Ebola Outbreak in Eastern Congo Spreads to Two New Health Zones, Totaling 60 Affected

The latest figures from Congo's Ministry of Health, published Friday, put the country's Ebola outbreak at 5,794 confirmed cases and 2,786 deaths. Two more health zones, Biena and Manguredjipa in North Kivu province, have now been added to the list, bringing the total number affected to 60. The outbreak is described as the fastest-growing Ebola outbreak in history.

The ministry data show that in the two new zones the case fatality rate runs well above the national rate of 48%, a gap officials attribute in part to delayed response efforts. Across North Kivu as a whole, the fatality rate is close to 69%, among the highest in the country. Most cases are concentrated in Ituri province in the northeast, but North Kivu's death rate has made it a particular worry.

The conditions are punishing. The outbreak is moving through a region marked by insecurity, displacement, a health workers' strike and heavy movement of people. The World Health Organization has said the outbreak remains out of control and is on track to pass 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 government's figures indicate the virus is spreading faster than efforts to track and slow it.

The timeline is longer than the official one. 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, and most cases and deaths are occurring in communities, outside the network of contacts that responders are monitoring.

On Friday, Doctors Without Borders said it had opened a new treatment center in Beni, in North Kivu, in what it called one of the hardest-hit areas. The group said the center allows rapid treatment of patients, strengthens contact tracing and supports health authorities in containing the virus.

There is also a vaccine development. On Thursday, Congo began vaccinating health workers and other front-line workers with Ervebo, which was effective in earlier outbreaks caused by the more common Zaire type of Ebola. But the current outbreak is caused by the rare Bundibugyo virus, for which there are no approved vaccines or treatments. Clinical trials are underway to find a licensed vaccine.

The control measures themselves have changed daily life in the six affected provinces. Limits on public gatherings, social distancing and airport closures have disrupted routines, particularly in Ituri, which has been ravaged by rebel violence. 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. Neighboring 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 expanded toward border areas. Those two countries, along with the pace of tracing in North Kivu, are the places to watch next.