WHO says it can ID only 75% of Ebola cases in DRC

Health responders could be missing up to a quarter of Ebola cases in the Democratic Republic of Congo, the World Health Organization said Thursday, underscoring the challenge it faces in ending an outbreak that’s killed over 1,350 and is nearly a year old.

Mike Ryan, WHO’s director of emergencies, said the 75-percent ID rate is a rough estimate, and sometimes it’s unclear which cases are missed completely or caught later on.

“Do we believe that there’s a massive undetected transmission? No,” he said. “Do we believe that there is undetected transmission? Yes.”

Violence in the region poses a challenge in identifying cases, and so does the migration of infected persons. Often, a person will be infected in one health zone and show up at a health facility in another zone. About one-fifth of those infected will catch the disease in one health zone and seek care in another zone.

“It’s quite difficult to make connections between transmission chains,” Dr. Ryan said.

When cases are missed and someone dies in the community, he added, it’s a “disaster.”

“It’s a disaster for the response, because that person has been in the community potentially infecting others,” Dr. Ryan said. “So we must get earlier detection of cases, we must have more exhaustive identification of contacts. We need to convince all of those contacts to accept vaccination.”

He said 90 percent of people accept vaccination, it’s the “10 percent that don’t” who matter right now.

Ebola is a serious often-fatal disease that is transmitted to people from wild animals and spreads from human to human through the bodily fluids of people who exhibit symptoms.

The outbreak in northeast DRC, which began in August, has resulted in more than 2,000 cases, making it the second-worse on record after the massive West African outbreak in 2013-2016.

Though responders have an experimental vaccine and new trial drugs to combat the disease, they are dealing with unique challenges, including attacks from rebel groups and community skepticism of outsiders.

Dr. Ryan said they’ve made progress in gaining acceptance, though there is more work to do. The pace of new cases has slowed of late, which is also a good sign. He said there’s been 88 new cases per week over the last two weeks, compared to an average of 126 per week in April.

“The numbers have stabilized and, in fact, fallen in the last two weeks,” he said. “However, there is still substantial transmission in a number of health zones.”

He called on global partners to continue funding the campaign.

“The outcome is effort-related,” he said. “Are we prepared to make immediate, sustained comprehensive efforts to bring this disease under control?”

The virus, he said, “will exploit any opportunity that it gets to increase transmission.”