Ebola risk is high inside DR Congo but it’s no pandemic emergency: WHO

In an update on the fast-developing situation in eastern DRC, World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus said that beyond the several dozen confirmed cases of infection, there are almost 600 suspected cases of Ebola Bundibugyo virus and 139 suspected deaths. 

“We expect those numbers to keep increasing, given the amount of time the virus was circulating before the outbreak was detected,” the WHO Director-General told journalists in Geneva.

Uganda reported two confirmed cases of Ebola in Uganda’s capital, Kampala, he added.

In the absence of any vaccine or therapeutics for the virus – which Tedros stressed is extremely rare and was last detected in 2007 – WHO teams are already working with community leaders in the epicentre province, Ituri, to help prevent wider transmission. 

Decades of violence in mineral-rich eastern DR Congo have contributed to chronic vulnerability among the population, including healthcare workers caught up in ongoing insecurity. 

According to the UN refugee agency, UNHCR, there are more than two million people internally displaced in the affected provinces of Ituri and North Kivu, where the provincial capital of Goma remains under the control of rebel militia M23.

“We always have a team in Goma and we always continue to provide us support to the population. And this is what we will continue doing this, during this outbreak…we never left Goma during all the insecurity happening, so we will continue staying to provide the security to the community we serve,” stressed WHO’s Dr Marie Roseline Belizaire, Regional Emergency Director (ad interim) and Incident Manager.

Danger zone

Underscoring the “inherently challenging” task of detecting outbreaks of Ebola in Ituri province where April saw a new spike in civilian deaths, WHO’s Regional Director for Africa Dr Mohamed Yakub Janabi, explained that effective disease surveillance depends on reliable community reporting, local health facilities being open and laboratory confirmation of infection. “In remote or insecure areas, it can take time for cases to be recognized,” he said, pointing out that Ebola Bundibugyo virus was only identified after samples were transported some 1,700 kilometres (1,056 miles) across the country to the capital, Kinshasa.

“As soon as WHO was aware of the [threat], support was provided to DR Congo to investigate as quickly as possible. And this ended up with the confirmation late last week,” stressed Dr Anais Legand, WHO Technical Officer for Viral Haemorrhagic Fevers. “Investigations are ongoing to ascertain when and where exactly this outbreak started. Given the scale, we are thinking that it started probably a couple of months ago, but investigations are ongoing and our priority is really to cut the transmission chain.”

Wednesday’s briefing followed a meeting of the WHO ​Emergency Committee ‌on Tuesday in Geneva which confirmed that the Ebola outbreak is a public health emergency of international concern but not ​a pandemic emergency.

Chair of the panel, Prof Lucille H Blumberg, stressed that Ebola transmission is through direct contact with blood and body fluids of an infected person – which was likely the case of a patient who died on 5 May in Bunia, capital city of Ituri province, after their family decided to replace the coffin. 

“So, it’s not casual contact, it’s not airborne. I think we need to be aware of that. And this relates to travel restrictions, which are not supported under the [International Health Regulations] IHR recommendations,” she insisted.

Prof Blumbert underlined the challenges of bringing the outbreak under control given the ongoing humanitarian crisis, security challenges, the highly mobile population, and close proximity to many borders.

“Resources, additional people…research and development of countermeasures [are] urgently required,” she insisted, including intensified surveillance and identification of potential contacts.

It was in accordance with IHR Article 12 that Tedros on Sunday declared a public health emergency of international concern over the Ebola outbreak.