The Democratic Republic of the Congo has confirmed 3,532 cases of Bundibugyo virus disease and 1,556 deaths as of July 31, making this the second largest Ebola outbreak ever recorded and the largest the country has ever had. [1] The previous national record, the 2018 to 2020 epidemic in the east, closed at roughly 3,470 cases. [1] This outbreak passed it by about 62 cases in under three months.
Only the West Africa epidemic of 2014 to 2016 was bigger, at 28,616 cases and 11,310 deaths. [1] The current outbreak is roughly one eighth that size and kills a larger share of the people it confirms. Dividing 1,556 deaths by 3,532 confirmed cases gives 44.05 percent. The same division for West Africa gives 39.52 percent.
The rate depends entirely on which numbers you put on each side of the line, and the published numbers do not agree. WHO's Disease Outbreak News of July 17, working from a July 15 cutoff, put the DRC at 2,124 confirmed cases and 828 deaths, a case fatality ratio of 39 percent. [2] UN News, reporting figures as of July 16, gave 2,273 cases and 796 deaths. [3] Deaths fall by 32 as cases rise by 149 across a single day, which happens when one count is confirmed cases and deaths only and the other folds in probable ones. Run the division on the UN News pair and the rate is 35.0 percent. Run it on WHO's and it is 39.0 percent. Run it on the July 31 figures and it is 44.1 percent. All three are defensible and none of them are the same measurement.
One further gap is worth naming. Al Jazeera's July 31 breakdown lists 626 people recovered, 807 in isolation and 1,556 dead. [1] Those three add to 2,989 against a confirmed total of 3,532, leaving 543 confirmed cases the published breakdown does not place.
What is not in dispute is the speed. Carl Skau, acting head of the World Food Programme, called it "the fastest spreading Ebola epidemic that we have ever seen" and said "The world needs to pay much more attention." [1] WHO Director-General Tedros Adhanom Ghebreyesus said in mid-July that the outbreak "is continuing to outpace the response." [3] The DRC reached figures in roughly two months that took the 2018 to 2019 outbreak more than ten. [3] Between WHO's July 15 cutoff and the July 31 count, confirmed cases rose by 1,408 and deaths by 728, about 88 new confirmed cases and 45 deaths a day, though those two counts come from different reporting bodies and are not a clean series.
The reason this epidemic does not behave like the last one sits in the virus name. Ebola is a family, not a single pathogen, and the vaccine the world stockpiled after West Africa is licensed against one member of it. "The only approved vaccine and treatments are for the Zaire strain," CBS News reported, and Merck said in a statement that its vaccine is not approved for the Bundibugyo strain. [4] WHO says flatly that "no approved vaccines or specific treatments currently exist for BVD." [2] Dr. Celine Gounder, an infectious diseases specialist, said other vaccines are in development but "nothing that targets Bundibugyo virus is close to being ready for use." [4] The ring vaccination that walled off the 2018 to 2020 epidemic is therefore unavailable, not delayed.
Bundibugyo has only been recorded twice before. Uganda in 2007 produced 149 cases and 37 deaths, a rate of 24.8 percent. Congo in 2012 produced 57 cases and 29 deaths, a rate of 50.9 percent. [4] Together those outbreaks amount to 206 cases. This one is more than seventeen times both of them combined, and WHO's Africa office confirms it is now the largest Bundibugyo outbreak on record. [6]
Without a vaccine, containment reduces to finding people, which is where the outbreak is winning. More than 80 percent of new infections come from contact chains nobody has traced, and about two thirds of deaths happen in communities before anyone reaches treatment. [3] Angele Gapio, head of emergencies for Caritas in Bunia, described the mechanism directly: "The disease has now settled in the community. People continue to seek treatment from traditional healers, and the chain of transmission continues." [1] Cases have reached 46 health zones across five provinces, with Ituri reporting from 27 of its 36. [2]
That leaves money as the substitute for medicine, and the money is mostly a promise. Africa CDC put the response requirement at 518 million dollars in early June and revised it to 1.4 billion. Roughly 910 million dollars has been pledged, of which 13 percent has been released, which works out to about 118 million actually moved. [5] The joint WHO and Africa CDC plan remains short by more than 400 million dollars, and UNICEF has a quarter of what it needs. [3] Africa CDC Director-General Jean Kaseya put it without hedging: "If we don't have this $1.4 billion and if we don't resolve the humanitarian issue, we will not stop this outbreak." [5] Gavi has committed 40 million dollars to accelerate access to a Bundibugyo vaccine, which is a commitment to buy something that does not yet exist. [5]
One number cuts the other way. As of mid-July, 377 people had recovered from a disease with no approved treatment, and by July 31 that figure stood at 626. [3][1] Supportive care alone is doing that. It is also the only thing on offer.
