Congo’s Ebola outbreak has spread to a sixth province after a man died in the previously unaffected Bas-Uele province, the head of the Africa Centres for Disease Control and Prevention said Thursday.
The man died in Buta, the provincial capital, after traveling there from Isiro in neighboring Haut-Uele province, said Jean Kaseya, director general of Africa CDC.
Jean-Jacques Muyembe, head of Congo’s National Institute for Biomedical Research, said the man was a motorcycle-taxi driver who sought treatment at several hospitals before his death. Afterward, some of his colleagues attempted to take his body by force, prompting police to intervene and raising concerns that others may have been exposed to the virus, Muyembe said.
The outbreak in eastern Congo is considered the fastest-growing Ebola outbreak on record and is on pace to surpass the deadliest outbreak in history, which struck West Africa between 2014 and 2016 and killed more than 11,000 people, the World Health Organization said Wednesday.
The current outbreak is caused by the rare Bundibugyo virus, for which there are no approved vaccines or treatments.
More than 2,100 people have died among more than 4,500 reported cases, according to the latest government figures. The death toll has been reached nearly three times faster than during the 2014-16 West Africa outbreak, the deadliest Ebola epidemic on record.
The outbreak is unfolding in some of the most challenging conditions imaginable, with strikes by some unpaid health workers, threats from rebel groups, anger among long-traumatized communities and misinformation claiming that Ebola is not real.
Bas-Uele is a vast province in northeastern Congo that borders the Central African Republic, where recurring armed violence has forced thousands to flee and seek refuge in the province. Access can be difficult because of poor and poorly connected roads, as well as limited communications networks. There are also frequent population movements related to gold mining and displacement caused by conflict.
As of Thursday, six of Congo’s 26 provinces had been affected. About 90% of all cases and 80% of deaths are concentrated in Ituri province, the WHO said Wednesday.
Mercy Corps, an aid group, warned Thursday that Ebola cases have been reported along a major travel route about 35 kilometers (22 miles) from Congo’s border with South Sudan, expressing concern over the outbreak’s "widening footprint.” No cases have been confirmed in South Sudan so far.
Meanwhile, health workers at the Nizi Treatment Center in Ituri province, one of the areas most affected by the outbreak, went on strike Thursday, leading to the temporary closure of the center after they said they had not been paid for three months.
Kaseya on Thursday called on the Congolese government to pay the outstanding salaries.
"We need to pay health workers,” he told reporters. "This is the responsibility of the government, not partners. And they told us that money is available.”
The real scope of the outbreak remains unknown. It was declared May 15, but the WHO now says sequencing showed it began months earlier, in February.
Health authorities have said between 60% and 70% of new cases are being recorded outside the group of contacts being monitored and that the disease is spreading at an "alarming” rate. Contact tracing helps break chains of transmission by identifying exposed people early and responding quickly if they develop symptoms.
"We are chasing the virus; the virus is ahead of us,” the WHO regional director for Africa, Dr. Mohamed Yakub Janabi, said this week.
On Thursday, Kaseya of Africa CDC said, "The concept of contact tracing in DRC has become useless.”
Ebola is rare but highly contagious and can be contracted through bodily fluids such as vomit, blood or semen, as well as through contaminated surfaces and materials such as bedding and clothing. The disease it causes is severe and often fatal.
Clinical trials of two possible treatments for this type of Ebola began last month in Ituri, the most affected of the five provinces in Congo where cases have been reported.
Two vaccines developed specifically for the Bundibugyo virus are now being tested in people for the first time, the WHO said Wednesday.
The WHO also plans to test whether an existing Ebola vaccine could protect people against the virus after studies in animals showed promising results.
Kaseya said Thursday that Africa CDC supports the use of Ervebo, a vaccine authorized against the Zaire Ebola strain, in provinces affected by the Bundibugyo virus. He said some studies show that the available vaccines may provide some cross-protection.
"We are in a gray area,” he said. "And when you are in a gray area, you have to make strong decisions to stop seeing people dying.”