In May, I noted that the African nation of Congo was battling an Ebola epidemic.

It is now being reported that the most recent outbreak of the gruesome hemorrhagic disease is the worst it has experienced in history.

Congo’s latest Ebola outbreak is the worst in the country’s recorded history with 319 confirmed and probable cases, the health ministry said.

The deadly virus has killed about 198 people since the outbreak was declared Aug. 1 in the volatile east, the ministry said. Those dead include 163 confirmed Ebola cases, with 35 probable deaths. Nearly 100 people have survived Ebola.

In a troubling development, cases are now being reported in Congo’s second largest city, which is also a critical regional economic hub.

Butembo, a bustling city of almost a million people in the eastern Democratic Republic of Congo, is reporting an increasing number of cases of Ebola virus disease in the country’s current epidemic. There has been a “significant increase” in infections there over the past three weeks, with a total of 25 confirmed cases thus far, according to Thursday’s bulletin from the country’s health ministry.

Butembo is a key trading and transport hub with links to other major cities in the country as well as to neighboring Uganda. It’s about two times the size of the city of Beni, the outbreak’s epicenter, and is located just 35 miles away. The health ministry said the “high density and mobility” of Butembo’s population presents new challenges to containment efforts, already complicated by sporadic rebel attacks on remote villages in and around Beni.

Aid workers have faced many unique challenges in battling this particular outbreak.

American aid agencies like the Centers for Disease Control and Prevention (CDC) and the U.S. Agency for International Development have largely stayed on the sidelines during the outbreak, because of unrest in a province long riven by sectarian and ethnic tensions. Several American aid workers were pulled back to their base in Kinshasa in August after a rebel attack on a Congolese military base.

In September, a terror attack in Beni, at the heart of the outbreak, killed almost two dozen people. In October, several Congolese health-care workers were killed in an ambush. Several international health-care workers told The Hill they routinely hear gunfire in the streets of Beni.

In addition to civil strife, public health officials are now worrying about the Ebola vaccine supply, given the potential numbers of exposed people who should be vaccinated.

We are extremely concerned about the size of the vaccine stockpile,” Dr. Peter Salama, emergencies director for the World Health Organization, told the Stat media outlet in an interview this week, saying 300,000 doses is not sufficient as urban Ebola outbreaks become more common.

Health workers, contacts of Ebola victims and their contacts have received the vaccine in a “ring vaccination” approach, but in some cases all residents of hard-to-reach communities have been offered it. The prospect of a mass vaccination in a major city like Butembo has raised concerns. Salama called the approach “extremely impractical.”

I suspect that without the new vaccine, the spread of Ebola would be far worse. Let’s hope that the containment teams get this outbreak contained soon before it spreads farther.


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