Ebola in Democratic Republic of Congo

There’s a worrying new Ebola outbreak in the Democratic Republic of the Congo — the second the country has faced since the largest-ever Ebola epidemic swept West Africa in 2014-’15.

The World Health Organization learned about the new outbreak on May 8, when DRC health officials reported two confirmed cases of Ebola in Bikoro, a health zone in the country’s northwest Équateur province.

No one knows when or how the outbreak started, but the WHO suspects that since April 4, a total of 34 people are thought to be infected with Ebola (though only two of them are confirmed so far), including 18 deaths. Three of the deaths involved health care workers.

Health officials suspect that the high case fatality rate means there may be more Ebola cases already out there, and that this outbreak could have been simmering undetected for some time. “If you have 18 of [34] cases that are fatal, that tells me we don’t know how big the iceberg is — that there’s more that have not been detected yet,” said Daniel Bausch, thedirector of the UK Public Health Rapid Support Team, who has been advising on the outbreak response.

An Ebola outbreak is never good news. But there are some reasons not to fear the worst with this one just yet. To start, with DRC has a long history with Ebola (unlike the West African countries where the 2014-2015 outbreak started). This would be the ninth known Ebola outbreak to strike DRC, including one that involved five confirmed cases last year. So that means health officials are experienced in spotting the virus and preventing it from spreading.

What’s more, the Bikoro region is in a pretty remote area of the country, with a population of about 163, 000 and little connection by road to more densely populated areas of the country, like the capital Kinshasa. There’s also a promising vaccine to prevent Ebola: It hasn’t yet been approved for market but could be deployed if the outbreak grows.

On the other hand, as Bausch indicated, the outbreak might be much larger than it seems for now. And while Bikoro is nearly 200 miles by road from Mbandaka — the capital of the Équateur province — it’s also a market town with a port, situated on a lake connecting the highly trafficked Congo and Ubangi rivers. So people with Ebola could be a boat ride to Kinshasa or Brazzaville, the capital of the DRC. (For more on the risk of spread, read Helen Branswell’s explainer.)

Taken together, this means this DRC outbreak could go either way: be quickly stamped out before the virus is on the move — or spin into something larger. And if this outbreak becomes bigger, one thing is for sure: America, traditionally a global health leader, isn’t ready for a pandemic right now.

There have been more than 30 known Ebola outbreaks in history. Nine of them happened in the DRC.

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