The outbreak in the two eastern provinces of the Democratic Republic of Congo has become the worst known epidemic of the deadly Ebola virus in the history of the country.
The Congolese Ministry of Health said in a statement Saturday that 326 people were infected with the Ebola virus in the provinces of North Kivu and Ituri.
This means that this epidemic is worse than the Yambuk epidemic in 1976, which infected 318 people and left 280 deaths. This outbreak was the first time scientists have discovered what is now known as the most dangerous strain of Ebola virus. The Kikwit outbreak in 1995 infected 315 people, of whom 250 died.
The current outbreak is now the third worst epidemic of Ebola in modern history. The outbreak in West Africa from 2013 to 2015 infected more than 28,600 people, mainly in Liberia, Guinea and Sierra Leone. An outbreak in Uganda in 2000 saw the suckling strain of the Ebola virus more than 400 people.
Following the start of the proceedings, the number of cases in the province of North Kivu deteriorated in September and October and worried public health officials around the world. At a school in Capitol Hill last week, Robert Redfield, Director of the Center for Disease Control and Prevention, warned that the outbreak could spread so widely that the Ebola virus could become endemic to Central Africa.
The Congolese Health Service, the World Health Organization, and non-governmental organizations such as the Red Cross and MSF have sent hundreds of people to the epicenter of the outbreak. They have been waiting for more than 28,000 people, including those who have come into contact with Ebola victims and leading healthcare professionals who are most susceptible to the virus.
However, the response was partly mitigated by the unstable security situation, when dozens of armed groups that opposed the government threatened or attacked health workers.
Bombing at the end of August, accused by Islamic militants from crossing the border in Uganda, has shut down the reaction in Beni for several days, allowing the spread of the virus. Last month, two Congolese army medical staff were killed in reserve.
"No other epidemic in the world has been as complex as the one we are currently experiencing, and since their arrival in the region, the reaction teams have faced threats, physical attacks, the repeated destruction of their equipment and abduction," Oly Ilung Kaleng, Congolese Minister of Health, he said in his statement.
The current outbreak began at the end of July, probably at a time when the virus spread to the funeral of the family of a woman who had become ill. The virus later expanded to Beni, a regional shopping center about a quarter of a million. From there, it expanded to Butembo, an international business hub on the Ugandan border.
Approximately half of the cases so far, 159, were published in Beni. Another 36 were found in Butembo. The World Health Organization has sent aid to Uganda, Rwanda, Burundi and South Sudan, expecting the virus to cross international borders.
"There is still a difficult way to control intensive transmission in Beni and emerging points in the villages around Beni and Butemba," the World Health Organization said in a weekly assessment of the situation on the ground.
North Kivu is home to about 8 million people, of which about a million are internally displaced after years of ethnic conflict. It is the largest province of Congo outside the capital of Kinshasa.
Oliver Johnson, guest lecturer for global health at King's College in London and co-author of the Getting to Zero book, Ebola epidemic in West Africa in 2014-2015, said that the conflict in the eastern Congo would cause mistrust against the government in Kinshasa, and all international groups that might come to the scene to try to help.
"There is a lot of suspicion that reports of Ebola and outbreaks are fake and are part of the conspiracy, so it is very difficult to persuade people to seek treatment or change behaviors to protect themselves," Johnson said in an email on Sunday. "There is a real challenge for respondents to get physical access to the affected communities – whether to collect a sick patient through a rescue ambulance, bring them to the treatment center, work with communities to prevent the further spread or distribution of the vaccine."
Violence in northern Kivu has limited American reaction to outbreak. After an attack on the Congolese army base in August, the Department of Foreign Affairs ordered respondents from the United States Agency for International Development and the Center for Disease Control and Prevention outside the area, first to the Goma Regional Capital, and then to Kinshasa, 1700 miles from the epicenter epidemic.
Moving CDC staff back to the capital "in response to the risk of failure in critical time," Johnson said.
The World Health Organization said that 29 new cases arose in the region in the last week. Three medics were among the new victims.
The WHO said the risk of spreading virus across domestic or international borders "remains very high". The Ministry of Health deployed experts on the preparedness of ten provinces around North Kivu.
Health officials are tracking over 5,400 people who have come into contact with Ebola victims, a practice known as contact tracking, in order to get new cases into treatment at the first symptom of infection.
"The epidemic remains dangerous and unpredictable, and we must not leave our guard," said Health Minister Ilung Kaleng. "We must continue to strive for a very dynamic response that requires sustained adaptation and real ownership at the community level."