WHO Declares Ebola Outbreak in DRC and Uganda a Global Health Emergency

The World Health Organization has declared an Ebola outbreak in the Democratic Republic of the Congo and Uganda a public health emergency of international concern.

The WHO made its declaration Sunday after more than 80 deaths and 246 suspected cases linked to the Bundibugyo virus outbreak.

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

The Bundibugyo virus is one of three strains that can cause Ebola virus disease and is the least common. No approved vaccines or treatments exist for the strain, nor 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 unable to provide the supportive care typically available in high-income country intensive care units.

The Africa Centres for Disease Control and Prevention publicly announced the outbreak Friday but said it was not yet clear when it began.

In the DRC’s Ituri province, eastern DRC bordering Uganda and South Sudan and about five days’ travel from the capital, there have been 80 suspected deaths, eight laboratory-confirmed cases and 246 suspected cases.

Two cases, including one death, have also been reported in Uganda’s capital, Kampala, in people who had apparently traveled from the DRC. A further case has been confirmed in the DRC’s capital, Kinshasa.

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

It said 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 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 continues in the Ituri region, the WHO said, with many people moving and living in close quarters in urban or suburban areas – factors that can facilitate spread.

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.

“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 traveled to Goma after her husband’s death whilst already infected,” Prof Jean-Jacques Muyembe, director of the Congolese National Institute for Biomedical Research, told AFP.

Journalists from Associated Press interviewed residents in Ituri’s capital, Bunia, who reported unusually high numbers of burials and expressed fear.

“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 Bunia resident. “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 galvanize support and resources for the affected region.

At a press briefing Saturday, Dr Jean Kaseya, director general of Africa CDC, said officials had yet to pinpoint the outbreak’s origin, and slow detection had delayed the response and allowed time for spread.

A DRC official announcement said the first known case was in a nurse on April 24.

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

He said officials were in talks with companies that have potential tests, vaccines and treatments at an early stage of development to see if any could be safely used or trialed during the outbreak.

Helen Clark, 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 mobilization.”

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.”