Congo's Ebola deaths pass 5,000, and the outbreak becomes the second deadliest on record

The number crossed a line this week that health officials had hoped to hold. Congo's National Institute of Public Health counted 5,026 confirmed Ebola deaths and 10,351 confirmed cases as of October 29, in situation report 168, published on Friday. In the single reporting day the institute recorded 77 new cases and 34 deaths. The outbreak has reached 67 health zones across eight of Congo's 26 provinces, with 2,788 people recovered and 1,101 patients in isolation or treatment centres. Ituri and North Kivu, in the conflict scarred east, account for most of the dying.

The strain matters. This outbreak is Bundibugyo Ebola, a species of the virus for which medicine has no approved vaccine and no specific treatment. Doctors can support a patient, replace fluids and treat other infections, but they cannot attack the virus itself, and nearly one patient in two dies. The outbreak was declared in mid May and caught the authorities by surprise. It is now the second largest and second deadliest Ebola outbreak ever recorded. Only West Africa in 2014 to 2016 was worse, with about 28,600 cases and more than 11,000 deaths across Guinea, Liberia and Sierra Leone.

It is also the widest. Kenya has confirmed eight cases and two deaths, Nigeria confirmed its first case last week, a patient evacuated to Switzerland, and Uganda confirmed cases earlier in the outbreak. No previous Ebola outbreak has been recorded in three African regions at once. Dr. Patrick Otim of the World Health Organization called the 5,000 figure a devastating milestone and spoke of thousands of families and communities torn apart.

The youngest are faring worst. Doctors Without Borders says one in four of the infected in North Kivu province is a child, and that at its treatment centre in Butembo, 24 of the 30 children hospitalised between June and September died. The group is calling for children to be protected first and included in research on the virus, work that is hard to do for a strain with no licensed products at all. The health workers themselves are on the casualty list. Two doctors, Marie France Shogogo in North Kivu and Samuel Safari in Ituri, died of Ebola on October 27 and 29, the third and fourth medical deaths the Africa Centres for Disease Control and Prevention has marked in recent months, after neurosurgeon Charles Mbusa Munyumu in August.

Containment is fighting the geography and the war at the same time. About 80 percent of new infections, by the Africa CDC's count, are turning up in people who were never identified as contacts of a known patient, which means the chains of transmission are running ahead of the tracers. Armed clashes in Ituri have cut aid and disease surveillance at displacement sites where cases have already been confirmed. The United States begins a new screening rule on November 3, under which every passenger flying to America must attest that they have not been in Congo in the previous 21 days. The airlines have asked the CDC to delay it. Nothing in the latest figures suggests the outbreak is close to ending.