Congo’s health ministry has announced a new Ebola outbreak, the 16th in the central African country, after a case was confirmed in the southern Kasai province

KINSHASA, Congo — Congo’s health ministry on Thursday announced a new Ebola outbreak, the 16th in the central African country, after a case was confirmed in the southern Kasai province.

“To date, the provisional report shows 28 suspected cases and 15 deaths, including 14 in Boulapé and 1 in Mweka, as well as four healthcare workers,” said Samuel-Roger Kamba, Congo’s health minister.

He added that the case fatality rate, estimated at 53.6%, showed the gravity of the situation.

He said that the figures were provisional and research was ongoing. The suspected cases and deaths presented symptoms such fever, vomiting, diarrhoea and haemorrhage. The Ebola virus is highly contagious and can be contracted through bodily fluids such as vomit, blood, or semen. The disease it causes is a rare but severe — and often fatal — illness in humans.

GOMA, Congo — Rebels backed by Rwanda captured more towns in eastern Congo on Wednesday as they moved beyond the key city of Goma in an apparent attempt to expand their control in the conflict-battered region.

The rebels advanced toward the center of South Kivu province after taking several towns, including Kalungu, Kanyezire and Mukwinja, according to a local civil society leader and an aid worker in the area. They spoke on condition of anonymity because they were not authorized to talk to the media.

U.N. spokesman Stephane Dujarric said the developments were concerning, and that the United Nations was taking measures to protect civilians and U.N. staff. The advance also raised fears of a prolonged occupation by the rebels, who have said they plan to set up a new administration in Goma, a city of 2 million people.

“Left unchecked, the fighting could spread … recalling the horrors of the late 1990s and early 2000s, when millions died,” the Crisis Group said, citing the last, multi-country war there.

Unlike now, the rebels captured Goma only briefly during their first rebellion in 2012, withdrawing after a few days under international pressure on Rwanda.

Meanwhile, Congolese President Félix Tshisekedi was conspicuously absent from a summit of a regional East African bloc that began late Wednesday

Faced with the rebel offensive, soldiers fighting for Congo — many of them mercenaries from other nations — were laying down their weapons at the border with Rwanda. Congo’s army seemed to be in disarray, and those at the border appeared disorganized and ill-equipped for any major fighting.

A rebel spokesman said nearly 300 mercenaries have surrendered their arms and returned to their countries.

“Let the people of Goma be calm, peace is here,” said Willy Ngoma, a spokesman of the M23 group. Ngoma, who is on the U.N. Security Council’s sanctions list for crimes committed by the rebels.

“It’s like you are fighting without command,” said Jean Marie Ndahambaza, one of the surrendering soldiers.

Armed groups have long vied for control of eastern Congo, which is rich in minerals critical to much of the world’s technology, and has been the scene of proxy battles between Congo and neighboring Rwanda, as well as other powers. Fighting reignited this week, and the rebels backed by Rwanda, known as M23, announced Monday that they had captured much of the provincial capital of Goma.

Hundreds of thousands of Goma residents were trying to get away from the fighting, with some retreating into Congo’s interior to seek protection, and others crossing into nearby Rwanda. Rwandan border patrol agents thoroughly searched the belongings of the men, women and children crossing the border in waves, with suitcases and children in tow. The displaced people, looking exhausted but relieved, were then taken care of by the Rwandan Red Cross.

Meanwhile, rebels took control of Goma’s airport, said U.N. spokesperson Stephane Dujarric, warning of risks of a breakdown of law and order in the city of 2 million people “given the proliferation of weapons.” Clashes with rebels continued in some parts of the city on Wednesday afternoon, including at the center of Goma in the neighborhoods of Katoyi and Kahembe. Other parts of the city were calm, with less fighting after a day during which thousands of fleeing people hunkered down by roadsides as missiles flew overhead, and injured people streamed to overwhelmed hospitals.

Congolese President Félix Tshisekedi, expected to address the country later on Wednesday in his first public remarks since the incursion.

