management efforts.

Several factors contribute to the surge in cases and deaths. Health authorities face significant hurdles in delivering essential aid to remote areas due to ongoing rebel conflicts, dilapidated road networks, and strikes stemming from payment disputes affecting healthcare workers.

Dr. Jean-Marie Akandabo, who assists in patient care at a local clinic in Ituri in the northeast, described the death toll as “alarming.” He urged for a substantial increase in the response efforts within the affected communities.

This marks the 17th outbreak of the highly contagious disease in the country, already recognized as the most extensive in the Democratic Republic of Congo’s history. Sania Nishtar, Director-General of the global vaccine alliance Gavi, cautioned that it “could well become the largest outbreak ever observed.”

The current Ebola epidemic’s case fatality rate is estimated at 45.9%. This figure is notably higher than the 39.6% recorded during the deadliest Ebola outbreak in West Africa between 2014 and 2016, which resulted in over 11,000 deaths from 28,000 cases. That particular outbreak remains the worst Ebola epidemic on record.

State of emergency declared

Although the current outbreak was officially declared on May 15, health authorities have indicated that viral sequencing revealed its origins several months earlier, in February. Consequently, a state of emergency has been declared across the Democratic Republic of Congo to bolster the response.

This particular Ebola outbreak presents unique challenges, as it is caused by the rare Bundibugyo virus, for which no approved vaccines or treatments currently exist. Clinical trials for potential treatments have commenced in the province of Ituri, which serves as the epicenter of the epidemic in eastern Congo.

Humanitarian workers on the ground report that the epidemic continues to outpace the response efforts, which are struggling to expand across the five affected eastern provinces. Many health workers have initiated strikes to protest a lack of payment since the outbreak was declared. Furthermore, the World Health Organization (WHO) has highlighted that most new cases are still being identified outside of monitored contacts, indicating that transmission remains largely uncontrolled by healthcare personnel.

“In the absence of an effective vaccine, control [of the epidemic] relies on identifying cases and then managing them in secure facilities until their recovery or, unfortunately, their death,” explained Paul Hunter, a professor of medicine at the University of East England in the United Kingdom. He added that in a remote, conflict-ridden region with disrupted communications, routine surveillance can be exceedingly difficult, making it “impossible to identify cases early enough to prevent spread.”

Experts from the World Health Organization’s vaccine committee recently recommended launching a large-scale human clinical trial for the only currently licensed Ebola vaccine. The aim is to determine if this vaccine offers cross-protection against the Bundibugyo strain, which is currently spreading in the Democratic Republic of Congo and for which no specific vaccine yet exists.

The Ervebo vaccine has demonstrated its safety and effectiveness against the more common Zaire strain of the Ebola virus. WHO experts suggest that preliminary data, including findings from animal trials, indicate it might also provide some protection against the rare Bundibugyo strain now prevalent in the DRC.

Currently, two potential vaccines specifically targeting the Bundibugyo strain are in the early phases of human clinical trials, with a third candidate under development for testing at this stage.

Dr. Mohamed Yakub Janabi, WHO Regional Director for Africa, candidly stated that officials are “running after the virus, which has a head start.”

The Ebola virus is transmitted through contact with bodily fluids and manifests as hemorrhagic fever. The first identified instance of the virus occurred in 1976, near the Ebola River, within what is now the Democratic Republic of Congo.