In an update on the rapidly evolving situation in eastern DRC, World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus said that in addition to the several dozen confirmed cases of infection, there almost 600 suspected cases of Ebola Bundibugyo virus and 139 suspected deaths.
“We expect these numbers to continue to rise, given the time the virus circulated before the outbreak was discoveredthe WHO director-general told reporters 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 discovered in 2007 – WHO teams are already working with community leaders in the epicenter province, Ituri, to help prevent wider transmission.
Decades of violence in the mineral-rich eastern DR Congo have contributed to chronic vulnerability among the population, including health workers trapped in persistent insecurity.
According to the UN refugee agency, UNHCR, there is more than two million internally displaced persons in the affected provinces of Ituri and North Kivu, where the provincial capital Goma remains under the control of the rebel militia M23.
“We always have a team in Goma and we always continue to provide support to the population. And that is what we will continue to do during this outbreak … we have never left Goma during all the uncertainty that is happening, so we will continue to stay to provide security to the community we serve,” emphasized WHO’s Dr Marie Roseline Belizaire, Regional Emergency Director (ad interim) and Incident Manager.
Danger zone
WHO Regional Director for Africa, Dr. Mohamed Yakub Janabi, stressed the “inherently challenging” task of detecting Ebola outbreaks in Ituri province, where April saw a new spike in civilian deaths, 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 the Ebola Bundibugyo virus was only identified after samples were transported about 1,700 kilometers (1,056 miles) across the country to the capital, Kinshasa.
“As soon as the WHO was aware [threat]support was provided to the DR Congo to investigate as soon as possible. And this ended with the confirmation at the end of last week,” emphasized Dr. Anais Legand, WHO technical officer for viral hemorrhagic fevers. “Investigations are underway to determine when and where exactly this outbreak started. Given the scale, we think it probably started a few months ago, but investigations are ongoing and our priority is really to cut the chain of transmission.”
Wednesday’s briefing followed 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.
Chair of the panel, Professor Lucille H Blumberg, emphasized that Ebola transmission occurs through direct contact with the blood and body fluids of an infected person – which was likely the case of a patient who died on May 5 in Bunia, the capital of Ituri province, after their family decided to replace the coffin.
“So, it’s not accidental contact, it’s not airborne. I think we should be aware of that. And this relates to travel restrictions that are not supported under [International Health Regulations] IHR recommendations,” she insisted.
Prof. Blumbert emphasized the challenges of bringing the outbreak under control given the ongoing humanitarian crisis, security challenges, the highly mobile population and 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.
