Ebola outbreaks in DR Congo and Uganda: WHO declares international emergency

The acronym is Pheic and is the acronym for Public Health Emergency of International Concern. And this is the level of alarm raised yesterday by the World Health Organization (WHO) in reporting new outbreaks of Ebola (Bundibugyo Virus Disease, Bvd) in the Democratic Republic of Congo and Uganda. In the same note, the WHO specifies that this is not a pandemic emergency and thanks Congo and Uganda for the commitment shown in taking “necessary and vigorous” measures in order to bring the situation under control, but also for the “candor” with which they made the risks for other nations known.

According to the same note signed by the WHO director general, Tedros Adhanom Ghebreyesussuspected cases (as of May 16) were 246 with 80 deaths in the Congolese province of Ituri (in particular in Bunia, Rwampara and Mongbwalu). Two cases (including one fatal) were recorded in the Ugandan capital Kampala: in both cases they were travelers coming from Congo. Unusual outbreaks of deaths in the population with symptoms compatible with Bundibugyo virus disease have been reported in several areas of Ituri, while suspected cases have been reported throughout Ituri and North Kivu.

Furthermore, at least four deaths among healthcare workers have been reported from the affected area in a clinical context indicative of viral haemorrhagic fever: on this point, the WHO said it was concerned because healthcare-associated transmission would demonstrate gaps in infection prevention and control measures with the potential for spread within healthcare facilities.

The risk of a widespread epidemic and the lack of specific vaccines

“At the moment – writes the WHO – there are considerable uncertainties regarding the actual number of infected people and the geographical spread associated with this event. Furthermore, the understanding of the epidemiological links with known or suspected cases is still limited”. However, the high positivity rate of the initial samples collected (with eight positive cases out of 13 samples collected in various areas), the confirmation of cases in both Kampala and Kinshasa, the increase in reports of suspected cases and the outbreaks of deaths across Ituri province indicate that we are facing a potentially much larger epidemic than currently detected and reported, with “a significant risk of spread at a local and regional level”.

The spread of the virus then affects very unstable areas: the persistent insecurity, the humanitarian crisis, the high mobility of the population, the urban or semi-urban nature of the current outbreak and the large network of informal health facilities, according to the WHO, “further aggravate the risk of spread, as occurred during the large Ebola epidemic in the provinces of North Kivu and Ituri in 2018-19”. A situation made more serious by the lack of effective health responses: unlike the Ebola-Zaire strains, currently In fact, there are no specific approved therapies or vaccines for the Bundibugyo virus.