KINSHASA, Sept. 8 (Xinhua) -- The Ebola outbreak in the Democratic Republic of the Congo (DRC) is "becoming increasingly heterogeneous," with divergent transmission trends across affected provinces and health zones, according to the latest WHO external situation report published on Tuesday.
"The trends reinforce an increasingly heterogeneous epidemic, with declining transmission in some areas occurring alongside intensification and continued geographic spread elsewhere," the report said.
A key development is the rising proportion of deaths occurring in the community. During the week of Aug. 31 to Sept. 6, the proportion of confirmed deaths in the community reached 75 percent, the highest weekly proportion observed during the reporting period, up from 56.6 percent two weeks earlier.
"This divergence is concerning, as the increase in community deaths alongside the continued decline in treatment facilities deaths indicates that the earlier reduction in overall mortality has not been sustained," the report said.
The persistence of high community mortality, the report explained, "may reflect multiple barriers along the pathway to care, including delayed detection and notification, delayed referral or transfer to treatment facilities, limited recognition of illness or perceived severity, geographic and transport barriers, care-seeking outside formal health facilities, and community acceptance or trust."
As for vaccines, the Ervebo vaccine, the licensed shot against the Zaire ebolavirus, is currently being evaluated for cross-protection against the current Bundibugyo strain through an effectiveness study in the field.
Meanwhile, under protocol-governed compassionate use, which allows the use of unapproved or partially studied vaccines in an outbreak setting, vaccinations for frontline healthcare workers and at-risk populations began on Aug. 27.
As of Sept. 6, a total of 2,007 healthcare workers and frontline workers had been vaccinated, said the report.
As of Sept. 6, the cumulative totals stand at 6,686 confirmed cases and 3,226 confirmed deaths, with a case fatality ratio of 48.3 percent among confirmed and probable cases, according to the report. Healthcare worker infections remain a major concern, with 167 confirmed infections, including 47 deaths.
The WHO assesses the risk of further spread as "very high" within the DRC and "high" for neighboring countries. The second IHR Emergency Committee, convened on Aug. 18, emphasized that "the outbreak remains far from controlled" and continues to constitute a public health emergency of international concern.
The current outbreak, declared in May, has since become the country's largest and deadliest Ebola epidemic on record and the second-largest globally, behind the 2014-2016 epidemic in West Africa.
