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Expand chart
Data: Ministry of Health DRC; Chart: Andrew Witherspoon/Axios

Health officials' longstanding fears about the potent mix of armed conflict in weak states — combined with a highly infectious disease outbreak — are being realized. In the Democratic Republic of the Congo (DRC), an Ebola virus outbreak is now at a tipping point and threatens to expand.

Why it matters: The current outbreak began Aug. 1 and appeared to be slowing down, as most of the new cases were contacts of known infected people. However, as security deteriorated, new cases surged — with 25% of all suspected and confirmed cases being recorded in the first 2 weeks of this month alone. Experts say a combination of ongoing violence in North Kivu's Beni town, community distrust, population density and other factors are hampering containment efforts.

Between the lines: Tom Inglesby, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, tells Axios that this outbreak is the "kind of scenario that many people who care about epidemic response, pandemic response have been worried about for a long time.”

The latest: The World Health Organization met on Wednesday and decided not to declare the outbreak a "Public Health Emergency of International Concern," which could've triggered international travel restrictions. But the security situation in DRC continues to deteriorate — with 8 major security incidents in north Kivu in the last 8 weeks, per WHO.

  • The violence has led to an interruption in public health initiatives — including efforts to quarantine those who may be infected, to vaccinate all "contacts" of people who were infected, and to educate pockets of people who are suspicious of health care workers.
  • This has led to a spike in cases — with special concern voiced that roughly half of them are not on contact lists of previously known patients, meaning the outbreak is definitely spreading.

Details: The violence has been serious enough to cause the CDC to withdraw its Ebola experts from field work in that area, as first reported by STAT News and confirmed by Axios.

  • The CDC says it moved an Ebola expert adviser, a vaccine expert and a border health expert to Kinshasa, which is more than 1,500 kilometers from Beni.
  • Since the start of the outbreak, the U.S. has deployed more than 2 dozen experts from USAID and the CDC to support preparedness and response in the DRC and neighboring countries.

Vaccination's impact: The DRC's Health Ministry mobilized an experimental ring vaccination campaign a week after the first case was reported. Between Aug. 8 and Oct. 17, nearly 19,000 people have been vaccinated, DRC ministry says.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), tells Axios the Ebola outbreak in DRC is "obviously a difficult situation."

"We're all concerned about it because we want to have optimal response to the outbreak but we're restrained because of the security issue."
— Anthony Fauci, NIAID director

Julie Fischer, co-director of the Center for Global Health Science and Security at Georgetown University, tells Axios there's a "real risk this outbreak is ready to explode locally."

  • "Contact tracing is absolutely essential to the ring vaccination campaign," Fischer says, but this requires face-to-face meetings that can't be completed without workers feeling secure.

The bottom line: This outbreak is nowhere near over. The longer it lasts, the greater the chances of it spreading. However, the WHO says it has confidence that at-risk neighboring countries are prepared.

Go deeper

Updated 34 mins ago - Politics & Policy

Arizona GOP's private recount of 2020 election confirms Biden's win

Contractors working on behalf of the GOP examine and recount 2020 ballots at Arizona Veterans Memorial Coliseum in Phoenix in May. Photo: Courtney Pedroza/Getty Images

In an odd coda to the 2020 election, private contractors conducting a GOP-commissioned recount in Arizona confirmed President Biden’s win in Maricopa County.

Why it matters: The unofficial, party-driven recount has been heavily covered on cable news as part of former President Trump's continued effort to sow doubt about the election result.

Del Rio bridge camp empty following Haitian migrant surge

A boy bathes himself in a jug of water inside a migrant camp at the U.S.-Mexico border on Sept. 21 in Del Rio, Texas. Photo: John Moore/Getty Images

The last migrants camping under the Del Rio International Bridge, which connects Texas and Mexico, departed on Friday, Homeland Security Secretary Alejandro Mayorkas announced during a White House press briefing.

Driving the news: Thousands of migrants, mostly from Haiti, had arrived to the makeshift camp after crossing the southern border seeking asylum. Roughly 1,800 migrants will now head to U.S. Customs and Border Protection processing centers.

White House says it expects federal contractors to be vaccinated by Dec. 8

Photo: Stefani Reynolds/Bloomberg via Getty Images

The White House said in new guidance Friday that it expects millions of federal contractors to be vaccinated against the coronavirus no later than Dec. 8.

Why it matters: Companies with federal contractors have been waiting for formal guidance from the White House before requiring those employees to get vaccinated, according to Reuters.

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