ABUJA, Nigeria — The Ebola outbreak that is spreading at unprecedented speed in Congo has not peaked yet and could be three times the current known size, according to data from authorities and Africa’s top public health agency.
It is history’s fastest Ebola outbreak, and the World Health Organization says it is on track to surpass the deadliest on record, which was between 2014 and 2016, with over 11,000 deaths across West Africa.
This latest outbreak has recorded 2,516 deaths out of the 5,290 confirmed cases as it rages in Congo’s vast eastern region, exacerbated by an intensely mobile population, including those displaced by armed conflicts, and distrust of medical authorities.
Less than 10% of cases are currently coming from known contacts, far below the 90-95% rate when the outbreak can be said to be under control, according to Yap Boum, head of emergency preparedness and response at the Africa CDC.
Boum told reporters Thursday that under current estimates only 30% to 40% of cases have been detected.
Here’s what the data shows about the outbreak:
At this stage, it’s recorded ten times more cases than history’s largest
Compared to the 2014-2016 West Africa Ebola outbreak that ended with over 28,000 cases, including more than 11,000 deaths, this outbreak has recorded ten times more cases and seven times more deaths by the 13th week from when it was declared, data from the Africa CDC shows.
Congo’s deadliest Ebola outbreak before now had been that of 2018-2020 with 3,400 cases and more than 2,200 deaths. This is moving 18 times faster in terms of the confirmed cases and 13 times faster regarding the deaths.
One key source of concern is that experts believe the outbreak began spreading from the mining town of Mongbwalu as early as February, months before authorities declared the outbreak on May 15.
Responders have traced only 16% of expected contacts
Africa CDC data from the past three weeks shows the contact tracing rate of those exposed to patients is 82% out of 19,630 contacts in total.
But that doesn’t give the full picture. The agency said with an average of 60 contacts per confirmed case, it was expecting 99,780 contacts to be recorded for the 1,663 cases it said it confirmed in that three-week period.
However, many of those contacts are not known, and therefore cannot be contacted for follow-up. Therefore, the “actual contact tracing rate is only 16% of the expected,” the Africa CDC said in its update.
It is caused by Bundibugyo virus, which has no approved vaccines or treatments, unlike the most common Ebola virus type. Its symptoms also are milder, which could mean that many patients feel less immediate need to alert responders or seek treatment.
A previously unaffected province has now recorded 2 cases
The health zones affected in the outbreak have grown from three at the onset to 56 across six provinces.
In the previously unaffected Bas-Uele province, two cases have been reported over the past week and a half in two separate parts of the province, data from Congo’s government has shown.
However, the spread is slowing down in some places, such as in South Kivu province, which has not recorded any case for 79 days.
Most people are dying without medical attention
Deaths in the community – that is outside Ebola treatment centers – have been on a steady rise in recent days, and constituted an overwhelming 97% of the deaths reported on August 17th, the Africa CDC data shows.
Despite this, only 20% of health alerts are coming from within the community, underscoring the need to engage more communities.
And although the overall case fatality rate is 46.7%, it is quite high in some places such as North Kivu, one of the country’s most populous, where the rate is 68.2%.
The data suggests most people are still not reporting symptoms early or at all for various reasons: misinformation that the outbreak isn’t real, initial preference for traditional medicine, fear of being kept in isolation especially in the event that initial symptoms are of something else, or the lack of severe symptoms.
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