Ebola risk is high in Congo but this is not a pandemic emergency: WHO

In its latest update on the rapidly developing situation in eastern Congo, the World Health Organization (WHO) Director General Tedros Adhanom Ghebreyesus said that beyond a few dozen confirmed cases of infection, there were nearly 600 suspected cases Ebola Bundibugyo virus and 139 suspected deaths.

“We expect these numbers to continue to rise, given the length 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 a vaccine or cure for the virus – which Tedros said is extremely rare and was last detected in 2007 – the WHO team has been working with community leaders in the epicenter province of Ituri to help prevent wider transmission.

Decades of violence in mineral-rich eastern Congo have contributed to chronic vulnerability among the population, including healthcare workers trapped in persistent insecurity.

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

“We always have a team in Goma and we always continue to provide support to the community. And this is what we will continue to do, throughout this outbreak… we never leave Goma during times of insecurity, so we will continue to provide security to the communities we serve,” stressed Dr Marie Roseline Belizaire, WHO Regional Emergency Director (ad interim) and Incident Manager.

Danger zone

Underlining the “extremely challenging” task of detecting an Ebola outbreak in Ituri province where in April there was a new spike in civilian deaths, WHO Regional Director for Africa Dr. Mohamed Yakub Janabi, explained that effective disease surveillance depends on reliable public reporting, open local health facilities, and laboratory confirmation of the infection.

“In remote or unsafe areas, it takes time for cases to be recognized,” he said, noting that the Bundibugyo Ebola virus was only identified after samples were transported some 1,700 kilometers (1,056 miles) across the country to the capital, Kinshasa.

“As soon as WHO found out about this [threat]support is being provided to DR Congo to investigate as quickly as possible. And this ended with confirmation at the end of last week,” stressed Dr Anais Legand, WHO Technical Officer for Viral Dengue Fever.

“Investigations are ongoing to determine exactly when and where this outbreak started. Given its scale, we think that this outbreak may have started several months ago, however investigations are ongoing and our priority is to break the chain of transmission.”

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

Low transmission

The chair of the panel, Prof Lucille H Blumberg, emphasized that Ebola transmission occurs through direct contact with the blood and body fluids of infected people – most likely the case of a patient who died on May 5 in Bunia, the capital of Ituri province, after their family decided to replace their coffin.

“So, this is not casual contact, not through the air. I think we need to be aware of that. And this relates to travel restrictions, which are not supported under the regulations [International Health Regulations] IHR recommendations,” he insisted.

Prof. Blumbert underlined the challenges of controlling this outbreak considering the ongoing humanitarian crisis, security challenges, high population mobility, and proximity to many borders.

“Resources, additional people… research and development of countermeasures [are] is urgently needed,” he stressed, including increased surveillance and identification of potential contacts.

In accordance with IHR Article 12, Tedros on Sunday declared a public health emergency of international concern over the Ebola outbreak.