Congo’s Bundibugyo Ebola outbreak reaches 60 health zones and 5,794 confirmed cases

The World Health Organization’s latest Disease Outbreak News on the Bundibugyo-virus Ebola epidemic in the Democratic Republic of the Congo puts the tally at 5,794 confirmed cases and 2,786 deaths as of 26 August. The crude case fatality ratio is 48.1 percent. The outbreak now covers 60 health zones in six of the country’s 26 provinces: Bas-Uélé, Haut-Uélé, Ituri, North Kivu, South Kivu and Tshopo. On 14 August the count of zones was 54.

Biena and Manguredjipa in North Kivu are among the newest zones on the list, together with Ganga and Viadana in Bas-Uélé, Mutwanga in North Kivu and Tshopo health zone in Tshopo province. Ituri remains the centre of gravity, with 4,802 confirmed cases, including 52 in the 24 hours to 26 August. Across the 60 zones, 81 new confirmed cases were logged that day from 19 zones. Ituri has 28 of its 36 health zones affected. North Kivu has 15 of 34.

North Kivu’s case fatality rate is near 69 percent, against the national 48 percent. Congolese health ministry data blame delayed response. Doctors Without Borders said on Friday it had opened a new treatment centre in Beni to cut the time between a suspected case and a bed. Health Minister Roger Kamba was photographed on Thursday giving vaccine to a health worker in Kisangani.

Africa CDC’s Yap Boum told a briefing that four zones, Kambala, Goma, Lubunga and Miti-Murhesa, had gone 42 days without a new case, the standard window of twice the incubation period. Uganda marked 42 Ebola-free days the same week and closed its own outbreak. Those clean zones sit beside Mongbwalu, Rwampara and Nizi in Ituri, which still report the highest incidence. Most new infections, WHO and Kinshasa both say, are appearing outside known contact lists, which means tracing is behind the virus.

The epidemic was declared in mid-May. Officials now think transmission began in February. Conditions that feed it are listed in every update: armed groups in Ituri and North Kivu, large displaced populations, a health-workers’ strike, and roads that do not hold in the rains. WHO has already said the outbreak is on a path that could pass the 2014-16 West Africa epidemic, which killed more than 11,000 people. That comparison is a warning, not a forecast. It turns on whether the village-level method Boum described, and the new Beni beds, can shrink the share of cases that never appear on a contact list.

Bundibugyo virus is less familiar to the public than Zaire ebolavirus, the strain behind most historic outbreaks. It is still a filovirus that kills close to half of confirmed patients in this wave. The operational fact that matters this weekend is narrower. Sixty zones are now in play. Four have gone quiet. The rest have not.