The Ebola epidemic in the Democratic Republic of the Congo (DRC) has reached 10,990 confirmed cases and 5,354 deaths, according to the latest bulletin from the European Centre for Disease Prevention and Control (ECDC), published on 10 November with Congolese data through the 8th. Over one week, 70 new confirmed cases and 31 deaths were added.
Declared on 15 May in Ituri province, in the country's north-east, the epidemic is caused by Bundibugyo virus, one of the six known species in the Orthoebolavirus genus — and the one for which no vaccine or treatment is licensed. Two days after the outbreak began, on 17 May, the World Health Organization (WHO) declared a public health emergency of international concern.
Eight provinces, 67 health zones
The outbreak has spread to eight of the DRC's 26 provinces and reached 67 of the 178 health zones in those regions. It remains concentrated in the east:
- Ituri: 7,654 confirmed cases and 3,613 deaths, in 28 of 36 health zones
- North Kivu: 2,720 cases and 1,488 deaths, in 17 of 34 zones
- Haut-Uélé: 491 cases and 214 deaths
- Tshopo: 98 cases and 32 deaths
Bas-Uélé, Nord Ubangi, South Kivu and Sud Ubangi together account for fewer than 30 confirmed cases. Another 966 people are hospitalised in isolation and 2,951 have recovered.
The crude fatality rate is 48.7% — almost one death for every two confirmed cases. In North Kivu, a province whose health system has coexisted with armed conflict for years, the figure reaches 54.8%, the highest in the country, according to the WHO bulletin of 6 November. That same document recorded that of the 512 deaths counted since 21 October, 335 occurred in communities rather than in treatment centres, indicating that some patients die without reaching care.
Contact tracing is the other weak point. Follow-up covers 79.2% of identified contacts in the affected provinces, according to the ECDC; the WHO calculates an average of 86% against a 95% target. The ECDC itself says the epidemic in the DRC is likely larger than the reported figures.
Kenya and Nigeria: nine cases and one
Outside the DRC, two African countries have recorded cases in this epidemic. Kenya has nine confirmed cases and two deaths, all linked to the chain of the first patient — eight of them in a single cluster that includes four health workers. The last case was reported on 20 October and the second death on 23 October; six patients have recovered. Kenyan authorities traced 62 contacts in the neighbouring country and, as of 5 November, had screened 760,415 travellers at designated points of entry.
Nigeria reported one case on 20 October: a patient who had travelled from Uganda and was medically evacuated to Switzerland on 26 October, where she remains in treatment along with her husband, a close contact. Uganda, which had 20 cases and two deaths, declared its outbreak over in July.
Several European countries treated imported or evacuated cases over the course of the year — Germany, France, the Netherlands, Switzerland, the United Kingdom and Czechia. In November, the United Kingdom evacuated a British health worker. For the general population of the European Union, the ECDC rates the risk as very low and considers screening returning travellers ineffective, recommending instead clear information on symptoms and what to do if they appear.
Vaccine: one trial and two candidates waiting
As no approved immunisation exists against Bundibugyo, the WHO and its Strategic Advisory Group of Experts on Immunization (SAGE) have recommended using the licensed Ervebo vaccine — developed against Zaire ebolavirus — only within a research protocol. The DRC began vaccinating frontline workers on 27 August, starting in Kisangani, with a focus on Tshopo, Bas-Uélé and Haut-Uélé.
On 23 October the phase 2/3 Tumaini trial began in Bunia, the capital of Ituri, testing Ervebo. WHO expert committees recommended adding two candidates to the study: ChAdOx1-BDBV, from Oxford and India's Serum Institute, and mRNA-1469, from Moderna. Both will join after national approvals. Other candidates — two rVSV-based platforms and MVA-CR19 — remain in preclinical or early clinical stages.
The WHO risk assessment of 14 August, now under revision, rated the risk as very high in the DRC, high in countries sharing a land border with it and low in the rest of the continent and globally. The organisation recommends against travel or trade restrictions.
With information from the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO).
