Nearly 300 Ebola-positive people unaccounted for in Democratic Republic of the Congo outbreak

Public health officials in the Democratic Republic of the Congo say the whereabouts of almost 300 people who have tested positive for Ebola are currently unknown. The warning comes as the outbreak continues to grow in conflict-affected areas where health workers have limited access to camps and communities. Officials say the situation is raising concern about wider community transmission.

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Jean Kaseya, director general of the Africa Centres for Disease Control and Prevention, said on Thursday that more than 1 million people are living in camps that health workers cannot reach. He said figures on recovered patients, those in treatment and deaths indicate that 297 people who tested positive are unaccounted for. Kaseya asked publicly where those patients are, describing the issue as a major concern for the response.

The outbreak has so far led to 1,118 confirmed cases and 291 deaths in the Democratic Republic of the Congo, according to the supplied figures. In neighbouring Uganda, officials have recorded 20 cases and two deaths. On Wednesday, France said a doctor who had been working in the Democratic Republic of the Congo tested positive after returning home, and his employer, the medical non-governmental organisation Alima, said it was working to understand how the contamination may have occurred.

The latest modelling from the World Health Organization's Africa regional office, published in The Lancet Infectious Diseases journal, projects about 8,210 cases and 1,420 deaths by mid-September. The same modelling gives the outbreak a 70% chance of spreading to South Sudan in the coming weeks. That makes the current phase of the outbreak significant not only for the Democratic Republic of the Congo, but also for neighbouring countries already facing the risk of cross-border transmission.

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The outbreak is caused by the Bundibugyo strain of Ebola and is described in the supplied material as the largest on record for five weeks after declaration. The response is taking place in a difficult security and humanitarian setting, with authorities saying people who have been in affected provinces must wait 21 days before travelling onwards. The modelling also notes that current figures are most in line with a central scenario, suggesting between 6,636 and 10,287 cases by 16 September if transmission follows that path.

The comparison with the West Africa outbreak of 2014 to 2016 underlines why officials are watching the situation closely. At a similar stage, that epidemic had 239 cases and 160 deaths, far below the current confirmed toll in the Democratic Republic of the Congo. The supplied figures also suggest that 30% of new cases are among known contacts of confirmed patients, which may help explain why tracing and access remain central to the response.

What remains unclear is where the unaccounted-for patients are and whether they are still able to spread the virus. The next key developments will be whether access improves in the affected provinces, whether contact tracing can be strengthened, and whether the outbreak begins to move beyond the current areas of concern. Officials and health agencies are also likely to watch closely for any further spread into South Sudan or other neighbouring states.

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