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An epidemic in two eastern provinces of the Democratic Republic of Congo has become the worst known epidemic of the deadly Ebola virus in the country's history.
The Congolese Ministry of Health announced Saturday in a statement that 326 people had been infected with the Ebola virus in the provinces of North Kivu and Ituri.
This worsens this epidemic compared to a 1976 outbreak in Yambuku, which infected 318 people and killed 280 people. This outbreak was the first time scientists identified what is now known to be the deadliest strain of Ebola. An epidemic in the city of Kikwit in 1995 infected 315 people, 250 of whom died.
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, mainly in Liberia, Guinea and Sierra Leone. In 2000, in Uganda, a strain of Sudanese Ebola virus infected more than 400 people.
After a first appearance under control, the number of cases in North Kivu province increased in September and October, which worried public health officials around the world. 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 widely that the Ebola virus could become endemic in Central Africa.
The Congolese Ministry of Health, the World Health Organization and non-governmental groups such as the Red Cross and Doctors Without Borders have sent hundreds of people to the epicenter of the epidemic. They vaccinated more than 28,000 people, including those who have been in contact with Ebola victims and front-line health workers who would be most exposed to the virus.
But the response was hampered in part by the volatile security situation in which dozens of armed groups opposed to the government threatened or attacked health workers.
A bomb attack in late August, blamed on Islamist activists from across the Ugandan border, interrupted the reaction in the city of Beni for several days, allowing the virus to spread further. Last month, two health workers employed by the Congolese army were killed in an ambush.
"No other epidemic in the world has been as complex as the one we are currently experiencing." Since their arrival in the region, the intervention teams have been threatened with physical assaults, repeated destruction of their equipment and kidnappings, "said Oly Ilunga Kalenga. the Congolese Minister of Health, said in a statement.
The current outbreak began in late July, probably when the virus spread during a burial in the family of a sick woman. The virus then spread to Beni, a regional shopping center of about a quarter of a million inhabitants. From there it extended to Butembo, a hub of international trade on the border with Uganda.
About half of the cases identified to date, 159, have been reported in Beni. 36 others were identified in Butembo. The World Health Organization has sent aid to Uganda, Rwanda, Burundi and South Sudan in anticipation of the risks of transmitting the virus at international borders.
"There is still a long way to go to control the intense transmission in the city of Beni and the emerging hot spots in the villages around Beni and Butembo," said the World Health Organization in a weekly assessment the situation on the ground.
North Kivu is home to about eight million people, about one million of whom are internally displaced after years of ethnic conflict. It is the largest province of Congo outside the capital, Kinshasa.
Oliver Johnson, guest lecturer in global health at King's College London and co-author of "Getting to Zero," a book on the Ebola outbreak in 2014-2015 in Africa. West, said the conflict in eastern Congo was raising distrust of the government in Kinshasa, and of all the international groups that could arrive on the scene to try to help.
"There is a lot of suspicion that Ebola messages and the epidemic are fake and are part of a conspiracy, which makes it very difficult to convince people to seek treatment or change their behavior to protect themselves," said Johnson in an email on Sunday. "Stakeholders face a real challenge in gaining physical access to affected communities: bringing a sick patient together by ambulance to a treatment center, talking to communities to prevent spreading or distributing the vaccine."
Violence in North Kivu has limited the US response to the epidemic. After an attack on a Congolese army base in August, the state department ordered the US Agency for International Development and Centers for Disease Control and Prevention to leave. the sector, first to the regional capital Goma, then to Kinshasa, at 1,700 km. from the epicenter of the epidemic.
The return of CDC field staff in the capital "exposes the response to the risk of failure at a critical time," Johnson said.
According to the World Health Organization, 29 new cases have appeared in the region over the past week. Three health workers were among the new victims.
The WHO said the risk of spreading the virus beyond national or international borders "remains very high." The Ministry of Health has deployed experts in preparation in ten provinces of North Kivu.
Health officials are monitoring more than 5,400 people who have been in contact with Ebola victims, a practice known as contact tracing, with the goal of treating any new cases at the first sign of life. ;infection.
"The epidemic remains dangerous and unpredictable, and we must not let our guard down," said Minister of Health Ilunga Kalenga. "We must continue to seek a very dynamic response that requires permanent readjustments and real ownership at the community level."
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