Late last night rebel forces set fire to a Doctors Without Borders (MSF) Ebola treatment center in Katwa, forcing MSF to evacuate patients and staff. The attack—coupled with new cases recorded in the city this weekend—have made Katwa the epicenter of the Democratic Republic of the Congo's (DRC's) Ebola outbreak.

"Attacks like this could undo the progress we have made. Despite this setback, we will keep working with the government, partners & communities to end this outbreak," said World Health Organization Director-General Tedros Adhanom Ghebreyesus, PhD, on Twitter earlier this morning.

According to Reuters, MSF announced on Twitter today that the treatment center is closed. Today the ministry of health said a nurse died while trying to escape the fire, but the 10 patients housed in the center had all been safely relocated to other treatment centers.

The attack is the latest setback to Ebola response efforts. Since the outbreak began last August, several rebel groups of have attacked both health workers and clinics and spread misinformation about vaccination and Ebola transmission.

13 new cases in 3 days

Over the weekend and through today, the DRC recorded 13 new Ebola cases, 8 in Katwa and 5 in Butembo. Katwa has now surpassed Beni as having the most cases during this outbreak. There were also 12 deaths recorded, including 5 community death in Katwa.

"Katwa remains the main focus of the epidemic. In the last 21 days, 86 new confirmed cases were reported, of which 49 (57%) were reported in Katwa," The DRC health ministry said in its update yesterday.

"Katwa surpassed Beni in terms of number of cases and deaths. To date, Beni has reported 235 cases (226 confirmed and 9 probable) and 127 deaths while Katwa is 239 cases (228 confirmed and 11 probable) and 182 deaths."

The mortality rate of cases in Katwa has also been markedly higher than in Beni, 76% versus 54%. Health officials said the difference is attributed to the higher percentage of community deaths and vaccination refusals in Katwa.

"This situation demonstrates the importance of increasing community engagement and active case finding in the community and health facilities in Katwa," the ministry said.

The new cases raise outbreak totals to 872 cases, of which 807 are confirmed and 65 are probable. There have also been 548 deaths, and 176 suspected cases are still under investigation.

Since the outbreak began, 83,517 people have been vaccinated with rVSV-ZEBOV in a ring vaccination campaign, including 21,357 in Katwa and 20,613 in Beni.

Phase 1 vaccine trials

Currently only Merck's unlicensed rVSV-ZEBOV has been okayed for use in the DRC. But today the Journal of Infectious Diseases published two phase 1 trials involving prime-boost Ebola vaccines, Ad26.ZEBOV, manufactured by Johnson & Johnson, and MVA-BN-Filo, made by Bavarian Nordic.

Both vaccines were well-tolerated and immunogenic up to a year in healthy volunteers from Kenya, Uganda, and Tanzania.

See also:

Tedros Adhanom Ghebreyesus Twitter feed

Feb 25 Reuters story

Feb 25 DRC update

Feb 24 DRC update

Feb 23 DRC update

Feb 23 J Infect Dis Kenya study

Feb 23 J Infect Dis Uganda and Tanzania study