According to official figures, more than 5,000 people in the Democratic Republic of Congo have already died of Ebola. Here too, as with the number of cases, experts assume that there are unreported cases.
Kinshasa/Berlin. The number of Ebola infections and deaths in the Democratic Republic of Congo is increasing dramatically. According to the health authorities in the Central African country, 5,026 people have now died from the highly contagious fever. There are cases in eight provinces of Africa's second largest country. It is already the fastest-growing Ebola outbreak to date on the continent. What do you need to know about the situation?
How reliable is the information on Ebola cases?
"The number of cases reflects the dynamics of the outbreak fairly reliably. However, we know that there are significant unreported cases and gaps in surveillance," says Torsten Feldt, head of the tropical medicine department at Düsseldorf University Hospital. “According to current estimates, the actual number of infections could be two to three times higher than the official figures.”
“The confirmed numbers are probably the lower limit,” estimates Jürgen May, CEO of the Bernhard Nocht Institute for Tropical Medicine. "It may be that there is a delay in the reporting of new cases, a subsequent classification of suspected cases that have died, and a lack of reports of milder cases because they were never tested. A reliable figure for the unreported number is difficult to obtain and is not known."
Why is it so difficult to control this outbreak?
More than half of the deaths have occurred outside treatment centers, where each death poses a high risk of infection for families and the population. "These figures illustrate the gaps in monitoring. The increasingly critical security situation in Congo with displacement of population groups and limited access for aid organizations further complicates monitoring and combat measures dramatically," said Feldt.
Tracking contacts of Ebola patients is also critical. The African health authority Africa CDC has long been pointing out that too few contacts are actually recorded and tracked. In addition, many patients do not die in the Ebola treatment centers, but at home or in normal hospitals, where they were not recognized as having Ebola. In the case of the currently rampant Ebola pathogen of the Bundibugyo type, it is possible that the symptoms could be confused with a much more common malaria disease.
In addition, most of the cases have so far been recorded in the northeast and east of the huge country - regions where there have been armed conflicts for decades and where more than 100 militias are active. The uncertainty makes the work of helpers more difficult, but also prevents people from going to health centers to get tested. Furthermore, there are still many who deny the existence of Ebola, even though thousands of volunteers are doing educational work.
Is there a vaccine?
There is currently no vaccine against the Bundibugyo Ebola pathogen. The Ervebo vaccine, which was developed against the Zaire Ebola virus, could possibly offer some protection. A laboratory study with healthy people recently carried out in Germany showed that the vaccination can trigger a so-called T-cell reaction against the Bundibugyo and Sudan Ebola viruses. Studies on primates had already suggested this. T cells make a significant contribution to long-lasting immune memory.
Since hundreds of thousands of people - especially in the North Kivu region - were already vaccinated with Ervebo during the last major outbreak of the Zaire Ebola virus in Congo between 2018 and 2020, it should soon be possible to assess whether and to what extent this vaccination can now also protect against the Bundibugyo virus, says Christof Geldmacher from the Institute for Infectious and Tropical Medicine at the University of Munich. "This is currently being systematically recorded. Nevertheless, an approved specific Bundibugyo vaccine would be important as it would probably offer significantly better protection."
The aid organization Doctors Without Borders (MSF) also fears that production bottlenecks could limit access to the Ervebo vaccine. “Vaccines are only useful if they are available to people at risk of infection,” said Julien Potet, vaccine access expert at Doctors Without Borders. “In a situation where vaccines are urgently needed to contain outbreaks such as Ebola, we must leave no stone unturned to ensure that available vaccine stocks reach affected communities without delay.”
Can developing a vaccine against Bundibugyo stop the outbreak?
Clinical trials to evaluate vaccines specifically developed for the Bundibugyo virus have been underway since July - but these trials are still at an early stage. However, studies and production of the vaccines take months rather than weeks, says May. Widespread use is hardly realistic earlier than mid-2027. There are no official estimates of how long the Ebola outbreak will last.
