Staff members at CBCA Virunga Hospital prepare rooms intended for possible suspected Ebola cases in Goma, Democratic Republic of Congo, on Sunday.JOSPIN MWISHA/AFP/Getty Images
A rare strain of Ebola, without any approved treatment or vaccine, has caused a suspected 88 deaths and more than 300 cases in a war-ravaged region of the Democratic Republic of the Congo.
The World Health Organization, moving swiftly without its usual internal procedures, immediately declared it a public health emergency of international concern – its most severe designation for a crisis, short of a pandemic.
The latest outbreak is “potentially much larger” than the cases detected so far, the WHO said in a statement on Sunday.
The health organization is worried about the latest outbreak for many reasons. The virus had been circulating for at least four weeks without detection, allowing cases to spread. It is centred in an impoverished region of mining towns, rebel insurgencies and densely populated cities, which could accelerate the spread. And the virus has already crossed an international border, reaching Uganda’s biggest city, Kampala, where two cases are confirmed.
Ebola is an infectious viral fever, transmitted among humans through close contact with blood, secretions or other bodily fluids. This is the 17th outbreak in Congo since it was first discovered in 1976.
The World Health Organization on Sunday declared an Ebola outbreak in the Democratic Republic of Congo and Uganda a public health emergency of international concern, after 80 suspected deaths and nine laboratory-confirmed cases.
Reuters
In the latest outbreak, the virus is the Bundibugyo strain of Ebola. It has an estimated death rate of 30 per cent to 50 per cent, similar to other strains, but there is no approved treatment or vaccine for it. This is only the third recorded outbreak of the Bundibugyo strain, which was first detected in Uganda from 2007 to 2008, where 37 people died.
“Great confusion reigns among the population,” said Gratien Iracan, an opposition politician in eastern Congo. “Many still do not know the exact causes of the recorded deaths, which further fuels fear and general panic.”
The two cases in Kampala did not have any apparent link with each other, which raises concerns about undetected chains of transmission. One of the two individuals arrived in Kampala on a public bus, died in a city hospital and was transported back to Congo on the same day for burial – all of which raised the risk of further transmission.
Another case has been confirmed in Goma, a densely populated city on the Rwanda border, which is occupied by the Rwanda-backed M23 rebel militia.
Local media said Rwanda temporarily closed its official border crossings with Congo – a move that is not recommended by the WHO because it can shift migrants to unofficial sites that are not monitored. But the Rwandan government insisted it was only reinforcing its “screening and vigilance” at the border.
The WHO normally convenes a committee of experts to decide whether to declare an international emergency for an Ebola outbreak – but it did not wait for this process this time. It said the situation is exceptional because of the “significant uncertainties” about the geographic spread of the virus. It also cited the high positivity rate, with eight confirmed cases among the 13 samples tested so far.
“Insecurity in the affected areas and movement restrictions are hampering the surveillance and follow-up efforts,” the WHO said. “Several listed contacts became symptomatic and died before they could be isolated.”
What we know so far about the Ebola outbreak in Congo and Uganda
The Africa Centres for Disease Control and Prevention, in a media briefing on Saturday, said the latest Ebola outbreak posed a high risk to Congo and the entire East Africa region for several reasons: the lack of a vaccine or treatment, the delayed detection of the outbreak, the weak level of contact-tracing and screening so far, the frequent movement of people in the mining hub where it apparently began, and the heavy cross-border migration between eastern Congo and the neighbouring countries of Uganda and South Sudan.
Health experts are also worried that the recent U.S. withdrawal from the WHO, and its drastic cuts to U.S. foreign aid, could weaken the global response to the latest Ebola outbreak. The Congo government has decades of experience with Ebola, but it normally relies on global aid as a key element in its response.
Help began arriving at the epicentre of the outbreak, the Congolese province of Ituri, on Sunday. Nearly seven tonnes of emergency supplies – including tents, beds and protective equipment – reached Ituri’s main city, Bunia, along with a team of 35 experts from the WHO and the Congolese health ministry.
“The DRC has already defeated Ebola 16 times with courage and determination,” said Congolese health minister Roger Kamba, who arrived in Bunia on Sunday. “And for the 17th time, we will defeat this epidemic once again through unity, vigilance and the mobilization of all.”
The humanitarian group Médecins sans frontières (Doctors Without Borders) is also mobilizing teams to respond to the outbreak. “The number of cases and deaths we are seeing in such a short timeframe, combined with the spread across several health zones and now across the border, is extremely concerning,” said the group’s emergency program manager, Trish Newport, in a statement on Sunday.
Mark Johnson, a spokesperson for Health Canada, said the federal government is closely monitoring the Ebola outbreak and could collaborate with the WHO if there is a need for technical expertise.
In December, three members of the special pathogens program of Canada’s National Microbiology Laboratory travelled to Congo to help train local staff, Mr. Johnson told The Globe and Mail in response to questions on Sunday.
With a report from Kristy Kirkup in Ottawa