Deaths from an Ebola outbreak in the Democratic Republic of Congo have surpassed 5,000, with the disease continuing to spread despite containment efforts and cases being reported in other African countries, according to the latest government data released Saturday.
Figures from the Congolese Ministry of Health showed that 5,026 people have died among 10,351 confirmed and suspected cases, putting the fatality rate at nearly 50%. The rising death toll has heightened concerns among health experts over the authorities' ability to bring the outbreak under control.
The outbreak, caused by the Bundibugyo virus, was declared in mid-May, catching health authorities off guard and presenting major challenges to efforts to contain its spread. Since then, the disease has continued to claim lives as infections have extended beyond Congo's borders.
It has become the second-deadliest Ebola outbreak on record, surpassed only by the 2014-2016 West African epidemic, which killed approximately 11,000 people across several countries over two years.
"It is a very tragic milestone because it is just not a number," said Dr. Patrick Otim, a program area manager with the World Health Organization. "It is families and communities that have been devastated by this outbreak. The number also shows the severity of this outbreak."
A total of 2,788 people have recovered from the virus so far. The Bundibugyo virus has no known vaccine or specific treatment, but health workers provide supportive care based on patients' symptoms.
Since May, the disease has spread to 67 of the country's 178 health zones in eight of its 26 provinces. Fifty of the 67 affected health zones have active cases.
The virus has been concentrated in eastern Congo, particularly in Ituri and North Kivu provinces, which have recorded a combined 9,782 confirmed cases and 4,792 deaths.
Authorities are still struggling with contact tracing and testing, key components of efforts to curb the outbreak.
According to the Africa Centers for Disease Control and Prevention, about 80% of new cases are being detected outside monitored chains of transmission, meaning health authorities cannot trace the infections to previously identified contacts.
One-third of recorded deaths have involved people who died outside treatment centers before being tested for Ebola, WHO's Otim said. Health officials say these challenges contribute to community transmission beyond the immediate reach of health workers and make it harder to ensure patients receive appropriate care.
"These are people we never had opportunity to try to save, and it is one of the biggest concerns for us in this outbreak. How do we try to reach people early to get them to come to health facilities to get a fighting chance to survive?" Otim said.
The surge in infections in Congo comes amid a series of challenges that have hampered efforts to contain the outbreak.
Eastern Congo, where the outbreak is concentrated, is also the scene of conflict between government forces and several armed groups, most prominently the Rwanda-backed M23 rebel group. An Islamist insurgency along the border with Uganda, where the Allied Democratic Forces carry out attacks, has also restricted the movement and reach of health workers.
Widespread distrust among local communities has further complicated the response, contributing to attacks on health workers and medical facilities. A nurse was killed while responding to an Ebola alert last week, and a politician from the ruling party was killed in September after advocating health measures on the radio.
Health workers have also staged multiple strikes, shutting down facilities treating infected people over prolonged delays in government payments.
On Friday, workers at an Ebola treatment center in Tchomia, Ituri province, stopped working to demand four months of unpaid wages. The center currently has five confirmed Ebola patients and 10 suspected cases under care.
"We are tired of requesting our salaries. If they want to pay us, they will. ... Today, being able to feed our families has become a real problem," Moise Mugenyi, one of the striking workers, told The Associated Press.
Dr. Justin Mukonkole, acting head of response operations in Ituri, said workers should be patient as the government addresses their demands.
Similar situations have unfolded in other health zones, including Beni in North Kivu province, where services at some treatment centers have ground to a halt. Alain Siwako, an elected public official in Beni, said cases were spiraling because of a lack of fuel and financial resources from the central government.
"Across Ituri and North Kivu, this outbreak is stretching everyone responding to it, including the communities themselves," said Rose Tchwenko, country director for the Democratic Republic of Congo at Prosper Global, formerly Mercy Corps.
In October, Kenya and Nigeria both confirmed Ebola cases. Kenya reported eight cases and two deaths, while Nigeria's only confirmed patient was evacuated to Switzerland.
The cases in Kenya and Nigeria, following an earlier outbreak in Uganda, made the latest epidemic the first recorded across three African regions and the continent's most geographically widespread Ebola outbreak.