Ebola suspected cases in DRC more than double as towns lock down

Suspected cases of Ebola in the Democratic Republic of the Congo have more than doubled in the past week, health officials said Thursday, prompting local lockdowns in Kasai province and heightened international concern.

The national health agency said suspected infections rose from 28 to 68 in recent days after an outbreak was declared last week in the towns of Bulape and Mweka. The cases have spread to two additional districts, and authorities reported 20 deaths, including four health workers, the U.S. Centers for Disease Control and Prevention said. The CDC said there have been no reported cases in the United States linked to the current outbreak and assessed the overall risk to Americans as low, but it issued a Level 1 travel notice advising travelers to take precautions if visiting the DRC.

Local authorities in Kasai, a remote region about 621 miles from the capital, Kinshasa, have imposed confinement measures and erected checkpoints to restrict movement in and out of affected areas, the province governor said. The World Health Organization said the first confirmed case in the current outbreak was a pregnant woman who sought care at Bulape General Reference Hospital on Aug. 20 with high fever, bloody stool, excessive bleeding and weakness. She died five days later; laboratory testing on Sept. 4 confirmed Ebola, the WHO said.

Officials and aid agencies warned that containment will be complicated by limited resources and insecurity in parts of the country. Dr. Ngashi Ngongo, a principal adviser with the Africa CDC, told the Associated Press that ongoing fighting in eastern Congo could hinder response efforts and that what began as cases in two districts has now reached four. "It was two [districts], now it is four," she said.

Local officials described the outbreak as a crisis for residents. Francois Mingambengele, administrator of the Mweka territory that includes Bulape, told Reuters, "It's a crisis, and cases are multiplying." Emmanuel Kalonji, a resident of Tshikapa, the Kasai provincial capital, said some villagers have fled to avoid infection but that limited resources make survival uncertain. Ethienne Makashi, a local water, hygiene and sanitation official, said one patient was showing progress, providing a rare sign of hope for those receiving care.

Ebola virus disease is transmitted through direct contact with the blood or body fluids of infected people or with contaminated objects, as well as contact with infected animals. Symptoms can include fever, headache, muscle pain, weakness, diarrhea, vomiting, abdominal pain and unexplained bleeding or bruising. The disease can be severe and has a high mortality rate without treatment.

The DRC has recorded repeated Ebola outbreaks since Ebola was first identified in the country in 1976. The current flare-up is the 16th recorded outbreak in the DRC and the seventh in Kasai province since 2008. Large outbreaks in eastern Congo in 2018 and 2020 each killed more than 1,000 people. The largest recorded Ebola epidemic occurred in West Africa from 2014 to 2016, when more than 28,600 cases were reported.

There are FDA-approved treatments for Ebola, including the antibody therapies Inmazeb and Ebanga, and an FDA-approved vaccine that is typically used only for ring vaccination of contacts and responders during outbreaks rather than for general public use. Health agencies are mobilizing testing and response teams, and vaccination strategies used in past outbreaks, including targeted vaccination of contacts and frontline workers, are expected to be part of the response.

Earlier this year, Uganda declared an outbreak of the Sudan virus, a strain that causes a severe form of Ebola hemorrhagic fever; that outbreak was declared over in April. In February, two patients in New York who had recently traveled from Uganda were evaluated for possible Ebola infection but later tested negative. The first person confirmed with Ebola in the United States was a traveler from Liberia in 2014 who died after being treated in the United States.

Health authorities in the DRC and international partners said they are working to trace contacts, expand surveillance and establish treatment and isolation centers. Officials urged communities to report suspected cases promptly and follow public-health guidance on safe caregiving, handling of the sick and burial practices while response teams seek to contain the spread.