This July, the World Health Organization declared that an outbreak of Ebola in the provinces of Ituri and North-Kivu, in the eastern Democratic Republic of the Congo, was a “public health emergency of international concern.” This particular strain of the virus, which first appeared in the region in 2018 and hasn’t been given a formal name—I’ll call it Kivu Ebola—is a variant of a species known as the Zaire Ebola virus. As of last Saturday, 2,753 cases of Kivu Ebola have been reported, with 1,843 deaths. There appear to be many undiscovered cases in the region, too. Ella Watson-Stryker, a social scientist with Doctors Without Borders, who has been studying the outbreak, said that around half of all Ebola patients admitted to treatment centers in eastern Congo aren’t part of any known chain of transmission. In other words, the infected person has caught Ebola from somebody whom disease investigators haven’t yet identified. “A lot of transmission is not being seen, but nobody knows the exact amount,” Watson-Stryker told me.
Ebola virus is a microscopic parasite that replicates inside the cells of a host. The outbreak in eastern Congo began more than a year ago, in or near a town called Mangina, when a few particles of Ebola virus apparently moved out of some wild creature, Ebola’s natural host—in this case, probably a bat—and entered the bloodstream of an as yet unidentified person. From that person, the virus began spreading through the local population. Ebola can overwhelm the human immune system in a matter of days. Symptoms typically include vomiting, diarrhea, coughing, rash, dementia, hemorrhages, and hiccups. Death occurs like the slamming of a door, when the patient abruptly goes into shock.
The Kivu Ebola outbreak area is in a conflict zone, beset by armed militias and ethnic violence. Local people often don’t trust the international medical organizations that run the Ebola treatment centers. There have been at least a hundred and ninety-four attacks on local health workers, seven of whom have been killed. Watson-Stryker, the researcher, said that social media complicates containment and treatment efforts. Conspiracy theories about medical workers and false information about how the virus is spread are ricocheting around popular platforms like WhatsApp. “The problem is the post-factual reality that exists in social media,” she said.
Right now, there may be around six hundred people in eastern Congo who have Kivu Ebola particles replicating in their bodies. As Ebola re-creates itself, many of the resulting particles are deformed duds and can’t replicate further. The ones that can copy themselves are infective. The Kivu swarm, with its three new lineages of Ebola, may amount to about one or two quadrillion infective particles of the virus. If these particles were collected in one place, they would fill three teaspoons and would weigh about fifteen grams. That small space contains numberless genetic possibilities. The longer the outbreak is allowed to continue, the greater the chances that Ebola will mutate, get better at spreading in humans, and vastly enlarge its circle of victims.