Ebola case confirmed in rebel-held Congo area far from outbreak's epicentre

• Confirmed Ebola case in South Kivu raises fears of spread
• Case in area of the east under rebel control
• Aid shortages, armed violence hamper response
• Police fire warning shots amid burial dispute

By Ange Kasongo and Benoit Nyemba, Reuters

A case of Ebola has been confirmed in eastern Democratic Republic of Congo's South Kivu province, hundreds of kilometres from the outbreak's epicentre, the rebel alliance that controls the area says.

The case, in a rural area near the provincial capital Bukavu, signals the spread of an outbreak that experts believe circulated undetected for around two months in Ituri province, several hundred kilometres to the north, before being identified last week.

The outbreak has resulted in 160 suspected deaths out of 670 suspected cases, and 61 of the cases have been confirmed, according to DRC health ministry data.

Two cases have also been confirmed in neighbouring Uganda, which said it would suspend flights to the DRC, effective within the next 48 hours, as a precautionary measure.

The WHO has declared the outbreak of the virus's Bundibugyo strain, for which there is no vaccine, a public health emergency of international concern.

The Alliance Fleuve Congo, which includes the Rwanda-backed M23 rebels who seized swathes of eastern DRC last year, said the 28-year-old patient in South Kivu had died and been buried safely.

It said the individual had travelled from the northern city of Kisangani but gave no details of recent movements.

South Kivu health spokesperson Claude Bahizire told Reuters that two suspected cases had been detected in the province, including the fatal case. The other patient was in isolation awaiting test results, he said.

An Ebola case was also confirmed last week in Goma, capital of neighbouring North Kivu province, which is under M23 control.

Protesters attack hospital

In the town of Rwampara, one of the outbreak's hotspots in Ituri, clashes broke out after the family of a suspected Ebola victim disputed that the disease had killed him and demanded his body, Reuters witnesses said.

Protesters gathered outside the hospital and set fire to tents run by the medical charity ALIMA, prompting police to fire warning shots and tear gas, the witnesses said.

Hundreds of health centres were attacked by armed groups and angry civilians during the 2018-2020 Ebola outbreak in eastern DRC, which was the second deadliest on record, with nearly 2300 fatalities.

First responders expect widespread armed violence across eastern DRC, where dozens of militias operate, and for community mistrust of medical workers to again complicate efforts to contain the outbreak.

Speaking to reporters in Geneva, Jane Halton, chair of the Coalition for Epidemic Preparedness Innovations (CEPI), said the confirmed cases announced to date likely represented only "the top of the iceberg".

CEPI, which funds vaccine development, is assessing potential candidates for Ebola. Halton said it might be possible to meet CEPI's target of having a safe, effective vaccine for major outbreaks within 100 days, although this would be "a big lift".

In a sign of further restrictions aimed at preventing Ebola entering the US, the State Department said Americans who have been in Congo, Uganda, or South Sudan within the last three weeks must only return to the United States through Washington Dulles for enhanced screening.

Supplies running short

Aid workers responding to the outbreak have said they lacked basic supplies, which some have attributed to foreign aid cuts by major donors that have weakened local health services and disease surveillance.

Britain said it was allocating up to £20 million (NZ$44m) to the response. The United States, which gave around US$600 million (NZ$1m) to the 2018-2020 response, has so far committed $23m and said it would help open up to 50 clinics in DRC and Uganda.

Uganda's health ministry said it had not been consulted by the US on plans to establish clinics and stressed there was no known local transmission.

Information Minister Chris Baryomunsi told Reuters the US was "overreacting" by banning most travellers from Uganda, along with DRC and South Sudan.

"We've handled cases of Ebola at other epidemics for a number of years," he said. "There is capacity within the country to contain these epidemics."

The African Union said the India-Africa Forum Summit scheduled to take place in New Delhi from 28-31 May would be rescheduled due to "the emerging public health situation on the continent".

- Reuters