DRC Ebola outbreak could be three times larger than confirmed cases, warns AU

The ongoing Ebola outbreak in the eastern Democratic Republic of Congo (DRC) may be significantly larger than official figures suggest, with the African Union's Africa Centers for Disease Control and Prevention (Africa CDC) warning that detected cases represent only 30% to 40% of the real total.

Yap Boum, head of Emergency Preparedness and Response at Africa CDC, stated that models estimate the actual number of cases could be three times the confirmed count of 5,208. He explained that less than 10% of cases stem from known contacts, and fewer than 40% have a clear epidemiological link to a confirmed case. This low detection rate is partly attributed to the outbreak being caused by the Bundibugyo strain, which presents milder symptoms and fewer hemorrhagic signs than the Zaire variant. This can lead to a delayed perception of severity and a reluctance to seek medical attention.

Consequently, a high percentage of recent deaths, at least 97%, are occurring within the community or in general health facilities lacking adequate isolation and infection control protocols. While transmission has slowed in some areas, with no active cases reported for over 42 days in three health zones, the outbreak continues to affect provinces like Ituri, North Kivu, and South Kivu. The confirmation of two cases in Buta, located in the northern Bas-Uélé province near the border with the Central African Republic, has triggered the deployment of mobile laboratories and cross-border surveillance measures to prevent regional spread.

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We estimate that only 30% to 40% of real cases are being detected. Models from the DRC analysis team together with Imperial College assess that the actual size of the outbreak could be three times greater in number of confirmed cases.