The number of suspected Ebola cases in the Democratic Republic of the Congo (DRC) has surpassed 900, with concerns mounting that the country's disease control system is faltering due to rebel activity, mass displacement, and reduced international aid.
The DRC's Ministry of Public Health announced on X on Monday that cumulative suspected Ebola cases stood at 904 as of November 23. Suspected deaths totaled 119, with 101 confirmed cases and 10 confirmed deaths. No official recoveries have been reported to date.
Earlier figures released by authorities showed 867 suspected cases and 204 suspected deaths as of November 22, and 746 suspected cases and 176 suspected deaths as of November 21. Authorities have not provided an explanation for the decline in suspected deaths over the one-day period, though some cases may have tested negative for Ebola or been reclassified as deaths from other illnesses.
The World Health Organization (WHO) assessed the internal risk in the DRC as "very high" but said the risk of international spread remains low.
The outbreak is centered in Ituri province in eastern DRC. However, response efforts have been hampered by a confluence of crises including armed rebel activity, security instability, and local resentment.
According to the Associated Press, two Ebola treatment centers in Rwampala and Mongbwalu in Ituri province were targeted in arson attacks by residents last week. Experts said accumulated grievances over armed group violence, the collapse of local administration, and reduced aid have led to extreme expressions of public distrust.
Several rebel groups are active in eastern DRC, including the Rwanda-backed M23 rebels and the Allied Democratic Forces (ADF), an Islamic State-affiliated armed group. Ituri province, the epicenter of the current outbreak, has seen approximately 1 million people displaced.
Ebola virus disease is an acute hemorrhagic fever transmitted through contact with the blood, bodily fluids, or contaminated materials of infected individuals. Early symptoms include fever, vomiting, diarrhea, and abdominal pain. In severe cases, hemorrhagic symptoms can develop along with liver dysfunction and reduced white blood cell and platelet counts. The fatality rate can reach up to 90 percent depending on the virus strain and medical environment.
The current outbreak has been confirmed as an infection caused by the relatively rare Bundibugyo strain of the Ebola virus. With approximately 40 percent genetic difference from the Zaire strain, which has been the main pathogen in previous DRC outbreaks, existing vaccines and treatments are reportedly unlikely to be effective. There are currently no approved vaccines or treatments for the Bundibugyo strain.
As a result, field response is relying on non-pharmaceutical measures such as contact tracing, infection control, safe burial procedures, and the operation of isolation treatment facilities.
Meanwhile, the Korea Disease Control and Prevention Agency (KDCA) designated the DRC, Uganda, and South Sudan as priority quarantine management areas starting November 19, strengthening entry quarantine procedures. Travelers with a history of visiting these countries must submit a Q-code or health status questionnaire, and quarantine stations will conduct gate quarantines for all arrivals from the affected regions.
The KDCA judges the likelihood of domestic transmission to be low, considering that Ebola is transmitted through contact with the blood and bodily fluids of infected persons and that the current outbreak is limited to parts of Africa.