The chaotic situation has its roots in ethnic conflict: M23 says it is defending ethnic Tutsis in Congo. Rwanda has claimed the Tutsis are being persecuted by Hutus and former militias responsible for the 1994 genocide of 800,000 Tutsis and others in Rwanda. Many Hutus fled into Congo after the genocide.

Analysts say the real fight is for control over the Congo’s vast mineral deposits, estimated to be worth $24 trillion, and critical to much of the world’s technology. M23 appears to be preparing to stay in Congo for good, telling the AP of their plans to set up an administration and return displaced people to their homes.

Analysts have warned that securing a rebel withdrawal could be more difficult than in 2012, when M23 first captured Goma but withdrew after days. Murithi Mutiga, program director for Africa at the Crisis Group, said that the group has become more emboldened by Rwanda, which feels Congo is ignoring its interests in the region and failed to meet demands of previous peace agreements.

While Rwandan leaders, mostly Tutsis, have denied backing the rebels, U.N. sources say some 4,000 Rwandan troops are in the Congo.

South African President Cyril Ramaphosa, whose troops are among the foreign peacekeepers in Congo, blamed the “Rwanda Defence Force (RDF) militia” for the fighting and called for the withdrawal of the rebels.

“The territorial integrity (of Congo) must be respected,” Ramaphosa said, adding that South Africa will ensure its peacekeepers “remain well-equipped and sufficiently supported during this critical mission.”

Rwandan President Paul Kagame said on X that he spoke with U.S. Secretary of State Marco Rubio on “the need to ensure a ceasefire and address the root causes of the conflict once and for all.”

Kenya Airways canceled all of its flights to Kinshasa on Wednesday following the looting and burning of at least 10 foreign embassy buildings in the capital the day before, a company agent at Kinshasa airport told The AP.

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Asadu reported from Abuja, Nigeria. Associated Press writers Christina Malkia and Jean-Yves Kamale in Kinshasa, Congo; Ignatius Ssuuna in Gisenyi, Rwanda; Mark Banchereau in Paris, Mogomotsi Magome in Johannesburg and Edith M. Lederer in New York contributed to this report.

LONDON — The World Health Organization said mpox cases in the region of Congo where a new and more infectious variant was first detected appear to be “plateauing,” even as the virus continues to increase in other regions of the country, as well as in Burundi and Uganda.

In a report Monday, the U.N. health agency said the number of mpox infections “shows a general rising trend” but that they may have plateaued in South Kivu, where the more infectious form of mpox was first identified to be spreading earlier this year among sex workers and miners in the gold mining town of Kamituga.

WHO acknowledged, however, that testing is still not widespread, making it difficult to understand how exactly the virus is spreading.

According to data from last week, Congo reported fewer than 100 laboratory-confirmed mpox cases, down from nearly 400 in July. In recent weeks, experts say that infections appear to be stabilizing, offering a chance for health authorities to definitively stamp out the outbreak.

So far, about 50,000 people in Congo have been immunized against mpox; the Africa Centers for Disease Control and Prevention estimate that 3 million vaccines are needed to stop the outbreak.

Last week, Africa CDC’s director Dr. Jean Kaseya said the continent was “still in the acute phase” of the mpox epidemic, with 19 countries affected. He warned that without more resources to stop the virus in Africa, it could become a global threat.

WHO said the mpox outbreak in Burundi is also being driven by the newer variant, which causes less severe symptoms — meaning people who are infectious may not realize they are spreading it. In the last two weeks, Burundi has reported more than 200 new mpox cases every week, mostly in children and young adults.

In Uganda, which reported 100 new cases last week, WHO said the virus is spreading mostly through sex, with the vast majority of cases in adults.

Mpox, which was previously known as monkeypox because it was first seen in research monkeys, is spread primarily through close skin-to-skin contact with infected people or their soiled clothes or bedsheets. It often causes visible skin lesions that could make people less likely to be in close contact with others.

In August, WHO declared the rapid spread of mpox in Congo and elsewhere in Africa to be a global health emergency. To date, Africa has reported more than 46,000 suspected cases, including 1,081 deaths.

