刚果（金）埃博拉疫情恶化：病死率升至46%，传播速度超西非疫情

Bloomberg Audio Studios, podcasts, radio, news. The Ebola outbreak in the Democratic Republic of the Congo has become the worst outbreak in the history of the country. More than 1,800 people were confirmed to have died of Ebola since the outbreak was declared back in May. But the true number could be much higher as many infections have gone untraced. The director general of the World Health Organization, Dr. Tedros, has called for a faster response.

We need to do the right things and we need to do it with speed and we need to be faster. Unless we're faster, we cannot catch up. It's moving fast and it's ahead of us. We're playing a catch up, but from a very far distance now. Early treatment can dramatically improve the chances of survival, but too many cases are turning up to clinics too late or not at all. And a backdrop of collapsing health services and chronic deprivation has led to a growing sense of mistrust and miscommunication combining to make this the fastest growing Ebola outbreak ever encountered.

And battling the mistrust has become a priority for agencies fighting the outbreak, including the Africa CDC. who want this outbreak to remain a public health issue led by communities for communities by communities. There is no magical solution if we don't really work with communities and sit with them.

On this week's Next Africa podcast, we'll look at why this outbreak is growing so rapidly, whether enough is being done to slow the epidemic down, and how much worse things could still get in the DRC. I'm Jennifer Zabasaja and this is the next Africa podcast bringing you one story each week from the continent driving the future of global growth with the context only Bloomberg can provide. Joining me today is Bloomberg's global health editor Jason Gail.

Jason, thanks so much for joining us. Let's just start with what we have been seeing because cases have continued to grow rapidly in the DRC especially over the past few weeks. Can you just bring us up to speed on what the latest is with the situation right now?

Yeah, thanks J. I think while cases confirmed cases have been increasing, confirmed deaths from Ebola have been increasing faster and so the scientists call the crude case fatality ratio that's the number of people who have died from Ebola among all of the known cases. That ratio is up to now just over 46% and earlier on like maybe 2 months ago it was in the low30s. So that's been a big development and the reason for that is most likely experts say because we're not detecting less severe cases.

We're only seeing really really sick people, those who are dying and about to die coming into treatment. Otherwise, there are a lot of infections going on undetected in the community. Jen,

and you and the team have a report out about this, just how this outbreak has compared to previous ones. Can you just point out how it's working really for the health officials on the ground because as you mentioned people who are really really sick are getting to the hospital instead of those who are maybe earlier on in this illness.

Yeah. So we know that getting treatment early really improves your odds of surviving this infection like quite spectacularly. But as I just mentioned it the everything is moving in the wrong direction. and more people are dying from this in terms of what where this outbreak is versus previous large outbreaks. So, we're now into the 13th week of this outbreak since it was declared at the 12 week mark. There were 4,120 confirmed cases.

Now, the largest outbreak known so far is the one that occurred a decade ago in West Africa, which eventually got to around 24,000 cases. It took 27 weeks for that outbreak to get around 4,000 cases. So, this outbreak is already growing about two to three times faster than the West African outbreak 10 years ago.

Is it because some of these patients are not going to the hospital soon enough? What do we know about why these these cases and these deaths are arising as fast as what we've seen in the past?

Yeah, good question, Jen. So one of the hypotheses that have been put forward is a concept of walking Ebola. That is that the bundio virus that is driving this outbreak seems to replicate slower than other strains of Ebola. And that slower replication is causing a slower progression of symptoms. So essentially, people who are infected may not get really really sick for a little bit longer. So that allows them to continue being in the community, going to church, catching buses, doing their shopping for longer, potentially infecting other people for longer as well.

So that is believed to be one reason for why this is really exploding.

So it's not necessarily that people are avoiding care altogether. they may not even know that they have it. Is that sort of the hypothesis that you're hearing from experts?

That is one reason. Certainly, people are avoiding care for many reasons. But there is also the issue that when you initially present with the symptoms of bundjo, it's difficult to know if that's not malaria or many other diseases that's non-specific. Can you just clarify again what the symptoms are because you mentioned malaria and you mentioned Ebola and there are a bit of conflating symptoms that there are between these these viruses.

What is it that we need to know?

Yeah. So fever is really one of the main symptoms and of course you can get a fever with so many different illnesses.

Yeah. And then that can progress to you aches and pains that it feels like you're coming down with the flu. And then eventually patients may experience difficulty breathing. And that has been a feature that hasn't always been as prominent with past Ebola outbreaks. Mesrontier and groups like that have described patients needing a lot more oxygen than they have typically required in previous outbreaks. So again, not typical bleeding from your eyeballs and all kinds of horrific hemorrhagic symptoms that's being reported fairly rarely with this.

It can occur, but it's usually at the later stages and it's not really the the predominant features of this disease.

Is the classification for the types of patients that we're seeing making up the confirmed fatalities? Are we seeing a similar type of patient that is succumbing to this disease or is it across the board children, elderly, pregnant people, men, women? Do we know much about how it's hitting people yet?

We do. So, just in terms of overall prevalence, it's occurring more frequently in people roughly 20 to 40 and with a shift towards females. And that's because females are doing a lot of the caring. It's sisters, mothers, grandmothers, aunts that are caring essentially for relatives who get sick with this. But we know that among children, younger age groups, while they're not getting infected as frequently, their probability of dying is way higher.

Also with pregnant women that tends to lead to fairly catastrophic situations with spontaneous abortion, still birth, all kinds of obstetric complications from that. Often you know the women may bleed out because of this tendency to bleed when you have Ebola. So there is a real concern around maternal health in in this outbreak.

And stick with us. We're going to take a short break now and when we come back we'll have more on what is now the DRC's worst ever Ebola outbreak. We'll be right back. Welcome back. Today on the podcast, we're looking at the ongoing Ebola outbreak in the DRC that has now claimed more than 1,800 lives. Jason Gail is still with me. Jason, you and the team have been covering this now for several weeks. you've been watching the briefings that we've been getting from the WHO and Africa CDC and also speaking to those on the ground.

What can you tell us about the effectiveness of some of the actions that are being done to tackle this outbreak? What exactly is working and what maybe still needs some work?

Yeah. So, the Africa CDC said last week that their attempts to

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