Two Ebola-related fatalities have been identified in a displacement camp in eastern Congo, the U.N. refugee agency said, prompting urgent concern from humanitarian workers about the potential for swift transmission in densely populated refugee sites.
The victims were internally displaced people living in the Kpangba camp, which UNHCR said hosts 30,000 refugees. The virus has extended across three provinces since the World Health Organization declared the outbreak a public health emergency of international concern on May 17.
The three affected provinces - Ituri, South Kivu and North Kivu - have been devastated by decades of conflict and together accommodate more than 5 million displaced people. Aid workers describe the camps as congested and lacking adequate hygiene facilities.
"It’s a highly populated area so the risks of transmission are obviously higher and worrying," an aid worker said, noting the difficulty of isolating ill people in makeshift shelters. "These are tents with tarp walls, where do you isolate if you have symptoms?"
According to information provided by an aid worker, the two victims were a mother and daughter who died on May 31 and June 1. They were tested for Ebola by the World Health Organization after their deaths.
Humanitarian staff report that camp conditions frequently include crowded sleeping arrangements, insufficient sanitation and shared facilities. In some locations, hundreds of people may share a single toilet and open defecation has been reported, all factors aid workers say could accelerate transmission.
"We are all really worried that Ebola in these camps will spread extremely quickly and that there will be panic and people will flee all over whether or not they’re contacts, whether or not they’re ill," Caitlin Brady, interim country director for the Danish Refugee Council in Congo, said.
As of Friday, Congo had reported 676 confirmed cases and 136 deaths in the outbreak. The disease has also crossed into neighbouring Uganda, which has reported 19 cases.
Health authorities have identified the outbreak as involving the Bundibugyo strain of Ebola, a rare form for which there is no approved treatment or vaccine. Responders say the illness went undetected for weeks and that first responders are now attempting to contain transmission while addressing gaps in detection and response capacity.
Given the concentration of displaced populations in affected provinces and the limited capacity for isolation and sanitation within camps, aid groups and health authorities face acute challenges in preventing further spread while managing community fear and potential population movements.