Ebola outbreak likely three times official size

Health officials in the Democratic Republic of Congo are warning that the ongoing Ebola outbreak in the country may be significantly larger than official reports indicate, potentially affecting over 5,000 people rather than the current figure of roughly 1,700. The Africa Centres for Disease Control and Prevention (Africa CDC) estimates that only 30 to 40 percent of cases are being detected, pointing to a substantial underreporting of the virus’s spread.

Milder Symptoms Complicate Detection

Prof. Yap Boum, a regional epidemiologist at Africa CDC, explained that the Bundibugyo strain of the virus presents symptoms that differ from the more common Ebola Zaire strain. Because patients do not typically experience the severe internal bleeding associated with other variants, the illness can be mistaken for other diseases. This diagnostic ambiguity allows the virus to spread unnoticed within the community.

Surveillance efforts are further hampered by the fact that the vast majority of deaths—97 percent in the past week—are occurring outside of specialized treatment centers. The definition of “community” used by officials includes health facilities that are not equipped to handle Ebola, suggesting that many patients are dying before they can be diagnosed or treated.

Contact tracing remains a critical failure point in the response. Only about 16 percent of people who have been in contact with infected individuals are being tracked, leaving many potential transmission routes unmonitored. The situation is particularly precarious in the northern provinces of Haut-Uélé and Bas-Uélé, which border the Central African Republic. Two cases have already been identified in Buta, the capital of Bas-Uélé, situated approximately 200 kilometers from the border.

Health authorities are scrambling to reinforce defenses on the other side of the border. Last week, the World Health Organization (WHO) Director-General Dr. Tedros Adhanom Ghebreyesus and Africa CDC leadership met in the Central African Republic to assist the government in preparing for a potential cross-border outbreak. Measures under discussion include increasing surveillance at checkpoints and strengthening laboratory capacity.

Vaccine Stockpile Expanded

International response efforts have accelerated this week. The International Coordinating Group on Vaccine Provision (ICG) has agreed to release 70,000 doses of the Ervebo vaccine to the DRC. This stockpile is managed by the UN health agency, and the allocation comes following a direct request from the Congolese government.

While the Ervebo vaccine is licensed and recommended for use against the Zaire strain, a clinical trial is currently underway to evaluate its efficacy against the Bundibugyo variant. Early laboratory and animal data suggest the vaccine may offer some protection, though the trial results are pending. The shipment includes 20,000 doses allocated for the ongoing Phase 3 trial and 50,000 doses earmarked for frontline healthcare workers, aligning with current WHO guidelines.

Two additional vaccine candidates, the Oxford University-developed ChAdOx1 and Moderna’s mRNA vaccine, are also in the early stages of clinical trials within the DRC. While the immediate focus remains on containing the current flare-up, the simultaneous testing of multiple technologies reflects the urgent need for scalable tools against this persistent viral threat.