Countries bordering the Democratic Republic of Congo have increased screening at border crossings, trained frontline health workers and activated emergency plans to reduce the risk of imported cases as the DRC grapples with a growing Ebola outbreak.
On Monday, the DRC’s health ministry said at least 930 people had died from the disease. The DRC has recorded 2,344 cases of Bundibugyo, the virus behind the current outbreak, which the government announced on May 15. The World Health Organization (WHO) recently warned that the number of cases may be four times higher than known.
In Zambia, authorities have increased screening at entry points despite no confirmed cases of Ebola being recorded. Dr. Naeem Dalal, assistant director of preparedness and response at the Zambia National Public Health Institute (ZNPHI), told DW that prevention measures have been strengthened across the country.
“Infection prevention and control is currently being activated, where there will be a lot of disinfection, and face masks and hand washing with soap and water will become mandatory,” Dalal said.
He said provincial public health emergency response centers have been activated to coordinate rapid response when suspected cases are detected.
Uganda, which has successfully controlled previous Ebola outbreaks, has also increased surveillance along its border with the DRC. Speaking on Ugandan national television, Dr Beda Senkware of Kabale Referral Hospital said the country’s three western districts remained particularly vulnerable.
“The risk of getting this disease, Ebola, is very high. We have three districts bordering the DRC – Kisoro, Kanungu and Rukungiri. These three districts are most at risk of getting Ebola,” Senkware said.
Rwanda has also strengthened cross-border health checks, expanded disease surveillance and created rapid response teams to investigate suspected cases.
East African Community’s response to Ebola
Regional cooperation is also increasing. The East African Community (EAC) has agreed on a coordinated response to improve preparedness and reduce the risk of cross-border transmission.
EAC Secretary-General Stephen Mbundi said partners are working with the Africa Centers for Disease Control and Prevention (Africa CDC), WHO and other partners to expand state surveillance, laboratory testing and emergency response capacity.
“We are mobilizing regional mechanisms and working closely with partner states, Africa CDC, WHO and development partners to strengthen surveillance, laboratory diagnosis, infection prevention and control, risk communication and rapid response capacities,” Mbandi said.
The increased preparations follow a warning from WHO that the outbreak may be much larger than official figures because many infections in conflict-hit areas of eastern DRC are going undetected.
Speaking during a virtual news conference in Geneva, WHO Director-General Tedros Adhanom Ghebreyesus said the outbreak had become “the third-largest Ebola outbreak on record” and had “spread faster than any previous outbreak” over the past month.
Tedros also called on international donors to help close a funding gap of more than $400 million (€344 million) for the joint WHO-Africa CDC preparedness-and-response plan.
The outbreak is concentrated in eastern DRC, where conflict, insecurity and population displacement have complicated efforts to identify cases, trace contacts and contain the virus. The DRC has experienced several Ebola outbreaks since the virus was first identified in 1976, but health experts say insecurity has made the current outbreak particularly difficult to contain. There is currently no known vaccine for Bundibugyo.
Africa CDC urges early detection of Ebola
Jean Cassia, director-general of Africa CDC, urged neighboring countries to strengthen surveillance and laboratory capacity to improve early detection.
“This outbreak started in Ituri. It has now spread to Uganda and other parts of the DRC. It is putting the DRC’s neighboring countries at risk,” Kassia said. He said timely detection is important to prevent widespread transmission.
“If countries don’t increase tracing capacity, they are really at risk,” Kasia said. “This is the message we are sending to countries: If you are near the DRC, please increase your capacity to trace.”
Professor Eileen Marti, an infectious disease expert at Florida International University, said the ongoing violence was undermining prevention efforts.
“Cases are continuously increasing because this is a highly inflamed area where conflict has been going on for more than a decade,” Marty said.
“Some of our treatment centers have been burned,” he said. “It discourages health workers from going there to treat patients and increases the number of people traveling elsewhere if they become infected. It’s also making it exceptionally challenging.”
Martí said the situation underscores the importance of preparedness in neighboring countries, where surveillance, rapid diagnosis and coordinated public health responses are the best defense against regional spread.
Apart from Uganda, no neighboring countries have confirmed any cases linked to the outbreak, but health officials say vigilance is necessary until transmission in the DRC is under control. He warned that continued investment in surveillance, laboratory capacity and regional cooperation will be key to preventing the virus from spreading across borders.
Edited by: Crispin Mavakideau