Ebola outbreak spreads to remote, militia-controlled territory in Democratic Republic of Congo

PHOTO: A health worker wearing a protective suit enters an isolation pod to treat a patient at a treatment center in Beni, Congo DRC, July 13, 2019. PlayJerome Delay/AP, FILE
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A new case of Ebola has popped up in a remote, militia-controlled area in the eastern Democratic Republic of the Congo, hundreds of miles away from the epicenter of the yearlong outbreak.

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The patient is a 70-year-old woman living in Pinga, a rural village located in Walikale territory in North Kivu province, according to a recent statement from the technical committee running the country's Ebola response and reporting directly to the president. The woman has been hospitalized in Pinga since Aug. 13 and was placed in isolation on Aug. 15. Her blood samples were sent to a laboratory in Goma, the capital of North Kivu province, and came back positive for Ebola virus disease on Aug. 17.

A rapid response team was dispatched on Sunday and traveled by road, reaching Pinga a day later. A helicopter team also arrived at the village Monday, according the technical committee, which described Pinga as an "area of insecurity and poor telephone network coverage."

Walikale is a mineral-rich territory that is largely controlled by a faction of the Mai-Mai armed group. The region is remote and difficult to access due to its poor roads and thick forest. The village of Pinga has been the site of frequent attacks by the Democratic Forces for the Liberation of Rwanda, a notorious rebel group known by its French acronym FDLR.

It's the first Ebola case to be recorded in this part of North Kivu province, far from where previous cases have been concentrated near the country's eastern border with Uganda and Rwanda. Pinga is about 95 miles northwest of Goma, a major city and transportation hub near the Rwandan border where the virus reached last month, and is more than 200 miles from Beni, a conflict-torn city near the Ugandan border that is the center of the current outbreak.

The virus' spread to Walikale territory comes just days after cases were confirmed in a third province, South Kivu.

According to the latest data released by the technical committee, a total of 2,888 people have reported symptoms of hemorrhagic fever in the Democratic Republic of the Congo's eastern provinces of North Kivu, Ituri and now South Kivu since Aug. 1, 2018. Among those cases, 2,794 have tested positive for Ebola virus disease, which causes an often-fatal type of hemorrhagic fever and is transmitted through contact with blood or secretions from an infected person.

The ongoing outbreak has a case fatality rate of about 67%. There have been 1,938 deaths so far, including 1,844 people who died from confirmed cases of Ebola. The other deaths are from probable cases. Less than 900 people sickened with the virus have recovered so far, according to the technical committee.

An experimental Ebola vaccine developed by American pharmaceutical company Merck that was tested in the 2014-2016 West Africa epidemic was approved for use in the Democratic Republic of the Congo a week after the outbreak was declared last year. More than 198,000 people in the current outbreak zone have received the experimental vaccine since Aug. 8, 2018.

Meanwhile, two of four experimental treatments being tested in the outbreak are now being offered to all patients after showing promise in saving lives. Preliminary findings from a randomized controlled trial that began last November in four Ebola treatment centers in North Kivu indicated that patients receiving either of two antibody-based therapies, known as REGN-EB3 and mAb114, had a greater chance of survival compared to those receiving two other experiential drugs, known as ZMapp and remdesivir

After a meeting to review the initial results, an independent monitoring board recommended all future patients be offered either REGN-EB3 or mAb114, while the other two treatments be stopped.

"From now on, we will no longer say that Ebola is incurable," Dr. Jean-Jacques Muyembe, director general of the Democratic Republic of the Congo's National Institute for Biomedical Research, which is co-sponsoring the clinical study, told reporters during a telephone briefing last week.

Still, the epidemic continues to spread, with an average of 81 new Ebola cases confirmed each week, according to the World Health Organization, the global health arm of the United Nations which last month declared the current outbreak an international emergency.

This is the second-largest, second-deadliest Ebola outbreak in the world. It's also the 10th outbreak of the disease in the Democratic Republic of the Congo and the most severe there since 1976, when scientists identified the deadly virus near the Ebola River.

The WHO's director-general has described the current outbreak as more complex than the deadlier 2014-2016 outbreak in multiple West African countries due to the region's political instability, attacks on health workers, a highly mobile population and community mistrust and misinformation. It's the first Ebola outbreak to occur in an active war zone.