Ebola virus disease has sickened 188 people and killed 118 in the Democratic Republic of Congo's northeastern region, the World Health Organization reported Monday.
Of the total cases, 153 have been confirmed, and 35 are probable. Fifty-one people have survived the disease, according to WHO, the United Nations' public health division.
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Tedros Adhanom Ghebreyesus
On average, Ebola -- which causes fever, severe headache and in some cases hemorrhaging -- kills about half of those infected, but case fatality rates in individual outbreaks have varied from 25% to 90%.
'An outstanding job'
"The response to the outbreak is being led by the government of the DRC, which is doing an outstanding job in an extremely difficult situation," Dr. Tedros Adhanom Ghebreyesus, director-general of WHO, said at a UN Security Council meeting last week. He added that WHO has more than 200 staffers on the ground, operating out of four hubs and partnering with other organizations.
"We are now at a critical point in the outbreak," he said.
Fifty-two patients have received experimental Ebola treatments during this outbreak, Dr. Peter Salama, WHO's deputy director-general of emergency preparedness and response, tweeted on Saturday.
Four treatments may be administered under a compassionate use framework, with doctors deciding the best treatment for each patient based, in part, on the complexity of administering and monitoring the drug, according to WHO.
"This is the first time in history that treatments are being used at scale during an outbreak, providing hope for people with the disease," Salama tweeted.
Only two of the treatments are favored: ZMapp, an experimental treatment developed by San Diego-based Mapp Biopharmaceutical Inc., and remdesivir, an antiviral drug developed by Gilead Sciences Inc. in collaboration with the US Centers for Disease Control and Prevention and the US Army Medical Research Institute for Infectious Diseases.
A third drug, REGN3470-3471-3479, is in the early stages of development, and there is "uncertainty" about whether a fourth drug, favipiravir, provides benefit to patients, according to WHO.
North Kivu province is the epicenter of the current outbreak, though some cases have been reported in neighboring Ituri province, according to WHO. The two provinces, which are among the most populated in the nation, border Uganda, Rwanda and South Sudan.
Ebola most commonly affects people and nonhuman primates, such as monkeys, gorillas and chimpanzees. This is the second outbreak in Congo this year, according to WHO. A previous outbreak began in May and ended in July; it affected a western region of the country, where 54 cases were recorded, including 33 deaths.
Beginning with the 1976 discovery of Ebola in an area that is now the Democratic Republic of Congo, the country has experienced 10 outbreaks, including this year's outbreaks.
Congo is also experiencing a long-term humanitarian crisis that includes intermittent armed conflict, according to WHO. Other health epidemics, including cholera, measles and polio, as well as human trafficking, are flourishing there. WHO has estimated that more than 1 million refugees and internally displaced people are in North Kivu and Ituri, and their movement through and out of the provinces is a potential risk factor for the spread of Ebola.
Tedros noted an increase increase in the frequency and intensity of attacks by armed groups as a hindrance in stopping the outbreak.
On Thursday, three Red Cross volunteers were injured during a burial service in the city of Butembo, according to the International Federation of the Red Cross. Two suffered serious injuries.
Last week, a delegation from Congo participated in a meeting that brought together representatives from Uganda, Burundi, South Sudan, Tanzania, Kenya and Rwanda, Congo's Ministry of Health reported on Sunday.
The meeting, which took place in Entebbe, Uganda, focused on the measures to be taken to prevent the spread of the Ebola epidemic. The nations worked to develop an action plan to further develop their emergency preparedness and disease response mechanisms, the ministry said.
Since the start of a vaccination program August 8, 14,869 people have been vaccinated in Congo, according to the Ministry of Health. The experimental rVSV-ZEBOV vaccine, made by pharmaceutical company Merck, proved highly protective against the deadly virus in a major trial in Guinea, according to WHO.
Two barriers faced by the health workers include the security situation and "pockets of community mistrust, especially around a village called Ndindi, which is where many of the most recent cases have occurred," Tedros said.
"Small but significant numbers of people refuse active followup or refuse to be treated in the Ebola treatment units," he said. "We are working closely with religious leaders, youth and women's groups and with the families themselves to overcome this obstacle."