An outbreak in two eastern provinces of Congo has become the most known epidemic of the lethal Ebola virus in its history.
Congolese Health Ministry said in a statement Saturday that 326 people had been infected with the Ebola virus in northern Kivu and Ituri provinces.
This makes this outbreak worse than an epidemic in 1976 in Yambuku, which infected 318 people and left 280 dead. The outbreak was the first time researchers identified what is now known to be the deadliest strain of the Ebola virus. An outbreak in the city of Kikwit in 1995 infected 315 people, of which 250 killed.
The current outbreak is now the third worst Ebola epidemic in modern history. An outbreak in West Africa from 2013 to 2015 infected more than 28 600 people mostly in Liberia, Guinea and Sierra Leone. An outbreak in Uganda in 2000 of the Sudan strain of the Ebola virus infected more than 400 people.
After they were initially displayed under control, the number of cases in northern Kivu province in September and October sprang to worrying public health professionals worldwide. In a briefing at Capitol Hill last week, Robert Redfield, Director of Centers for Disease Control and Prevention, warned that the outbreak could spread so much that the Ebola virus could endemic to Central Africa.
Congolese Ministry of Health, the World Health Organization and non-governmental groups such as the Red Cross and MSF have sent hundreds of people to the epicenter of the outbreak. They have vaccinated more than 28,000 people, including those who have come into contact with Ebola victims and primarily healthcare professionals who would be most susceptible to the virus.
But the response has been partially subdued by a volatile security situation where dozens of armed groups opposed to the government have threatened or attacked health workers.
A bombing at the end of August blamed on Islamic militants from Uganda's border, turning off the answer in the city of Beni for several days, so that the virus spread further. Last month, two health workers were hired by the Congolese military in a hiding place.
"No other epidemic in the world has been as complicated as the one we currently experience. Since their arrival in the region, respondents have encountered threats, physical abuse, repeated destruction of their equipment and kidnapping," Oly Ilunga Kalenga, Congolese healthcare said in a statement.
The current eruption began in late July, probably when the virus spread at a funeral through the family to a woman who had become ill. The virus later spread to Beni, a regional trade center of about a quarter of a million inhabitants. From there it spread to Butembo, an international trading center on the border with Uganda.
About half of the cases identified so far, 159 have risen in Beni. Another 36 has been identified in Butembo. The World Health Organization has sent aid to Uganda, Rwanda, Burundi and South Sudan in anticipation of the possibility that the virus could cross international borders.
"There is still a challenging way forward to control intensive transfer in the city of Beni and new hotspots in villages around Beni and Butembo," the World Health Organization said in a weekly review of the situation on the ground.
Northern Kivu is home to about 8 million people, one million of whom are internally displaced after years of ethnic conflict. It is the most populous province in Congo outside the capital, Kinshasa.
Oliver Johnson, a visiting lecturer in global health at King's College London and co-author of "Getting to Zero: A Doctor and a Diplomat on Ebola Frontline," a book about the Ebola eruption 2014-2015 in West Africa said that Conflict In eastern Congo, there has been distrust of the government in Kinshasa and of all international groups that may come in place to try to help.
"It is highly suspected that the messages about Ebola and the outbreak are fake and part of a conspiracy, making it very difficult to persuade people to seek treatment or change behaviors to protect themselves," Johnson said in an email Sunday. "It's a real challenge to respond to getting physical access to the affected communities, that is, gathering a sick patient through an ambulance to take them to a treatment center, to engage in communities to prevent further spread or to distribute the vaccine."
The violence in northern Kivu has limited the US response to the outbreak. Following an attack on a Congolese Armbase in August, the Department of State ordered replies from the United States International Development Agency and CDCs in the area, first to the capital Goma and then to Kinshasa, 1,700 miles from the outbreak epicenter.
Move the CDC field staff back to the capital "sets the response to risk of failure at a critical time," Johnson said.
The World Health Organization said 29 new cases had appeared in the region during the past week. Three healthcare staff were among the new victims.
The World Health Organization said that the risk of the virus spreading over domestic or international borders "is very high". The Health Secretariat has deployed emergency preparedness experts to ten provinces around Nordkivu.
Health officials keep an eye on over 5,400 people who have come into contact with Ebola victims, an exercise called contact tracing, with the aim of getting new cases to be treated at the first sign of infection.
"The epidemic remains dangerous and unpredictable, and we must not let our guard," said health minister Kalenga. "We must continue to drive a very dynamic response that requires permanent adjustments and genuine ownership at Community level."