Congo Ebola outbreak

Where things stand

The Ebola epidemic in the Democratic Republic of Congo has passed 3,200 confirmed infections and at least 1,405 deaths, according to government data released on Sunday, and the pace of accumulation remains the defining feature of the outbreak, with roughly 1,000 cases added in ten days. Authorities attribute part of that jump to expanded testing, so some of the rise reflects better detection rather than purely new transmission, though the scale of the increase is not explained by testing alone. Geographically the World Health Organization now describes the virus as present in five provinces, two of them recently affected, with close to 90 percent of cases concentrated in north-eastern Ituri, following the earlier spread into a previously untouched health zone in Haut-Uele. The outbreak was declared on 15 May. The labour dispute that had appeared only as a general reference to wage strikes hampering containment now has a concrete shape: health workers at the Ebola treatment centre in Bunia and at other sites stopped work on Saturday in protest at unpaid bonuses, according to Al Jazeera and Breitbart, with the walkout coinciding with documented cases passing 3,000 and a rise in reported deaths. That places the strike at the centre of the response in the province carrying the large majority of infections. The epidemic is caused by the Bundibugyo strain, for which no approved vaccine or treatment exists, a constraint that separates it from previous Congolese outbreaks where licensed vaccines were available. A first human trial of a Bundibugyo-specific vaccine candidate has been reported, but it offers nothing to the current response, which rests on case finding, isolation and supportive care delivered by staff who say they are not being paid what they are owed.

The outbreak is caused by the Bundibugyo strain of Ebola, a rare variant for which no licensed vaccine or treatment exists. Clinical trials launched earlier in the epidemic remain the only route to a strain-specific intervention, and nothing new has been licensed in the interim. Response performance is measured largely through contact tracing, which stands at 73.9 percent, below the level health officials consider necessary to interrupt transmission; that gap is the clearest published indication of why the epidemic continues to spread. The outbreak has now moved across dozens of health zones in the country's north-east, including Haut-Uele province.