Bulape ‒ Fifty-four-year-old Jacob Mukaba, who lost his wife recently to Ebola, is observing a 40-day mourning period during which he must not leave his home. This practice among the Kete community in Bulape, a locality in the Democratic Republic of the Congo’s Kasai Province and the epicentre of the ongoing Ebola outbreak—is working to the advantage of disease surveillance teams.

The practice, akin to a quarantine, facilitates monitoring of contacts of confirmed Ebola cases, as it limits movement of contacts and allows response teams to easily follow up on them to ensure swift and effective care is provided should they develop symptoms.

“I’m observing the 40-day mourning period and following instructions as a contact person. It’s not easy, but I’m confident it will be okay,” says a visibly emotional Mukaba.

Every day, health teams visit him to monitor his health. The visits are vital for immediate support as well as facilitating vaccination of all high-risk contacts. “It’s what allows us to detect and break the chain of transmission, especially through contact tracing,” says Dr John Otshudiema, epidemiologist and head of the World Health Organization (WHO) surveillance team in Bulape, pointing out that disease surveillance is the cornerstone of the Ebola response.

In Bulape, more than 250 frontline workers carry out disease surveillance, most of them are trained community health workers skilled in disease detection, contact tracing and public health awareness. On average, 50 Ebola alerts are investigated each day and nearly 10 suspected cases are isolated for testing.

Since the start of the outbreak, almost a thousand alerts have been reported, leading to the identification of 64 cases (53 confirmed and 11 probable). More than 2300 contacts have been monitored for 21 days and vaccinated.

However, challenges remain. Some localities are isolated and reachable only after hours of traversing forests or swamps. “Sometimes it takes two hours to cover just 24 kilometers by motorbike,” says Dr Otshudiema. “But that doesn’t stop us from going all the way, even to the most remote camps.”

Dr Richard Kitenge, Ebola incident manager for the Ministry of Health, commends this determination. “Many indicators show progress. All contacts are seen daily. We have very few unmonitored cases thanks to close supervision and effective coordination between the Ministry and WHO,” he notes. “Nineteen days without a case is not yet a victory. We must remain vigilant every day, as if it were the first.”

Support to the national authorities from WHO and partners has been crucial. More than 20 national epidemiologists, six vehicles (including two ambulances), 150 tonnes of medical supplies, 12 off-road motorcycles, and 200 tablets for rapid data transmission. WHO has also organized several training sessions for epidemiologists, community health workers and local surveillance teams to enhance their skills in early detection, rapid alert investigation, ambulance evacuation, isolation at Ebola treatment centers and contact tracing.

“We’re stronger together. The close collaboration between the Ministry and WHO has strengthened prevention, detection, and responsiveness,” says Dr Jean Djemba, expert at the Directorate of Epidemiological Surveillance at the Ministry of Health.

An important strategy in the ongoing response is the twice-daily contact follow-up, a strategy learned from previous outbreaks.

“In some epidemics, follow-up was done only once a day. Here, we’ve implemented two daily visits, which allows earlier detection of symptoms and faster action,” says Dr Mory Keita, Ebola incident manager for WHO Regional Office for Africa. “This precision work is vital. In surveillance, 99% is not enough. We must reach 100%, because the missing 1% can reignite the outbreak.”

The response in Bulape also relies on strong community mobilization. Village leaders accompany follow-up teams and raise awareness about vaccination and isolation.

Community forums are regularly held to identify high-risk contacts and encourage cooperation. This shared vigilance has become an important measure to in the efforts to halt the spread of the virus.

“Epidemiological surveillance is not just a technique — it’s a bridge between communities and public health,” says Dr Keita. “It’s through surveillance that we move forward, not just against Ebola, but to build trust, dignity, and resilience in our health systems.”