“Every day cases are being identified in new health zones. And that really reflects the scale of this outbreak, a scale much larger than what is being detected, and the high mobility of the population in this part of the DRC,” said Dr. Olivier le Polain, head of epidemiology and analysis at the World Health Organization (WHO).
In the approximately three weeks since the fast-moving outbreak was confirmed, DRC health authorities have reported 676 cases and 136 deaths from the rare and deadly Bundibugyo species of Ebola virus.
Infections have been identified in a zone stretching from Aru in the north of Ituri province to Miti Murhesa in South Kivu, about 1,000 kilometers. “And we have 34 health zones affected as of yesterday, so them health zones [with Ebola] continue to expand with new areas in North Kivu, which also reported [cases] yesterday”, Dr le Polain told reporters in Geneva via video link from Beni.
Those leading the response emphasized that many young people in the region are malnourished and unvaccinated against preventable diseases. T
his means they are extremely vulnerable to disease in the resource-rich region, where a humanitarian crisis is already unfolding, caused by decades of fighting between government forces and armed militias.
Households the new target
To date, most infections have been among adults going about their daily lives, “but as the outbreak develops, we must be prepared for increased household transmission, which means we could see more children affected in the coming days”, warned Dr. Douglas Noble, UNICEF Global Lead for Public Health Emergencies and Global Incident Manager for Ebola.
“These are already very vulnerable children, then the capacity of this society to absorb any additional stressors was already stretched to breaking point,” he said, noting that more than half of children under five in Ituri province are “chronically malnourished”.
Zero dose
More than one in five are also “zero dose” children, meaning they never received their first dose of diphtheria, tetanus and pertussis vaccine.
Estimating the number of children who may be affected is problematic because adequate surveillance tracking data is not yet available.
Nevertheless, previous Ebola outbreaks in the DRC have shown that children “constituted a significant proportion of the cases and an even greater proportion of the deathswhere the youngest face the highest rates of death and many have been orphaned or separated from caregivers,” explained Dr. Noble.
As part of its six-month effort to help 3.7 million people, the agency has sent eight transport flights of more than 100 tonnes of emergency humanitarian supplies to the DRC with support from the European Union.
The emergency cargo includes personal protective equipment for frontline health workers, medicine, hygiene materials and medical supplies to confront the virus in affected communities.
‘Schools can stay open’
Although Ebola can be fatal, it is transmitted very differently from COVID and commonly through bodily fluids, so children who can go to school should continue to do so, the UNICEF official stressed.
“There is no reason for a school to close. Infection prevention and control measures must be taken and there must be education in the school, among the teachers and staff and among the children.”
Unlike Ebola-Zaire strains of the disease there are currently no approved Bundibugyo virus-specific therapies or vaccines. This underscores the need for greater support for surveillance efforts to limit transmission, said Dr. le Polain. “We’re now at just over 70 percent of contacts being appropriately traced. That’s a huge improvement from where we were a week or two ago, but it’s still too low to ensure adequate control.”
Improving local testing capacity is another key factor in overcoming the health threat, as the full extent of the outbreak is “not yet clear”, the WHO official explained. He noted that a testing laboratory in Beni processed 500 tests on Thursday alone. “It will also really help clarify the extent of the outbreak in Beni,” he added.
For its part, UNICEF has also deployed more than 1,600 community health workers and mobilizers and 24 decontamination teams, which have already reached more than 160,000 households.
“We can spare children the worst of this outbreak. Rapid detection, strong pediatric care, contact monitoring and informed and engaged communities can help bring this outbreak under control“, Dr. Noble said. “What we need now are the resources, humanitarian access and trusted communities to succeed.”
