Reported Ebola cases in Congo dipped last week. Africa CDC is asking everyone not to celebrate yet. If you're new here, a quick catch-up. Since May 15, the Democratic Republic of the Congo has been fighting an outbreak of Bundibugyo virus, an Ebola species with no approved vaccine or treatment. Ituri province is the epicenter, North Kivu is the hotspot, and the outbreak now reaches 63 health zones in seven provinces. This is Ebola Watch. Today: whether a falling curve means anything, an MSF doctor flown to the Netherlands, a transit centre lost to fire in Bunia, and a killing in Butembo that shows what mistrust costs. This story isn't over, so follow us wherever you're listening and the next chapter comes to you. We start with the numbers.
Ananya S, writing for New Kerala:
The Africa Centres for Disease Control and Prevention warned Thursday that a recent decline in reported Ebola cases in the Democratic Republic of the Congo may reflect disruptions to disease surveillance rather than a sustained reduction in transmission, as the outbreak has claimed nearly 4,000 lives.
So cases go down, and the agency says, careful, that might just mean we stopped seeing them. Which is it? Africa CDC's Wessam Mankoula won't say it's progress. The curve has largely plateaued for four to five weeks and dropped in the latest week. But insecurity and community resistance have hampered surveillance in several areas. His words: 'Falling in this curve doesn't mean that the outbreak is totally under control.' And the new count? Per the DRC's latest situation report, 8,224 confirmed cases and 3,982 deaths as of Tuesday, September 29. That's a case fatality rate of 48.4 percent. Of the 63 affected health zones, 45 still report active transmission. Over the last three weeks, Ituri's cases fell about 32 percent, while North Kivu kept rising. Now the contact tracing number. This week we had the ministry at 79.2 percent, and WHO at over 85. Africa CDC says what? About 23 percent of estimated contacts are being followed up. And I want to be precise, because these aren't necessarily contradictory. The higher figures describe follow-up of identified contacts. Africa CDC is measuring against how many contacts there should be: about 14 found per confirmed case, against an expected level of around 60. And nearly 80 percent of new cases are detected outside known contact lists. So the list is well tended. It's just missing most of the people. That's Africa CDC's argument, yes. Different denominators, and listeners deserve to hear both.
Carlos Robles, writing for BNO News:
An aid worker infected with Ebola has been evacuated from the Democratic Republic of the Congo (DRC) and admitted to a hospital in the Netherlands, according to health officials. The patient is a staff member of Doctors Without Borders who had been working on the outbreak response.
Okay, the question people will ask. A confirmed Ebola patient landing in Europe. Should anyone in Leiden be worried? Here's what officials have said. MSF says the staff member tested positive for Bundibugyo virus disease. Reuters reports the Dutch health ministry described the patient as an MSF doctor. Leiden University Medical Center confirmed the arrival at 10 p.m. local time Thursday, on a special flight with precautionary measures, into a high-level isolation unit. The hospital says it runs regular drills for exactly this. And that's all we get about the patient? That's all, and rightly so. MSF and the Dutch ministry both cited privacy. What MSF did say is the uncomfortable part: despite training and the highest possible protection, 'the risk of exposure can never be completely eliminated.' And this isn't the only health worker story this week. No. In Kisangani, in Tshopo province, a doctor died of Ebola on September 24. The provincial health minister, Simon Bokongo, says that hospital closed for 21 days after more than 10 staff tested positive, with over 123 contacts identified. MSF put it simply: 'Healthcare workers are among those at greatest risk.' MSF also says the true toll is likely higher than reported, because of gaps in surveillance and case detection.
From UN News:
The enormous challenge of halting the spread of Ebola in the Democratic Republic of the Congo (DRC) just became even harder after a key transit centre for patients requiring treatment burned down in Ituri province.
This is Kigonze. On Wednesday we talked about soldiers searching that camp in Bunia and families running. Now the camp is empty and the Ebola centre is gone. The fire was Tuesday evening. The UN's senior Ebola official in Congo, Julien Harneis, called it 'deeply disappointing' and says the camp, which sheltered some 19,000 people, now lies abandoned. A transit centre is where suspected cases are isolated and tested before moving to treatment. His point: when you lose one, you lose capacity and investment and have to start again. Here's the line that matters for tracing. Reuters spoke to two health officials who said about 1,000 Ebola contacts lived in that camp. One says only about a fifth have since been traced. Which is Africa CDC's warning, made concrete. The UN refugee agency told Reuters there have been 88 confirmed cases and 56 deaths in Congo's displacement sites, and it says that's likely an underestimate. And UN News reports fighting has restricted access in Fataki, Drodro and Lita, and delayed lab samples moving from Fataki to Bunia. And in North Kivu? Two people involved in the Ebola response were reportedly killed in Lubero on September 27 and 28.
Sebastien Kitsa Musayi and Eve Brennan, writing for the Associated Press:
Marie-Célestin Karondwa, a local official with Congo’s ruling Union for Democracy and Social Progress party, was attacked Sunday at his home in Butembo, an Ebola hotspot in the eastern North Kivu province, after defending the government’s response efforts during a radio program, the party said.
A man goes on the radio, tells people to wash their hands and keep their distance, and he's beaten and his house is burned. That's the reaction? That's what his party says happened. He died later in hospital, and mourners buried him on Wednesday. A party official told AP the radio appeals are believed to have provoked the anger of certain young people. I'd keep that attribution, because no one has been charged in this reporting. Why is the mistrust this deep? AP points to how past Ebola outbreaks were managed, chronic corruption, and decades of conflict that left many residents wary of outsiders and state authorities. One Butembo resident told AP, 'Some say that the illness exists, while others refuse to accept that it does.' And Butembo is North Kivu. The one province Africa CDC says is still rising. Exactly. Africa CDC's line was that this outbreak cannot be controlled without building community trust. Beds and trials matter. But a curve can only be read if people are willing to be counted.
Got feedback, a story idea, or a correction? Email us at ebolawatch at lantern podcasts dot com. Your notes help make Ebola Watch more useful, so keep them coming.
Next time, we'll be watching for the DRC's next situation report, to see whether the dip in cases holds once surveillance recovers, and for any update from Leiden on the MSF doctor. We're also tracking the U.S. entry ban for recent travelers from Congo, Uganda and South Sudan, which runs through October 11 unless amended. Links to every story are in the show notes. That's Ebola Watch for this week. We'll be back Monday. This is a Lantern Podcast.