Viral strain: A health worker administers an Ebola vaccination in the port city of Mbandaka, in the DRC, on May 21. Picture: REUTERS
Viral strain: A health worker administers an Ebola vaccination in the port city of Mbandaka, in the DRC, on May 21. Picture: REUTERS

Kinshasa — Nine new suspected cases of Ebola were reported in northwestern Democratic Republic of the Congo (DRC) as authorities tackling the outbreak face challenges including resistance by local communities and multiple chains of transmission.

Fifty-eight cases, including 30 confirmed and 14 probable, have been registered since the outbreak was declared on May 8, the DRC’s health ministry said in a statement on Thursday. Of the nine new suspected cases, three are in Mbandaka, a provincial capital of 1.2-million habitants where four cases have so far been confirmed.

Twenty-seven people have died, according to the World Health Organisation (WHO).

The DRC’s latest Ebola outbreak was first identified around the remote town of Bikoro, 150km from Mbandaka.

The detection of the virus in an urban centre connected by busy river routes to the capital, Kinshasa, home to about 12-million people, as well as to cities in the Republic of Congo and Central African Republic, has fuelled concerns the disease could spread more widely.

On Monday, the health ministry and the WHO launched a vaccination campaign in Mbandaka and Bikoro with the still-unlicensed rVSV-ZEBOV treatment. The manufacturer, Merck, donated 7,540 doses, which arrived in the DRC last week. Another 8,000 doses will be donated, the WHO said.

This week, three people confirmed to be carrying Ebola were removed by their families from an isolation ward in Mbandaka, the health ministry said. Two have died, while one has returned to hospital and is under observation. "All efforts were made by staff to convince the patients as well as their families to not leave the centre," but "Ebola treatment centres are not prisons," the ministry said.

Medical teams have to tread carefully, Henry Gray, the Doctors Without Borders emergency co-ordinator in Mbandaka, said by phone on Thursday. "We don’t want to criminalise patients because if we criminalise people, they hide."

Medical organisations are working to ensure that "the families and the patients … understand the best chance of a full recovery is in a centre where they can be looked after".

Health workers were unable to take samples from a dead person in Bikoro "because of the resistance of the community," the health ministry said. In such cases, the fatalities are classified as a probable case of Ebola.

Medical teams in Mbandaka are investigating three separate transmission chains — one associated with a funeral in Bikoro, another linked to a health centre near Bikoro and the third related to a church service.

"Each one has the potential to expand if not controlled," said WHO deputy director-general for emergency preparedness and response Peter Salama in Geneva.