Case fatality among confirmed Bundibugyo Ebola cases in DR Congo reached 44.1% on 27 July, up from roughly 39.7% a week earlier, Africa CDC reported1. The agency attributes the rise to patients arriving later and to treatment sites running full, not to any change in the pathogen. Its headline totals now stand at 3,380 confirmed cases and 1,489 deaths, against 2,344 and 930 seven days before.
Those totals need one caveat carried alongside them. Africa CDC's own chart note marks the 22 July step change as retrospective harmonisation with the Ituri and North Kivu case registers rather than a single-day surge2. Read off the chart gridlines, the back-filled portion runs somewhere near 350 to 400 cases, an estimate rather than a figure the agency states. A meaningful share of the apparent week is therefore old cases arriving late in the ledger, and the raw difference between the two totals overstates how fast the epidemic moved.
Readers reaching for the 2018-20 Kivu epidemic as a yardstick will reach wrong. Kivu killed about 66% of those it infected, but Kivu was Zaire ebolavirus, a different species from the Bundibugyo ebolavirus circulating now. Bundibugyo has two earlier outbreaks in the literature: Uganda in 2007, with 131 cases and 39 deaths, and Isiro in eastern DRC in 2012, with 38 cases and 13 deaths, close to 30% in the first and 34% in the second. Measured against Kivu, 44.1% looks merciful. Measured against its own species, it runs ten points above anything Bundibugyo has done before, and the drift from 39.7% in seven days is the part that should concern anyone reading the trend rather than the level. Isolation coverage was already near 44% when WHO put cases at 1,481 in early July; untreated Ebola kills at rates no species comparison can soften.
