Ebola surveillance in eastern Congo hampered as outbreak accelerates

Community health workers in the Nizi health zone of Ituri province are handling 60 to 70 alerts each day as the Ebola outbreak, caused by the Bundibugyo virus, spreads rapidly. Health officials say 60%-70% of new cases are being identified only after patients become symptomatic, indicating gaps in the surveillance system.

"If surveillance does not work well, the entire response suffers," said Gédéon Banga Ngbape, a local surveillance coordinator. > "We are chasing the virus; the virus is ahead of us," added Dr. Mohamed Yakub Janabi, WHO’s regional director for Africa.

The outbreak has resulted in more than 4,700 reported cases and over 2,200 deaths, a death toll reached almost three times faster than the 2014-16 West African epidemic. The United Nations announced an additional $30.5 million in emergency funding to support the response.

Workers such as Ngbape and Ana Ndroy Kasime report long hours, limited protective equipment and unpaid or delayed salaries. Kasime said she must purchase disinfectant herself and receives about $50 a month, which she considers insufficient for the risks involved.

Security concerns, including attacks by rebel groups and occasional violence against health facilities, restrict movement in remote areas. Population displacement linked to mining and armed conflict further hampers contact tracing, while poor road conditions limit access to many communities.

African CDC head Jean Kaseya urged the Congolese government to release the outstanding wages, noting that funds are available. The government cited verification of payroll lists and a shift to mobile-money payments as reasons for the delay.

Despite exhaustion, Ngbape said his team continues to work to prevent individual infections from becoming larger transmission chains, emphasizing the importance of surveillance as the “engine of a response.”