DRC Ebola Outbreak Passes 4,000 Cases As Officials Fear The Virus Could Be Mutating

Health officials are racing to contain a massive Ebola outbreak in the Democratic Republic of Congo that has now passed 4,000 confirmed cases, as fears grow that the virus could be mutating to become more severe.

Africa's public health watchdog announced a major escalation of the response on Thursday, declaring that "the time for incremental action is over" and unveiling plans to go door-to-door searching for patients, according to The Guardian.

The Scale Of The Crisis

The outbreak, caused by the Bundibugyo strain of Ebola, was first officially reported on May 15, though health officials suspect the disease could have been spreading since January.

As of August 4, there have been 3,973 confirmed cases and 1,801 deaths recorded by the DRC's national public health institute. Dr Jean Kaseya, director general of the Africa Centres for Disease Control and Prevention, confirmed cases had topped 4,000 by Thursday.

This is now the second-largest Ebola outbreak on record. The numbers are staggering: eight times more cases and six times more deaths than were recorded 11 weeks into the devastating West Africa Ebola outbreak of 2014-18, which ultimately infected more than 28,000 people and killed at least 11,000.

Why Officials Fear Mutation

The severity of this Bundibugyo outbreak has health officials deeply concerned that something unusual is happening with the virus.

"We planned studies to check if there is no additional issue, or maybe if the virus is not mutating. Because the level of severity of this Bundibugyo outbreak is unprecedented," Kaseya told a press briefing after speaking with World Health Organization director general Dr Tedros Adhanom Ghebreyesus.

More than two-thirds of Ebola deaths are happening in the community rather than in treatment centres — a troubling sign of uncontrolled spread. In a treatment centre run by Médecins Sans Frontières in Bunia, the capital of Ituri province, 90% of admitted patients don't appear on authorities' lists of contacts of known cases.

Contact tracing has been insufficient, with only 10 contacts identified for every Ebola patient when the expected number would be around 40, Kaseya said.

Where The Outbreak Is Spreading

Ebola is a viral haemorrhagic fever that causes vomiting, diarrhoea, organ damage and internal bleeding. The outbreak is centred on the conflict-affected mining province of Ituri but has spread to Nord-Kivu, Sud-Kivu, Haut-Uele and Tshopo provinces.

Uganda recorded 20 cases before bringing its outbreak under control. DRC authorities are now investigating a suspected Ebola death on a boat heading to the capital Kinshasa from the northeast, with other passengers being quarantined and tested.

The New Response Plan

Health officials announced a dramatic shift in strategy, moving from contact tracing to active case searching.

"We're starting now the phase for scaling up," said Dr Wessam Mankoula, acting head of emergency preparedness and response at Africa CDC. Community health workers will begin "moving from door to door" asking households if anyone is sick with Ebola symptoms.

The response will also include:

• A "village-centered response" involving communities directly
• Greater use of digital tools for tracking
• Increased action in camps for people displaced by conflict
• Use of antiviral remdesivir on a compassionate basis
• Testing whether the Ervebo vaccine, licensed for a different Ebola strain, could help

Early data suggests Bundibugyo causes less serious disease and "zero death" among people who received the Ervebo jab, officials said.

Wider Health Impacts

The outbreak is disrupting essential healthcare as fear keeps families away from clinics. In Mongbwalu, the mining town at the outbreak's centre, the proportion of children receiving their first measles dose has fallen 69%, Unicef warned.

"Only the public health measure will not be enough to quickly control or stop this outbreak," said Dr Placide Mbala Kingebeni, Africa CDC director of research, clinical trials and innovation.

The conflict-affected region where the outbreak is centred makes the response even more challenging, with displaced populations and limited healthcare infrastructure complicating efforts to track and treat cases.

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Sources:

• Ebola virus behind massive outbreak in DRC could be mutating, officials say - The Guardian