Congo Ebola Outbreak Spreads as MSF Warns of Missed Cases and Hospital Infections

Six months into the Ebola outbreak in the Democratic Republic of Congo, the virus continues to spread with many infections likely going undetected and transmission occurring in healthcare facilities, medical charity Médecins Sans Frontières (MSF) warned on Thursday.

The outbreak, declared in mid-May and caused by the rare Bundibugyo strain, has recorded more than 11,000 confirmed cases. It is now the second-largest Ebola outbreak on record. There are currently no approved vaccines or treatments for this strain.

MSF said the response remained severely affected by shortages of trained and paid staff, fuel for ambulances, surveillance teams and essential supplies needed to manage suspected infections safely.

Dr Javid Abdelmoneim, MSF’s international president, said significant funding had been committed to the response but was not reaching frontline workers in sufficient measure.

“Despite the vast amounts of money provided for the response, many frontline responders are left trying to contain the outbreak with empty hands and empty pockets,” he said.

Abdelmoneim described the problems witnessed by MSF teams as unacceptable, calling on the Congolese government and United Nations agencies, including the World Health Organization (WHO), to ensure that available resources translate into practical support for affected communities.

The Congolese government did not immediately respond to a request for comment.

Many infections may be going undetected

British epidemiologist Neil Ferguson, who is modelling the outbreak in real time, said on Wednesday that authorities were probably identifying only about half of all infections.

His team estimates that between 2,000 and 3,000 people are currently infected with Ebola in Congo. Ferguson warned that continued gaps in case detection could allow transmission to persist for another year and potentially make the outbreak larger than the 2014-2016 epidemic in West Africa.

That outbreak recorded more than 28,600 cases and over 11,000 deaths, making it the largest Ebola epidemic on record.

Healthcare facilities and insecurity add to risks

MSF said conditions varied across the country, particularly in regions affected by armed conflict. In Ituri province, only 9 per cent of Ebola patients treated by the organisation were known contacts of previously identified cases.

Nearly two-thirds of reported Ebola-related deaths over the past month occurred in communities rather than treatment centres, the charity said.

Shortages of basic supplies, including water and chlorine, have also increased the risk of infections in healthcare settings. In the Beni health zone of North Kivu, almost three-quarters of Ebola patients are believed to have contracted the virus in such facilities.

The WHO acknowledged difficulties, including delays in paying healthcare workers. Director-General Tedros Adhanom Ghebreyesus said the organisation was working with Congolese authorities, Africa CDC and other partners to strengthen the response.

He also identified insecurity and attacks on health facilities as major obstacles. An attack in Cantine-Aloya, North Kivu, last week killed 66 civilians, including three health workers, according to Tedros.

The violence also disrupted contact tracing, leaving more than 1,000 people unaccounted for during follow-up efforts and three confirmed Ebola patients missing.