Health officials responding to the Ebola outbreak in the Democratic Republic of Congo (DRC) report that symptoms observed in the current epidemic appear to be milder than those seen in previous outbreaks. The outbreak, first detected in mid-May, has affected more than 1,000 people and caused over 250 deaths according to Congo’s health ministry, although experts believe the actual numbers may be higher due to underreporting and delayed detection.
The virus responsible for the outbreak is the Bundibugyo strain, which differs from the more lethal Zaire strain that was responsible for most past Ebola epidemics, including the 2014 West Africa outbreak that killed more than 11,000 people. While Ebola infections generally progress from initial “dry” symptoms such as fever, body aches, and fatigue to “wet” symptoms including diarrhea and vomiting, a hallmark of severe cases is extensive internal and external bleeding in later stages. However, health officials note that this hemorrhaging appears in only about 10 percent of current cases, compared with roughly half of Zaire Ebola patients who exhibited such symptoms during past outbreaks.
Experts say that milder disease and a potentially lower mortality rate, though positive for patients, may complicate efforts to contain the epidemic. Dr. Marie-Roseline Belizaire, leading the World Health Organization’s response team in Congo, highlighted early data indicating fewer deaths and less severe bleeding. However, Dr. Chikwe Ihekweazu, WHO’s Health Emergencies Program executive director, expressed concern that these factors could prolong the outbreak by making cases harder to recognize and trace.
Milder symptoms can be easily confused with other common illnesses in the region, such as malaria, typhoid, or dysentery, leading many infected individuals to avoid seeking medical care or delay reporting symptoms. Cultural beliefs, including fears of witchcraft or organ theft during isolation, further deter people from accessing treatment. This has resulted in many patients arriving at healthcare facilities only in critical condition.
Contact tracing, a key tool in outbreak control, faces significant challenges. On average, patients identified between five and eight contacts, fewer than the expected 15 to 40, and only about half of these contacts have been successfully located. Public health specialists caution that unidentified cases may continue to spread the virus, potentially igniting new transmission clusters.
There are indications that the virus might have circulated undetected for months, with some researchers pointing to unresolved clusters of viral hemorrhagic fever in neighboring countries such as Burundi and South Sudan. If these clusters are linked to the current outbreak, the geographical spread and duration of transmission could be wider than officially recognized.
The health system in the affected regions remains fragile. While larger Ebola treatment centers in Ituri Province, the epicenter of the outbreak, are now better equipped, smaller health facilities, especially in parts of North Kivu province such as Beni and Butembo, face severe resource constraints including limited testing capacity and insufficient protective gear. Humanitarian organizations emphasize the difficulty of managing the outbreak under these conditions, with inadequate infrastructure impeding effective care and prevention measures.
Efforts continue to focus on improving detection, treatment, and contact tracing, but the combination of milder symptoms and systemic challenges underscores the complexity of halting the outbreak’s progression in the DRC.