When three members of his hospital team tragically died within days of treating the same patient, Dr Richard Lokudu suspected Ebola had been spreading before authorities detected the outbreak, a suspicion quickly confirmed by the Democratic Republic of Congo (DRC) officially declaring an Ebola epidemic in early April. The patient, identified as a surgical assistant, was admitted on April 2nd and scheduled for surgery on April 7th, a crucial appointment that would become the epicenter of a devastating public health crisis.
“Before the outbreak was declared, we discovered at the hospital that there was a patient who had been admitted on 2 April and who was due to undergo surgery performed by our team on 7 April,” Lokudu told Al Jazeera. This patient, identified as a surgical assistant, was crucial to the planned surgical procedures and the subsequent death of the team.
The outbreak’s initial timeline reveals a complex sequence of events. Authorities, upon recognizing the distinct symptoms of Ebola – including neurological disturbances and severe illness – declared the outbreak in Ituri Province, a region already grappling with conflict and limited access to healthcare. The initial outbreak was centered in Mongbwalu Health Zone, a district within Ituri, with subsequent expansion to other areas of the province.
Three months after the declaration, the DRC recorded over 4,900 confirmed cases of Ebola, with over 2,300 deaths, according to health authorities and international agencies. The death toll has surpassed the previous record set during the 2018–2020 Ebola outbreak, which resulted in 2,299 deaths, highlighting the severity of the current situation. The current outbreak is attributed to Bundibugyo virus disease (BVD), a rare form of Ebola first identified in Uganda in 2007. Unlike the Zaire strain, which has vaccines and some treatments available, there are currently no licensed vaccines or specific approved therapies for BVD, significantly complicating containment efforts.
The disease’s spread has been complicated by armed conflict, population movements, and delays in identifying cases. Health workers are relying on early detection, supportive care, infection-prevention measures, and community engagement to limit transmission. The World Health Organization (WHO) has cautioned that the outbreak is concentrated in the Ituri Province and is spreading to other areas, emphasizing the challenges of coordinating efforts amidst ongoing conflict, population displacement, and mistrust within communities.
The current outbreak is also linked to the Bundibugyo virus disease, which is a rare form of Ebola, first identified in Uganda in 2007. The DRC has recorded Ebola outbreaks since 1976, and has extensive experience responding to the disease, but health workers acknowledge the limitations of experience alone. Congolese authorities have acknowledged that delays in identifying cases contributed to the spread of the virus, particularly when the initial investigation took time.
The Africa Centres for Disease Control and Prevention (Africa CDC) is supporting the response through surveillance, laboratory work, infection prevention, patient care, and community engagement. Dr. Justus Nsio, Africa CDC’s field incident manager for the DRC’s Ebola response, stated that reliance on laboratory facilities outside the province slowed confirmation of cases during the early stages of the outbreak. He said that, in the early stages of the outbreak, the DRC lacked the capacity to perform laboratory tests in Ituri, which hampered the situation.
In Ituri, Ebola response teams are operating in a province that has endured decades of armed conflict, where conflict has intensified the difficulties of movement and access to communities. Armed groups have fought for influence and control over mineral-rich areas, making it difficult to navigate and accessing some communities.
WHO said the outbreak was initially concentrated in Mongbwalu Health Zone in Ituri before expanding to other provinces. The DRC has recorded Ebola outbreaks since 1976, and has developed extensive experience responding to the disease.
For health workers in Ituri, stopping Ebola is not only a medical challenge; it is also a race against conflict and access. Dr Charles Kashindi, head of Nyakunde Hospital, nearly 40km (25 miles) southwest of Bunia, says stopping Ebola is not only a medical challenge; it is also a race against conflict and access.
Dr Thierno Balde, WHO incident manager for Bundibugyo virus disease in the DRC, says movement between affected areas has helped the virus spread. He said, ‘The geographical spread of the outbreak is mainly linked to the uncontrolled movement of people, particularly those who are ill, between localities that are already affected and neighboring areas.’ The DRC has recorded Ebola outbreaks since 1976, and has extensive experience responding to the disease, but health workers acknowledge the limitations of experience alone. The situation is not very favourable. We are in a war zone, and the province is under a state of siege.”
Source: Al Jazeera Africa
