Africa CDC cautions that the DRC's Ebola outbreak is not yet under control

The Africa Centers for Disease Control and Prevention (Africa CDC) said Thursday it remains too early to say that the Ebola outbreak in the Democratic Republic of the Congo (DRC) is under control, despite signs of stabilization in recent weeks.

"We're still early to say that we're controlling the whole outbreak," Africa CDC official Wessam Mankoula told an online press briefing, noting that the outbreak "is still evolving."

According to the latest situation report from the government, as of September 1, the DRC has recorded 6,250 confirmed cases and 3,039 deaths, resulting in a case fatality rate of 48.6%. A total of 1,439 patients have recovered. The outbreak has impacted 60 health zones across six provinces.

Four health zones have successfully interrupted transmission by reporting no new cases for over 42 days, while another five zones are in a "control phase," having gone between 21 and 42 days without new cases. However, active transmission persists in 51 health zones, Mankoula reported.

"For the last two weeks, we are seeing a decline in the number of cases; we are almost at the plateau phase," Mankoula said, cautioning that "it's very early to say we have sustained decline in this outbreak."

Mankoula said the plateau could reflect stronger surveillance, earlier case detection, active case finding, infection prevention and control measures, and improved case management. "Hopefully, when we're following now the third week, we continue with this plateau, then we start seeing a decrease," he said.

But he cautioned against drawing conclusions too soon. "We saw this plateau previously in June, then later on it's followed by an increase. This is why we are cautiously interpreting those data," Mankoula said.

The current outbreak, which was declared in May, has become the largest and deadliest Ebola epidemic in the country's history and the second-largest globally, behind the 2014-2016 epidemic in West Africa.

Mankoula also pointed out that, while Uganda recently declared its Ebola outbreak over, the ongoing active transmission in the DRC's eastern provinces bordering Uganda presents a persistent cross-border risk.

He emphasized the need for robust surveillance systems at points of entry and in border communities to detect any potential spillover cases early and to prevent a new wave of cross-border transmission. "This outbreak is still evolving," Mankoula reiterated. "Incremental measures are no longer effective; it is time to scale up all different responses to control the situation on the ground."

Africa CDC Director-General Jean Kaseya remarked on Wednesday that Ebola in the DRC "remains extremely serious and continues to spread." He added, "Despite considerable efforts by the DRC government and its partners, we are not yet where we need to be."

Currently, there is no approved vaccine or treatment specifically targeting the Bundibugyo virus, which is the cause of the ongoing outbreak. Therefore, the international community is relying on experimental and repurposed medical tools.

Regarding vaccines, the Ervebo vaccine, which is licensed for use against the Zaire ebolavirus, is being evaluated for cross-protection against the Bundibugyo strain through a field effectiveness study.