WHO says Ebola outbreak in DRC and Uganda is ‘emergency’ of international concern

Original article by Kat Lay Global health correspondent and agencies

An Ebola outbreak in the Democratic Republic of the Congo and Uganda is a “public health emergency of international concern”, the World Health Organization has said.

The WHO made its declaration on Sunday after more than 80 deaths and 246 suspected cases linked to the outbreak of the Bundibugyo virus, prompting Africa’s top health official to say he was “on panic mode”.

Dr Tedros Adhanom Ghebreyesus, the director general of the WHO, announced the decision before convening a formal emergency committee at the organisation. Experts said the speed was likely to reflect the gravity of the situation.

The Bundibugyo virus is one of three strains that can cause Ebola virus disease, and the least common. There are no approved vaccines or treatments for the strain, or specific tests.

Ebola is a highly contagious disease, spread via bodily fluids such as blood and vomit. It has a high fatality rate, particularly in low-resourced settings that are unable to provide the supportive care typically available in the intensive care units of a high-income country.

Africa Centres for Disease Control and Prevention (Africa CDC) announced the outbreak publicly on Friday, but said it was not yet clear when it had begun. It is convening experts and likely to announce a continental public health emergency in the coming days.

Dr Jean Kaseya, the director general of Africa CDC, told Sky News: “Currently, I’m on panic mode because people are dying. I don’t have medicines. I don’t have [a] vaccine to support countries.”

He said the outbreak pointed to the need for vaccine and medicine manufacturing capacity on the continent, describing it as an “equity issue” and warning: “Western countries, they don’t understand that when Africa is affected, they are also at risk because people are flying every day.”

Kaseya was due to be in Geneva this week for meetings at the annual World Health Assembly, but said he would return to Africa tomorrow in order to support the response.

He said officials were in talks with companies who had potential tests, vaccines and treatments at an early stage of development, to see whether any could be safely used or trialled during the outbreak – expressing a hope that some would become available in the “coming weeks”.

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Kaseya stressed the importance of basic infection control measures such as gloves and handwashing at an earlier press briefing, although officials said many informal health facilities in the affected regions may have limited supplies of that equipment.

There have been 80 suspected deaths, eight laboratory-confirmed cases and 246 suspected cases in the DRC’s Ituri province, which is in the east of the country, bordering Uganda and South Sudan, and about five days’ travel from the capital.

Two cases, including one death, have also been reported in Uganda’s capital, Kampala, apparently in people who had travelled from the DRC. A suspected case in the DRC’s capital, Kinshasa, had been previously reported, but the WHO later said the individual had “tested negative for Bundibugyo virus on confirmatory testing”.

There were “significant uncertainties as to the true number of infected persons and geographic spread associated with this event at the present time”, the WHO said.

It said that the signs, however, “all point towards a potentially much larger outbreak than what is currently being detected and reported, with significant local and regional risk of spread”.

The WHO stressed that, unlike for the Zaire strain of Ebola, which has caused multiple outbreaks in the DRC, “there are currently no approved Bundibugyo virus-specific therapeutics or vaccines. As such, this event is considered extraordinary”.

Conflict was continuing in the Ituri region, the WHO said, with a lot of people moving around and living in close quarters in urban or suburban areas – factors that can make spread more likely.

On Sunday, a laboratory confirmed a further Ebola case in the city of Goma, in a separate part of the DRC also affected by conflict and under the control of the Rwanda-backed M23 militia.

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“A positive case in Goma has been confirmed by tests carried out by the laboratory. It involves the wife of a man who died of Ebola in Bunia, who travelled to Goma after her husband’s death whilst already infected,” Prof Jean-Jacques Muyembe, director of the Congolese National Institute for Biomedical Research (INRB), told AFP.

Journalists from Associated Press in Ituri’s capital, Bunia, interviewed locals who said there had been unusually high numbers of burials and that they were afraid.

“Every day, people are dying … and this has been going on for about a week. In a single day, we bury two, three or even more people,” said Jean Marc Asimwe, a resident of Bunia. “At this point, we don’t really know what kind of disease it is.”

The WHO said the outbreak did not meet the criteria of a pandemic emergency, but the declaration of a public health emergency of international concern is designed to galvanise support and resources for the affected region.

An announcement from DRC officials said the first case they were aware of had been in a nurse on 24 April.

Helen Clark, a former prime minister of New Zealand and co-chair of the Independent Panel for Pandemic Preparedness and Response, said: “We commend the director-general for acting with urgency in declaring this PHEIC. His decision to proceed ahead of convening a formal emergency committee reflects the gravity of the situation and the need for immediate global mobilisation.”

She added: The world must now respond with the speed and solidarity this emergency demands – with resources, expertise, cross-border coordination, and critically, diagnostic capacity for this strain deployed to where it is needed most.”