Nord-Kivu DRC, is where the outbreak started, it spread to South Kivu and Ituri, as well as, the country of Uganda(there are rumored cases in Tanzania per WHO[1]).
While the Équateur outbreak occurred in 3 zones[3], this new EVD incident is occurring in almost a dozen zones(and 2 provinces)[4].
There is an armed military conflict[5] that is impeding health workers(vaccination)[6][7]
Finally, there is a mass refugee movement into Uganda from the DRC[8]
If the EVD lingers long enough due to military conflict and the high number of zones(area) affected,[9] Uganda and the millions of entering refugees could become a major problem[10]Currently there are 160 cases and almost 100 deaths, as of 23 September in DRC[11]Peter Salama of the World Health Organization on 25 September, indicated that insecurity is obstructing efforts to stop the virus and
believes a combination of factors could establish conditions for an epidemic[12] On 24 November, it was reported that the current EVD outbreak would become the second biggest ever in history.[13] Uganda would eventually declare 4 cases, all died of EVD.[14]
The WHO stated on 21 September that "to date, the clinical details and the results of the investigation, including laboratory tests performed for differential diagnosis of these patients, have not been shared with WHO. The insufficient information received by WHO does not allow for a formulation of a hypotheses regarding the possible cause of the illness".[15][16][17] On 27 September, the CDC and U.S. State Department alerted potential travellers to the possibility of unreported EVD cases within Tanzania,[18] one day later the United Kingdom began indicating to potential travelers to Tanzania, the undiagnosed death of an individual and the WHO, 21 September statement on the issue.[19]
As a recent article indicates transparency is very important[21]; in the use of treatment options in this outbreak 35 individuals have been treated, 16 were discharged, 11 are still in the hospital and 8 died.[22]On 12 August, for the first time, two clinical trial medications were found to improve the rate of survival in those infected by EVD. They are REGN-EB3, a cocktail of three monoclonal Ebola antibodies, and mAb114. These two will be further used in therapy, ZMapp has been discontinued.[23][24][25][26]
^"Uganda: Ebola Preparedness Emergency Plan of Action (EPoA) - DREF Operation n° MDRUG041 - Uganda". ReliefWeb. Retrieved 23 September 2018. outbreak of Ebola will be detected with transmission to many districts with potential of international spread. It is assumed that asymptomatic cases from DRC passed the Points of Entry undetected. Additionally, transmission with be propagated due to poor health seeking behaviours, preference for traditional healer, fear and distance to Ebola treatment centres. This will leave potentially hundreds of people exposed, thus allowing the disease to spread further into the communities, including outside the current at-risk districts, with contacts spread in refugee settlement, across the country, and potentially cross over to neighbouring countries
^Schlein, Lisa. "WHO Warns Ebola Spreading in Eastern DR Congo". VOA. Retrieved 25 September 2018. A perfect storm of active conflict limiting our ability to access civilians, distress by segments of the community already traumatized by decades of conflict and of murder, driven by a fear of a terrifying disease
^McNeil Jr., Donald G. (12 August 2019). "A Cure for Ebola? Two New Treatments Prove Highly Effective in Congo". The New York Times. Retrieved 12 August 2019. The two new therapies were among four that were tested in a trial that has enrolled almost 700 patients since November. The two worked so well that a committee meeting on Friday to look at preliminary results in the first 499 patients immediately recommended that the other two treatments, ZMapp, made by Mapp Biopharmaceutical, and remdesivir, made by Gilead Sciences, be stopped. All patients will now be offered either the Regeneron or the Biotherapeutics drug.
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