WHO also said it would convene an expert meeting next Monday to determine if mpox still constitutes an international emergency.

Last week, Britain announced the first instance of the more infectious kind of mpox spreading beyond Africa. It identified mpox in a person who had recently traveled to Africa and in three of their household contacts. All the individuals are currently being treated in two London hospitals.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

KAMITUGA, Congo — It’s been four months since Sifa Kunguja recovered from mpox, but as a sex worker, she said, she’s still struggling to regain clients, with fear and stigma driving away people who’ve heard she had the virus.

“It’s risky work,” Kunguja, 40, said from her small home in eastern Congo. “But if I don’t work, I won’t have money for my children.”

Sex workers are among those hardest-hit by the mpox outbreak in Kamituga, where some 40,000 of them are estimated to reside — many single mothers driven by poverty to this mineral-rich commercial hub where gold miners comprise the majority of the clientele. Doctors estimate 80% of cases here have been contracted sexually, though the virus also spreads through other kinds of skin-to-skin contact.

Sex workers say the situation threatens their health and livelihoods. Health officials warn that more must be done to stem the spread — with a focus on sex workers — or mpox will creep deeper through eastern Congo and the region.

Mpox causes mostly mild symptoms such as fever and body aches, but serious cases can mean prominent, painful blisters on the face, hands, chest and genitals.

Kunguja and other sex workers insist that despite risks of reinfection or spreading the virus, they have no choice but to keep working. Sex work isn’t illegal in Congo, though related activities such as solicitation are. Rights groups say possible legal consequences and fear of retribution — sex workers are subject to high rates of violence including rape and abuse — prevent women from seeking medical care. That can be especially detrimental during a public health emergency, according to experts.

Health officials in Kamituga are advocating for the government to shutter nightclubs and mines and compensate sex workers for lost business.

Not everyone agrees. Local officials say they don’t have resources to do more than care for those who are sick, and insist it’s sex workers’ responsibility to protect themselves.

Kamituga Mayor Alexandre Bundya M’pila told The Associated Press that the government is creating awareness campaigns but lacks money to reach everyone. He also said sex workers should look for other jobs, without providing examples of what might be available.

Miners stream into Kamituga by the tens of thousands. The economy is centered on the mines: Buyers line streets, traders travel to sell gold, small businesses and individuals provide food and lodging, and the sex industry flourishes.

Nearly a dozen sex workers spoke to AP. They said well over half their clients are miners.

The industry is well organized, according to the Kenyan-based African Sex Workers Alliance, composed of sex worker-led groups. The alliance estimates that 13% of Kamituga’s 300,000 residents are sex workers.

The town has 18 sex-worker committees, the alliance said, with a leadership that tries to work with government officials, protect and support colleagues, and advocate for their rights.

But sex work in Congo is dangerous. Women face systematic violence that’s tolerated by society, according to a report by UMANDE, a local sex-worker rights group.

Many women are forced into the industry because of poverty or because, like Kunguja, they’re single parents and must support their families.

The sex workers who spoke to AP described mpox as an added burden. Many are terrified of getting the virus — it means time away from work, lost income and perhaps losing business altogether.

Those who recover are stigmatized, they said. Kamituga is a small place, where most everyone knows one another. Neighbors whisper and tell clients when someone is sick — people talk and point.

Since contracting mpox in May, Kunguja said she’s gone from about 20 clients daily to five. When she was sick, the lesions on her genitals were so painful she could hardly walk, hunched over and wobbling to get around. Her 9-year-old son caught it from her, she said — he’s out of the hospital but still has lesions.

She’s been supporting her 11 children through sex work for nearly a decade, but said she now can’t afford to send them to school. To compensate, she’s selling alcohol by day, but it’s not enough.

She said she wants the government to subsidize her income so she doesn’t have to put herself or others at risk.

Disease experts say a lack of vaccines and information makes stemming the spread difficult.

Some 250,000 vaccines have arrived in Congo, but it’s unclear when any will get to Kamituga. Sex workers and miners are among those slated to receive them first.

