Africa CDC, the African Union's continental public health agency, recorded 683 of 1,033 reported deaths in DR Congo's Bundibugyo Ebola outbreak, 66% of the total, as having occurred in the community rather than inside a treatment or isolation centre. The finding sits in situation report 71 on Bundibugyo virus disease (BVD), whose case tables run to 27 July with a flash update appended by 30 July1. Two fatal cases in three never reached the system built to treat them.
Bundibugyo ebolavirus has been spreading through DRC's eastern provinces since May, and the community-death share gives physical shape to two things already on the record. Jean Kaseya, Africa CDC's director-general, estimated on 16 July that true infections run two to four times the confirmed count, and WHO found that more than 80% of new cases were arising outside any known contact chain. Neither finding could name the patients it implied. Situation report 71 counts 683 of them.
Ebola makes a body most infectious at the moment it stops living, and a body that never reaches a centre is washed and dressed by relatives before burial. Each of those 683 deaths is therefore also a plausible transmission event, which is why the number matters more than its share of the mortality table. Contact tracers reached 78.9% of listed contacts, 13,882 of 17,588, against the roughly 95% coverage epidemiologists treat as the threshold for breaking chains2. A 16-point shortfall in tracing coverage is what produces a death register like this one.
