An Ebola outbreak centred on Ituri province in the Democratic Republic of the Congo has killed nearly 3,200 people among more than 6,500 cases since it began in mid-May. The outbreak has spread across six provinces in eastern Congo, where rebel violence, displacement and intense population movements are helping drive transmission.
Ituri is the epicentre of what has been described as history's deadliest Ebola outbreak. The disease is spreading faster than responders can trace cases and try to slow transmission, according to the information provided by health and UN agencies.
The outbreak is caused by the rare Bundibugyo virus. There is no approved vaccine or treatment for that strain, leaving containment measures, including testing, contact tracing and safe burials, at the centre of the response.
Those measures are under strain. A weak healthcare and surveillance system has limited the response, while insufficient laboratory testing and contact tracing have made it harder to identify infections and follow people who may have been exposed.
Burial teams have faced particular risks since May. Health workers and burial teams have been attacked by bereaved families, while team members face potential exposure to the virus and rejection within their own communities. They have also faced attacks from people demanding that bodies be buried according to local customs.
Traditional burial rites are prohibited as part of efforts to reduce transmission. The restriction has intensified tensions with families seeking customary funerals. Burial team members are paid $20 a day despite the hazards involved.
Authorities have begun vaccinating front-line health workers with the Evrebo vaccine. The World Health Organization said Evrebo could offer some protection against Ebola, though there is no conclusive evidence that it would work against the Bundibugyo virus responsible for the current outbreak.
UN agencies and partners have expanded their work with 35 additional mobile safe and dignified burial teams and 286 community-based teams in high-risk areas. More than 2,500 volunteers and civil protection personnel are involved in the response, according to the UN Office for the Coordination of Humanitarian Affairs.
The UN Secretary-General said the Ebola Bundibugyo outbreak in the Democratic Republic of the Congo requires “urgent” action and funding to rein in its alarming spread. The World Health Organization projects that the outbreak could surpass West Africa's 2014-2016 epidemic, which killed more than 11,000 people.
The immediate challenge is to extend testing, tracing and safe burial operations in an area affected by insecurity and population movement. The effectiveness of Evrebo against the current virus remains uncertain, and the available information does not specify the testing gaps by location, the funding required, or the longer-term sustainability of burial teams.
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