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

The world's 2nd-largest Ebola outbreak on record in the Democratic Republic of the Congo is showing no signs of slowing after at least 5 months, with the number of cases soaring past 600 and the death toll eclipsing 400 on Jan. 14.

Why it matters: The outbreak of the deadly virus, which causes fever, headaches, diarrhea and bleeding, has been exacerbated by insecurity in eastern Congo. The World Health Organization and nongovernmental organizations responding to the outbreak have never had to combat Ebola in such a threatening environment before, and some treatment centers have been destroyed.

Details: On Jan. 14, the Ministry of Health in the Congo reported that there have been a total of 658 cases, along with 402 fatalities (confirmed Ebola deaths plus suspected deaths from the disease) since the outbreak began in August in the provinces of North Kivu and Ituri.

  • This makes this outbreak the 2nd-largest Ebola outbreak on record, well below the West Africa outbreak in 2014–16, which killed more than 10,000.
  • Ominously, the number of cases under investigation as of Jan. 14 were 200.
  • Unlike the largest Ebola outbreak on record, combatting the ongoing outbreak is largely being left to the World Health Organization.
  • The U.S. has been reluctant to send specialists from the Centers for Disease Control and Prevention to the front lines due to the security situation, particularly in Beni, the epicenter of the outbreak.

What they're saying: Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security, told Axios that the spike in cases under investigation likely has to do with Ebola workers resuming their work following election-related violence over the past few weeks.

  • "My hunch is because there was a gap in response due to the election-related interruptions," Nuzzo told Axios on Tuesday.

Nuzzo says she worries about the lack of a broader, international response to contain the outbreak, since the longer it festers, the more likely it is to spread to different parts of the Congo, and to neighboring countries.

“What’s been missing from this outbreak is the international response.”
— Jennifer Nuzzo, Johns Hopkins University

The WHO acknowledges the challenging circumstances facing its nearly 500 personnel in the Congo. "The Ebola outbreak in DRC is occurring in one of the most complex settings possible," WHO spokesperson Tarik Jašarević told Axios via email. "The main challenges are the security environment, pockets of mistrust among affected populations, and poor infection prevention and control in many public and private health facilities.

Why you will hear about this again: The Ebola outbreak in the Congo follows another Ebola outbreak in a different part of the country, and it comes soon after the Zika outbreak raised alarm from South America into parts of the U.S.

  • With a burgeoning population, increases in migration and the lack of a robust international rapid-response force to respond to emerging epidemics, more outbreaks like this one are inevitable, Nuzzo and other health experts warn.

Go deeper: Read Axios' full Ebola coverage

Go deeper

Updated 1 hour ago - Politics & Policy

Bipartisan tributes flood in for "giant of the Senate" Bob Dole

Then-Vice President Joe Biden and former Sen. Bob Dole at an event put on by the World Food Program where he was awarded the first “McGovern-Dole Leadership Award” in December 2013. Photo: Douglas Graham/CQ Roll Call

Republican and Democratic politicians, including former Senate colleagues, are sharing condolences and memories commemorating the life of Bob Dole, who passed away at 98 on Sunday morning.

The big picture: Dole, the Republican presidential nominee in 1996, was the longest serving Republican leader in the Senate until 2018, when current Senate Minority Leader Mitch McConnell surpassed his record.

Former Sen. David Perdue to launch bid for Georgia governor

Photo: Megan Varner/Getty Images

Former Senator David Perdue (R) plans to announce a campaign against Georgia's incumbent Republican Gov. Brian Kemp Monday, according to a source familiar with Perdue's thinking.

Why it matters: Perdue's challenge to his former ally Kemp sets up an unprecedented "scorched earth" battle between Georgia Republicans fueled by former President Donald Trump, in the battleground state. The news was first reported by Politico.

Former Sen. Bob Dole dies

Former Sen. Bob Dole in 2019. Photo: Tom Brenner/Getty Images

Former Kansas Sen. Bob Dole passed away Sunday morning at the age of 98, the Elizabeth Dole Foundation announced in a statement.

Driving the news: Dole, a revered figure in U.S. politics and the Republican presidential nominee in 1996, served in the Senate for 27 years, including 11 years as GOP leader. Earlier this year he revealed he had been diagnosed with stage 4 lung cancer.