An Ebola outbreak in Democratic Republic of Congo that has killed nearly 4,900 people is testing the ability of African countries to detect infectious diseases across borders, as infections reported in Kenya and Nigeria raise pressure on governments to strengthen surveillance, contact tracing and community engagement.
Congo has reported 10,060 confirmed cases and 4,887 deaths from the outbreak caused by Bundibugyo virus, according to the country’s public health institute. The outbreak, which began in May, is the country’s largest and deadliest Ebola epidemic, and has spread to neighbouring countries despite efforts to contain transmission.
The World Health Organization reported 9,704 confirmed cases and 4,687 deaths in Congo as of Oct. 20, with infections recorded across 66 health zones in eight provinces. More than 300 of the 482 deaths reported since its previous update occurred in communities rather than treatment centres, highlighting persistent problems with early detection and access to care, the WHO says.
The United States Centers for Disease Control and Prevention reported 10,091 confirmed cases and 4,891 deaths across affected countries as of Oct. 25, including nine confirmed cases in Kenya and one in Nigeria.
The outbreak has exposed the risks posed by population movements through the region, where trade, travel and cross-border family ties complicate efforts to identify and isolate infected people before they transmit the virus.
In Kenya, the first confirmed case was a man who travelled from Congo through Uganda before arriving in Nairobi in early October. Eight additional cases linked to him were subsequently reported, including family members and health workers, according to the WHO. The cluster had not shown evidence of wider community transmission as of Oct. 20.
Kenyan authorities have expanded contact tracing, isolation and screening at points of entry. By Oct. 22, more than 709,000 travellers had been screened and 461 samples tested across five laboratories, the WHO said.
Nigeria confirmed an imported case in Abuja on Oct. 20 in a patient who had travelled from Uganda. The patient was isolated and receiving medical care, while authorities investigated the travel history and possible source of exposure, the WHO said.
The case has prompted Nigeria to activate national and state incident management structures, with health authorities working with international partners on case investigation, contact tracing, infection prevention and the provision of protective equipment for health workers.
Uganda, which recorded 20 confirmed cases during an outbreak in May and June, offers a contrasting example of containment. The WHO declared the outbreak over on Aug. 27 after 42 consecutive days without a new confirmed case. The country recorded two deaths, according to the WHO and Uganda’s health authorities.
“Uganda has demonstrated that with decisive action, Ebola outbreaks can be brought under control quickly,” WHO Director-General Tedros Adhanom Ghebreyesus said in August.
He said preparedness, surveillance in health facilities and communities, and management of border crossings could help countries contain outbreaks while allowing people and goods to move.
Tanzania, which has not reported confirmed cases in the current outbreak in the sources reviewed, has strengthened its preparedness and supported Congo’s response. In September, it handed over about 52 tonnes of medicines and medical supplies, valued at 220 million Tanzanian shillings, to support the response, according to its Ministry of Health.
Tanzania has also updated national guidance for managing Ebola and other filovirus diseases, including clinical care, infection prevention and protection of health workers. The move reflects concern over the potential for transmission through population movements and regional trade.
The wider response faces significant operational obstacles. In eastern Congo, insecurity, displacement and distrust of health authorities have complicated efforts to identify cases, trace contacts and encourage people to seek treatment.
“In some areas of eastern DRC, the Ebola outbreak is outpacing our response, making it imperative that we rapidly scale up every aspect of our efforts to contain it,” Tedros said in a joint WHO and Africa Centres for Disease Control and Prevention statement on Aug. 6.
Tedros has previously said testing and laboratory capacity remained inadequate and that insecurity, displacement and population movements were complicating the response. He also identified mistrust among communities as a major barrier.
“Community mistrust is a major barrier in this outbreak because these communities feel – perhaps rightly – that the outside world only wants to protect itself from Ebola and doesn’t truly care about them,” he said.
The comments underscore a challenge facing health authorities beyond the provision of medical supplies: persuading communities to report symptoms, cooperate with contact tracers and seek care early, particularly where health services have been weakened by conflict or years of limited investment.
Prosper Global, formerly Mercy Corps, said its teams in Beni, North Kivu, had reported shortages of clean water and basic infection-prevention supplies, delays in responding to suspected cases and deaths, and difficulties reaching communities with accurate information. Insecurity has added pressure to already stretched health services, the organisation said.
“Ten thousand cases is a sobering milestone. Our experience from the previous outbreak showed that communities need more than information about Ebola. They need trusted people they can turn to, the chance to ask questions and raise concerns, and a response that acts on what they hear,” said Rose Tchwenko, Prosper Global’s country director for Congo.
“When local organizations and community leaders are supported to play that role, they can help connect families with care and make prevention practical.
“That work must happen at the same scale and with the same intensity and consistency as the medical response. Frontline health workers and local organizations need sustained, flexible support to reach communities early and respond consistently.”
During the 2018–2020 Ebola outbreak in Congo, Prosper Global said it worked with 40 local organisations in Butembo and Katwa to establish community information centres. Reported confidence in the response in those areas rose from 18% in June 2019 to 91% in April 2020, according to the organisation.
The current outbreak involves Bundibugyo virus, for which there is no approved vaccine or specific treatment. On Oct. 23, the WHO said a Phase 2/3 trial of vaccine candidates had begun in Bunia, Congo, an effort to generate evidence to protect against the virus.
The WHO has advised against restrictions on travel or trade, calling instead for coordinated cross-border surveillance, monitoring at points of entry, rapid case detection and stronger response capacity.
Faustine Ngila is the AI Editor at Impact Newswire, based in Nairobi, Kenya. He is an award-winning journalist specializing in artificial intelligence, blockchain, and emerging technologies.
He previously worked as a global technology reporter at Quartz in New York and Digital Frontier in London, where he covered innovation, startups, and the global digital economy.
With years of experience reporting on cutting-edge technologies, Faustine focuses on AI developments, industry trends, and the impact of technology on society.
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