Community leaders and aid groups are trying to teach sex workers about protecting themselves and their clients via awareness sessions where they discuss signs and symptoms. They also press condom use, which they say isn’t widespread enough in the industry.

Sex workers told AP that they insist on using condoms when they have them, but that they simply don’t have enough.

Kamituga’s general hospital gives them boxes of about 140 condoms every few months. Some sex workers see up to 60 clients a day — for less than $1 a person. Condoms run out, and workers say they can’t afford more.

Dr. Guy Mukari, an epidemiologist working with the National Institute of Biomedical Research in Congo, noted that the variant running rampant in Kamituga seems more susceptible to transmission via sex, making for a double whammy with the sex industry.

Even health experts admit the lack of information about the virus makes it unclear how effective condoms are. Lesions are usually found around the base of the penis, an area that condoms don’t cover, they note.

Some women resort to flimsy plastic bags when they can’t find condoms, sex worker Irene Mabwidi said. As a leader in her local sex industry group, she said she tries to advise women on other protection measures, such as inspecting clients’ bodies for lesions, though that’s far from foolproof.

Erin Kilbride of Human Rights Watch said it’s crucial that sex workers are in the room when the government designs outreach programs.

“The government should proactively reach out to sex worker organizations, at the local and national level, who are experts in what their communities need,” Kilbride said.

Health experts say miners are also key to containing the virus. While mpox is spread mainly through close contact, it can also occasionally spread from the environment via objects or surfaces touched by an infected person, according to the World Health Organization.

There’s little awareness of that in mines, where conditions are often unsanitary. Mines have few, if any, handwashing stations, and sometimes miners don’t shower for days. Infected miners might urinate or openly defecate in mines and contaminate water sources, health officials say.

Miners told AP more information and advocacy is needed in mines. Debus Bulambo said he got mpox in February, but sees most fellow miners failing to take the virus seriously. People want to spend cash on sex, even during an epidemic, sometimes paying five times more to go without a condom, he noted. And miners earn a lot — up to about $120 a month, more than double the country’s average annual income.

Bulambo said he occasionally paid for sex in the past but stopped, though he realizes he’s the exception.

“People aren’t afraid,” he said bluntly. “I don’t understand.”

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

KAMITUGA, Congo — It’s been four months since Sifa Kunguja recovered from mpox, but as a sex worker, she said, she’s still struggling to regain clients, with fear and stigma driving away clients who’ve heard she had the virus.

“It’s risky work,” Kunguja, 40, said from her small home in eastern Congo. “But if I don’t work, I won’t have money for my children.”

Sex workers are among those hardest-hit by the mpox outbreak in Kamituga, where some 40,000 of them are estimated to reside — many single mothers driven by poverty to this mineral-rich commercial hub where gold miners comprise the majority of the clientele. Doctors estimate 80% of cases here have been contracted sexually, though the virus also spreads through other kinds of skin-to-skin contact.

Sex workers say the situation threatens their health and livelihoods. Health officials warn that more must be done to stem the spread — with a focus on sex workers — or mpox will creep deeper through eastern Congo and the region.

Mpox causes mostly mild symptoms such as fever and body aches, but serious cases can mean prominent, painful blisters on the face, hands, chest and genitals.

Kunguja and other sex workers insist that despite risks of reinfection or spreading the virus, they have no choice but to keep working. Sex work isn’t illegal in Congo, though related activities such as solicitation are. Rights groups say possible legal consequences and fear of retribution — sex workers are subject to high rates of violence including rape and abuse — prevent women from seeking medical care. That can be especially detrimental during a public health emergency, according to experts.

Health officials in Kamituga are advocating for the government to shutter nightclubs and mines and compensate sex workers for lost business.

Not everyone agrees. Local officials say they don’t have resources to do more than care for those who are sick, and insist it’s sex workers’ responsibility to protect themselves.

Kamituga Mayor Alexandre Bundya M’pila told The Associated Press that the government is creating awareness campaigns but lacks money to reach everyone. He also said sex workers should look for other jobs, without providing examples of what might be available.

