Ebola outbreak in eastern Congo reaches 60 health zones as it outpaces containment efforts

On Friday, Congo's Ministry of Health published its latest figures, and they showed the Ebola outbreak in the east of the country had reached two more health zones, Biena and Manguredjipa, both in North Kivu province. That brings the total number of affected health zones to 60. The outbreak is now the fastest-growing in the disease's history.

The ministry's data count 5,794 confirmed cases, including 2,786 deaths. The overall case fatality rate stands at 48%, but the rate in the new zones is much higher. The ministry attributes that in part to delays in mounting a response there. North Kivu as a whole has a fatality rate close to 69%, among the highest in the country, even though the large majority of cases are concentrated in Ituri province in the northeast.

The pace of spread is the central problem. The outbreak is moving faster than the work of tracking and slowing it. Officials say most cases and deaths are occurring in communities, outside the network of contacts being monitored. The conditions are punishing: insecurity, displacement, a strike by health workers, and heavy movement of people. The World Health Organization has said the outbreak remains out of control and is on track to surpass the 2014-2016 West Africa epidemic, the deadliest on record, which killed more than 11,000 people, mainly in Guinea, Liberia and Sierra Leone.

The timeline shows how much ground was lost early. The outbreak was declared in mid-May, but officials believe the virus had been circulating since February. It has grown from three health zones to nearly 60.

On Friday, Doctors Without Borders said it had opened a new treatment center in Beni, in North Kivu, which it described as one of the hardest-hit areas. In a statement, the group said the center allows rapid treatment of patients, strengthens contact tracing, and supports health authorities trying to contain the virus.

The day before, Congo began vaccinating health workers and other front-line workers with Ervebo, a vaccine that worked in earlier outbreaks caused by the more common Zaire type of Ebola. This outbreak, however, is caused by the rarer Bundibugyo virus, for which there is no approved vaccine or treatment. Clinical trials are under way to find a licensed vaccine.

Containment measures have changed daily life across the six affected provinces. Public gatherings have been limited, social distancing introduced, and airports closed. Ituri, already ravaged by rebel violence, has been hit particularly hard. The government has installed health and sanitary equipment at some locations, but advocacy groups say more must be done to build trust within communities.

The risk also extends past Congo's borders. Uganda declared itself free of Ebola last month, but the WHO said Wednesday that cross-border spread remains a danger. WHO expert Marie Roseline Belizaire said the Central African Republic is now considered the country at highest risk of spillover, followed closely by South Sudan, as the outbreak has pushed toward border areas. Whether the case count overtakes West Africa's toll, and whether the virus crosses into either of those countries, are the developments to watch.