Ebola in DRC: What East Africa needs to know as deaths hit the 3000 mark

The scale of the outbreak is now difficult to overlook.

Government figures reported on September 2 put the death toll at 3,007, with 6,186 confirmed cases.

The outbreak, caused mainly by the Bundibugyo virus, has spread across six provinces in DRC and has become the country’s deadliest Ebola epidemic.

The outbreak was officially declared in May after cases were confirmed in Ituri Province, although investigators believe transmission may have started months earlier.

Since then, insecurity, population movement, weak surveillance and difficulty tracing contacts have made it harder to break chains of transmission.

One statistic captures the problem: about 60% of reported deaths are occurring outside treatment centres, suggesting many patients are reaching care too late or are not being identified early enough.

What exactly is Ebola?

Ebola is a rare but severe viral disease that can be fatal.

It is usually spread through direct contact with the blood or other bodily fluids of an infected person, including after death.

People do not generally transmit the disease before symptoms appear.

Early symptoms can resemble other illnesses, including fever, fatigue, headache, muscle pain and sore throat, followed by vomiting, diarrhoea and abdominal pain.

The incubation period can range from 2 to 21 days.

That resemblance to more common diseases such as malaria or typhoid is one reason rapid testing and trained health workers matter so much during an outbreak.

Ebola is also not one single virus.

The disease can be caused by different viruses, including Ebola virus, Sudan virus and Bundibugyo virus.

That distinction matters in the current crisis.

The problem with Bundibugyo virus

There are approved vaccines and specific treatments for Ebola virus disease, but there is currently no approved vaccine or specific treatment for Bundibugyo virus disease.

Supportive care such as rehydration and treatment of symptoms can improve a patient's chances of survival, while candidate vaccines and treatments are being studied.

DRC has nevertheless begun vaccinating frontline health workers with Merck's Ervebo vaccine, which is approved for the Zaire Ebola virus.

Authorities are using it because of the urgency of the outbreak, even though it was developed for a different Ebola virus.

Meanwhile, trials of potential Bundibugyo treatments and vaccines are under way.

Kenya's role

Kenya does not share a border with DRC, and the country has reported no confirmed Ebola cases from this outbreak.

But Kenya is a major regional transport, trade and travel hub, making imported infections a concern whenever a serious outbreak is active elsewhere in the region.

The Ministry of Health has already strengthened surveillance at airports and land borders, activated its national Ebola incident management system and established a multi-sectoral preparedness taskforce.

At JKIA, preparedness measures have included passenger screening, isolation arrangements, laboratory readiness and emergency response coordination.

At the Malaba border, Kenya stepped up surveillance after Ebola cases were reported in neighbouring Uganda earlier in the year.

Uganda gets hit

Uganda experienced imported Bundibugyo infections linked to transmission in DRC, including secondary cases among contacts and healthcare workers.

Kampala declared its outbreak over on July 28 after 42 days without a new locally transmitted case, but WHO warned that Uganda remained vulnerable to reintroduction because Ebola was still circulating in neighbouring DRC.

That is the regional lesson.

The map may separate DRC, Uganda and Kenya.

Roads, borders, business and migration do not.

The health-security question

WHO says the response in DRC now needs to be substantially expanded, with about $1.3 billion estimated to be required for treatment capacity and other response needs.

For East Africa, the Ebola outbreak is therefore about more than one country's health system.

It is a test of surveillance, laboratories, border preparedness, emergency coordination and public trust.

Kenya's most important advantage is that it can prepare before a case arrives.

Because with outbreaks like this, the real measure of preparedness is not how quickly a country reacts after the first case.

It is how ready it was before the first case appeared.