Miners stream into Kamituga by the tens of thousands. The economy is centered on the mines: Buyers line streets, traders travel to sell gold, small businesses and individuals provide food and lodging, and the sex industry flourishes.

Nearly a dozen sex workers spoke to AP. They said well over half their clients are miners.

The industry is well organized, according to the Kenyan-based African Sex Workers Alliance, composed of sex worker-led groups. The alliance estimates that 13% of Kamituga’s 300,000 residents are sex workers.

The town has 18 sex-worker committees, the alliance said, with a leadership that tries to work with government officials, protect and support colleagues, and advocate for their rights.

But sex work in Congo is dangerous. Women face systematic violence that’s tolerated by society, according to a report by UMANDE, a local sex-worker rights group.

Many women are forced into the industry because of poverty or because, like Kunguja, they’re single parents and must support their families.

The sex workers who spoke to AP described mpox as an added burden. Many are terrified of getting the virus — it means time away from work, lost income and perhaps losing business altogether.

Those who recover are stigmatized, they said. Kamituga is a small place, where most everyone knows one another. Neighbors whisper and tell clients when someone is sick — people talk and point.

Since contracting mpox in May, Kunguja said she’s gone from about 20 clients daily to five. When she was sick, the lesions on her genitals were so painful she could hardly walk, hunched over and wobbling to get around. Her 9-year-old son caught it from her, she said — he’s out of the hospital but still has lesions.

She’s been supporting her 11 children through sex work for nearly a decade, but said she now can’t afford to send them to school. To compensate, she’s selling alcohol by day, but it’s not enough.

She said she wants the government to subsidize her income so she doesn’t have to put herself or others at risk.

Disease experts say a lack of vaccines and information makes stemming the spread difficult.

Some 250,000 vaccines have arrived in Congo, but it’s unclear when any will get to Kamituga. Sex workers and miners are among those slated to receive them first.

Community leaders and aid groups are trying to teach sex workers about protecting themselves and their clients via awareness sessions where they discuss signs and symptoms. They also press condom use, which they say isn’t widespread enough in the industry.

Sex workers told AP that they insist on using condoms when they have them, but that they simply don’t have enough.

Kamituga’s general hospital gives them boxes of about 140 condoms every few months. Some sex workers see up to 60 clients a day — for less than $1 a person. Condoms run out, and workers say they can’t afford more.

Dr. Guy Mukari, an epidemiologist working with the National Institute of Biomedical Research in Congo, noted that the variant running rampant in Kamituga seems more susceptible to transmission via sex, making for a double whammy with the sex industry.

Even health experts admit the lack of information about the virus makes it unclear how effective condoms are. Lesions are usually found around the base of the penis, an area that condoms don’t cover, they note.

Some women resort to flimsy plastic bags when they can’t find condoms, sex worker Irene Mabwidi said. As a leader in her local sex industry group, she said she tries to advise women on other protection measures, such as inspecting clients’ bodies for lesions, though that’s far from foolproof.

Erin Kilbride of Human Rights Watch said it’s crucial that sex workers are in the room when the government designs outreach programs.

“The government should proactively reach out to sex worker organizations, at the local and national level, who are experts in what their communities need,” Kilbride said.

Health experts say miners are also key to containing the virus. While mpox is spread mainly through close contact, it can also occasionally spread from the environment via objects or surfaces touched by an infected person, according to the World Health Organization.

There’s little awareness of that in mines, where conditions are often unsanitary. Mines have few, if any, handwashing stations, and sometimes miners don’t shower for days. Infected miners might urinate or openly defecate in mines and contaminate water sources, health officials say.

Miners told AP more information and advocacy is needed in mines. Debus Bulambo said he got mpox in February, but sees most fellow miners failing to take the virus seriously. People want to spend cash on sex, even during an epidemic, sometimes paying five times more to go without a condom, he noted. And miners earn a lot — up to about $120 a month, more than double the country’s average annual income.

Bulambo said he occasionally paid for sex in the past but stopped, though he realizes he’s the exception.

“People aren’t afraid,” he said bluntly. “I don’t understand.”

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.