DRC Ebola Outbreak Becomes Second-Largest on Record as Contact Tracing Falls Far Behind

The DRC outbreak has surpassed the total case count of the 2018–2020 DRC outbreak — which lasted nearly two years — in just over two months. The only larger Ebola outbreak on record is the 2014–2016 West Africa outbreak, which ended with more than 28,600 reported cases and 11,325 deaths. The current outbreak reached its first 1,000 cases in 40 days of response activation, compared with roughly 235 days during the 2018 DRC outbreak, according to the US Centers for Disease Control and Prevention.

The Bundibugyo strain is driving the outbreak, which presents a particular challenge because vaccines and treatments targeting it are not readily available. The majority of cases have been reported in Ituri province in northeastern DRC, an area characterized by high population mobility, gold trade routes, more than one million displaced people, and active armed groups. WHO Director-General Dr. Tedros Adhanom Ghebreyesus said this month that "the outbreak in DRC is continuing to outpace the response," with Ituri remaining the primary concern.

Contact tracing has emerged as a central failure in the response. Each confirmed urban case is estimated to have 40 potential contacts, meaning roughly 135,000 people should be on response teams' follow-up lists. Fewer than 18,000 — about one in eight — have been identified, according to Dr. Jean Kaseya, director general of Africa CDC. More than 80 percent of new cases are being detected in people who had not been identified through contact tracing. "If we don't master this indicator, we'll not stop this outbreak," Kaseya said at a briefing Thursday. About two-thirds of deaths are occurring among people who never received care at a health facility.