Health workers struggle as new Ebola cases are found in border regions of South Ubangi and Haut-Uele.

The Ebola virus caused by the Bundibugyo strain has spread to two new health zones in the Democratic Republic of the Congo, according to the World Health Organization (WHO).

New cases were found in Bulu in South Ubangi governorate on the border with the Central African Republic and Dungu in Haut-Uele province on the border with South Sudan, the WHO said on Friday.

The additional cases bring the number of health zones affected to 63 across seven provinces as authorities struggle to control the outbreak.

As of September 23, the Democratic Republic of the Congo, or DRC, has reported 7,890 confirmed cases and 3,799 deaths, according to the WHO. That means that almost half the people who contracted the infection have died.

WHO Director-General Tedros Adhanom Ghebreyesus said conflict and population displacement were making it more difficult for health workers to reach ‌‌affected communities and trace people who may have been exposed to the virus.

“It’s very difficult to see Ebola in isolation because even our response to Ebola is affected by the conflict, because there is displacement and there is an access problem to some areas,” Tedros said.

The Bundibugyo strain is difficult to treat because there are no approved vaccines, Tedros said, adding that the WHO is accelerating clinical trials of vaccines and treatments.

Contact tracing falling short

Meanwhile, health workers looking for people who may have been exposed to the Bundibugyo strain are falling short of their targets.

According to Dr Jean Kaseya, the director-general of the Africa Centres for Disease Control and Prevention (Africa CDC), the more than 7,000 confirmed cases should translate to about 420,000 contacts.

“But currently, we have just 30,000 people in the contact list,” Kaseya said.

“When the outbreak is at community level, we cannot talk about control,” he added.

Ituri province in northeastern DRC continues to be the epicentre of the outbreak, accounting for 6,032 confirmed cases since the start of the epidemic in May, including 868 new confirmed cases reported in the last 21 days.

North Kivu is the second most affected province, with 1,480 new cases, including 567 reported in the last 21 days. The province now accounts for around a third of newly confirmed cases and deaths, the WHO said in a report on Sunday.

Nearly 60 percent of people diagnosed in North Kivu died, significantly higher than the national average of 48 percent, the data show.

Medical staff say patients are avoiding health facilities until it is too late.

“Patients think that if they arrive at the hospital, they will be immediately sent to the treatment centre to die,” said Dr Michel Paluku Mukuloli, who works at a hospital in North Kivu’s Butembo.

That complicates efforts to identify cases and start treatment before the disease reaches its most dangerous stages.

North Kivu was the epicentre of three previous Ebola outbreaks, including one in 2018-2020, which until this year was the DRC’s largest and deadliest. Those outbreaks, however, were caused by a different type of Ebola virus, known as the Zaire strain.

Much less is known about the Bundibugyo strain. But responders say in the early stages of infection, patients often experience milder symptoms easily mistaken for more common diseases such as malaria and typhoid fever.