The UN health agency assessed on Wednesday that there is a high risk from the Bundibugyo tribe at the national and regional level, but a low risk globally.
Low pandemic risk – for now
However, the UN agency’s emergency preparedness committee believes that it does not currently meet the criteria for a pandemic emergency.
To date, 51 cases have been confirmed in the Congolese provinces of Ituri and North Kivu, although the scale of the epidemic is much larger. The WHO has tallied nearly 600 suspected cases and 139 suspected deaths so far, with two cases linked to the outbreak detected in Kampala, Uganda.
Because there is currently no licensed vaccine or specific treatment for this rare strain, health authorities are looking to stop transmission quickly in a region characterized by insecurity and population displacement.
With support from the UN peacekeeping mission MONUSCO, the World Food Program (WFP), Doctors Without Borders (MSF) and other partners, experts and medical equipment have already been deployed to the affected areas while treatment centers are being set up.
speaks to PakinomistDr. Marie Roseline Belizaire, WHO’s Emergencies Director for Africa, emphasized the importance of a response that builds on community trust. “The speed of response in the first days is essential to interrupt transmission and avoid a wider spread of this epidemic” she emphasized.
Supplies to bolster efforts against the Ebola outbreak in Ituri province arrive in the town of Bunia.
Community centered
For WHO, public trust is at the heart of the answer. The health authorities are especially trying to prevent people with symptoms from feeling too afraid to report themselves or refusing isolation.
“Every emergency, every epidemic begins in a community and ends in a community,” recalls Dr Belizaire. “If we don’t have this community trust, they won’t be accepted no matter what actions we take.”
WHO insists on a participatory approach based on lessons learned from previous outbreaks in the region. “We don’t come and dictate our science…but work with them,” she explains.
Experiences
The WHO aims to bring the response to society by drawing on lessons from previous outbreaks, where many families hesitated to report cases or let their loved ones go to treatment centers.
Care and monitoring structures must be be established as close as possible to the affected populations to ensure care of confirmed patients, monitor suspected cases and contacts and maintain links with families.
“Family could visit their patients who are admitted to these treatment centers,” emphasizes Dr. Belize.
According to her The aim is to ensure comprehensive management, including medical care, psychosocial support and food needs for patientswhile also supporting families and contacts followed as part of the response.
Aid to strengthen efforts against the Ebola outbreak arrives in Ituri in eastern DR Congo.
‘A complex security context’
The outbreak is developing in a region characterized by insecurity, population displacement and high mobility linked to mining areas.
These factors complicate early case detection, contact tracing and rapid implementation of control measures.
Delivering aid also represents a major logistical challenge. “We work with other partners to facilitate the transportation of equipment by air“, says Dr. Belizaire. More than 11 tons of equipment have already been sent to Bunia to support the response.
WHO considers the lessons learned during the 2018-2020 Ebola outbreak in the same region – which was contained despite a similar security context – to be a major asset. “This is not the first time (…) we have already had outbreaks in this region and they were controlled,” recalls Dr. Belize.
Challenges of rare strains, no vaccine
Unlike the Zaire strain, which is more frequent, more virulent and causes more regular epidemics, the Bundibugyo strain remains poorly understood and currently has no licensed vaccine or specific treatment.
“We need to find the right formula to explain to society that the vaccine you received in 2018, 2020 only protects you against this [Zaire] tribe. And now you are not protected from this,” she explains.
Dr. Belizaire draws on his extensive field experience responding to Ebola outbreaks across Africa, and Dr. Belizaire notes that discussions have already begun within the WHO’s research and development program to accelerate potential medical development.
Research efforts had previously focused on the Zaire strain, which is responsible for the most frequent Ebola outbreaks and for which vaccines and therapeutic tools are now available.
Self protection
The WHO says several simple measures should be adopted at community level to limit the risk of transmission: avoid any contact with bodily fluids from a sick or deceased person, and use strict hygiene measures, especially regular hand washing.
The Danish Health Authority also emphasizes the importance of immediately reporting any suspected case and contacting a health center without delay if symptoms appear suddenly, including “high fever, great fatigue, muscle pain” as well as vomiting or diarrhea.
Dr. Belizaire also insists on the importance of allowing health teams to carry out contact tracing in communities as soon as a suspected case is reported, as well as the need to protect health workers.
Those who are ill must also be protected from feeling stigmatized. Trust only information that comes from health authorities, she warns, and avoid rumours, “which can really complicate the response and put their lives at risk.”
