WHO: Bundibugyo Ebola outbreak in eastern DRC worsening; deaths top 500

The World Health Organization warned Tuesday that the Bundibugyo Ebola outbreak in eastern Democratic Republic of the Congo is still worsening, with the death toll in the country now above 500 and no sign yet that transmission is stabilizing.

As of July 7, DRC had recorded 1,561 confirmed cases, including 506 deaths, according to Dr. Anne Ancia, WHO’s representative in the DRC. Speaking to reporters, Ancia said the outbreak remains in an “expansion phase.”

“It is still in the expansion phase unfortunately. We would like to say it is stabilising, but frankly we cannot say it yet,” Ancia said.

The outbreak is being driven by a mix of high population mobility, insecurity and fragile health systems, WHO says, with some treatment centers nearing capacity. Reuters and WHO reporting have also cited the movement of symptomatic workers from mining towns such as Mongbwalu as a factor in spread. The strain on the health system is also showing up among frontline staff: WHO reported that, as of July 1, 102 health and care workers in DRC had been infected, including 25 who died.

This outbreak is caused by the Bundibugyo species of Ebola, not the more common Zaire strain. Bundibugyo ebolavirus was first identified in 2007 and has caused fewer outbreaks, leaving health authorities with fewer established vaccines and treatments tailored to it. For DRC, this is the country’s 17th recorded Ebola outbreak since 1976, but the first large-scale epidemic there caused by the Bundibugyo strain.

WHO’s more detailed Disease Outbreak News bulletin, published July 3, showed earlier totals based on earlier reporting cutoffs. As of July 1-2, WHO had counted 1,481 confirmed cases overall, including 1,460 in DRC, 20 in Uganda and one imported case in France, with 454 deaths overall, including 452 in DRC and two in Uganda. The higher totals reported Tuesday reflect later field reporting and expanded testing and backlog processing, rather than a contradiction in the data.

The outbreak has already spread beyond DRC’s borders. Uganda has confirmed linked cases, and WHO has recorded one imported case in France, which was notified June 24. WHO declared the outbreak a Public Health Emergency of International Concern on May 17, a designation the U.N. health agency uses for serious cross-border public health threats requiring a coordinated international response.

At the same time, WHO is trying to speed both diagnosis and treatment in an outbreak for which there are no licensed, strain-specific vaccines or therapeutics approved for Bundibugyo ebolavirus. On July 2, WHO added the first molecular diagnostic test for Bundibugyo virus to its Emergency Use Listing, a step meant to help countries and aid groups deploy testing faster.

That same day, the PARTNERS clinical trial began enrolling patients in DRC to test potential treatments including MBP134 and remdesivir. The trial is notable because countermeasures proven against the Zaire species cannot simply be assumed to work the same way against Bundibugyo.

“Even without approved therapeutics, people are recovering from this disease, but of course, we could save many more lives with safe and effective therapeutics in our toolkit,” WHO Director-General Tedros Adhanom Ghebreyesus said July 2. “The PARTNERS trial, established with national authorities and scientific partners in record time, offers real hope that we can deliver concrete results for — and with — the communities at the heart of the outbreak.”

The twin push on faster testing and experimental treatment underscores the central challenge facing responders: this Ebola strain is spreading in a fragile setting, and it comes with fewer proven medical tools than past outbreaks caused by the Zaire species.