DRC Ebola outbreak grows to become one of worst recorded

The rapidly growing Ebola virus outbreak in the Democratic Republic of Congo (DRC) has now surpassed 1,000 confirmed cases.

It is now the second-largest outbreak on record in the DRC since the virus was discovered in 1976.

As of June 21, there are now 1,048 confirmed cases and 267 deaths, according to the DRC's Ministry of Communication and Media.

That is an increase of more than 211 confirmed cases in less than a week.

International aid organisation Save the Children said at least 52 children, including 16 toddlers and infants, have contracted the virus in the past month.

As of June 16, at least 19 of them had died, according to Save the Children.

DRC officials said surveillance efforts were intensifying and 97 per cent of "travellers [were being] screened at entry points".

The outbreak was first declared by the DRC's Ministry of Health on May 15, and identified as a health emergency by the World Health Organization on May 17.

The 2018-2020 Ebola virus outbreak in the Democratic Republic of Congo remains the largest ever recorded in the region, with 3,470 cases and 2,287 deaths.

Worldwide, the current outbreak is already the third largest ever recorded.

But it is likely the recorded cases are only part of the picture, according to aid organisations.

Kate White, an emergency medical coordinator for Médecins Sans Frontières, is based in Ituri Province at the epicentre of the outbreak.

Much of the outbreak has been concentrated in the mining town of Mongbwalu, where three Red Cross volunteers became some of the first known people to die from the disease.

"You have healthcare workers who have seen not only their loved ones die, but their fellow workers," Ms White said.

"We have patients coming in at the very, very end stage of their disease."

"They are already having vomiting, diarrhoea, really, really weak.

"And it's heartbreaking because sometimes you see the same family group over and over again over time now.

"Because what started with one person has been transmitting at a household level, and in comes the next person."

Health officials on the ground have repeatedly stressed they are "playing catch up" due to testing kits failing to detect the rarer form of Ebola virus until potentially weeks too late.

"Everyone is running around trying to … provide the best possible care in a situation where we just have no understanding of the actual transmission chains and the extent of the outbreak," Ms White said.

"We know that there's multiple community deaths every day.

"The deaths in the community outweigh, by a significant proportion, the number of confirmed cases that are alive."

"One average, [test results] of the last few weeks … will be that two-thirds of the confirmed tests [are] from people who have died.

"They are not people who we are catching early and can seek care."

Standard testing kits were designed to detect the more common Zaire Ebola virus, and not the Bundibugyo Ebola virus now spreading.

Many treatment centres in the area are overwhelmed, and testing remains "one of the most significant weaknesses" in the response, according to Ms White.

"Many communities … still have limited access to these kits," she said.

"Treatment centres continue to face significant delays in receiving laboratory results.

"Without faster and more widely available testing, we will struggle to detect cases early enough to contain the outbreak."

Health workers facing conspiracies and attacks

Despite a recent scale-up in the response, Médecins Sans Frontières (MSF) has said gaps in surveillance, contact tracing, diagnosis and more are undermining efforts to get the outbreak under control.

Insecurity, according to MSF, makes reaching certain communities difficult.

Ituri and North Kivu are among the DRC's "most volatile" regions, grappling with conflict, instability and climate shock.

The area has also seen an influx of almost 1 million displaced people, according to the United Nations High Commissioner for Refugees (UNHCR).

Contact tracing remains at about 70.8 per cent on average across the region, compared to the usual 80-90 per cent rate.

Babou Rukengeza, Save the Children's Ebola response lead, has been in Ituri's capital city of Bunia for almost three weeks.

The area is still facing high community transmission, he said, despite mobile laboratories allowing for more testing.

"We have some attacks on the team here on the ground, especially the team who are doing surveillance," he told the ABC.

"There are a lot of rumours around this outbreak here in Bunia.

"The misinformation is really [that] Ebola does not exist, that … it's really something the health workers and the international NGOs are saying to get money."

Other rumours have spread, according to Dr Rukengeza, claiming the virus has been created by local mining companies or is a result of witchcraft.

"We also have small churches here in Bunia [where] some of the pastors say, 'No, we cannot go to the hospital, just come to my church, I can pray for you,'" he said.

"They put Ebola on the side of satanic things … it's really confusing a lot of people here."

Health workers are now working closely with the community to spread awareness of Bundibugyo Ebola virus and help prevent the spread.

Save the Children is also working with community leaders, religious leaders and those who have survived the disease to speak out.

"The most affected age group is 20 to 40 [years old]," Dr Rukengeza said.

"And this age, they are using social media and we are explaining the message via social media for them to repeat.

"And now we are also trying to identify all those recovered persons, for them to be our champions, for them to be the persons we can showcase.

"What we are doing, we are just at the beginning."