For the 17th time since 1976, the Democratic Republic of the Congo (DRC) is experiencing an Ebola outbreak.
With 10 confirmed cases, 336 suspected cases, and 88 deaths in DRC and two confirmed cases and one death in Uganda since May 5, the World Health Organization (WHO) has deemed this epidemic a public health emergency of international concern (PHEIC) as of May 17.
This particular outbreak is caused by the Bundibugyo virus, a species of orthoebolavirus that can cause severe viral haemorrhagic fever. These fevers can harm the walls of small blood vessels to the point of leakage and can stunt blood clotting. The Bundibugyo virus, for which there are no approved vaccines, is spread through direct contact with the blood or other bodily fluids of someone who has been infected.
“WHO will continue working to support the DRC to bring this Ebola outbreak under control, and will deploy resources and work with and mobilize partners across the region to contain its spread and care for those affected,” said Dr. Tedros Adhanom Ghebreyesus, the director-general at WHO, during a May 15 media briefing.
So far, WHO experts have been working alongside DRC health authorities to respond to and contain the outbreak. WHO deployed medical supplies to Bunia, the capital city of the affected Ituri Province. On May 15, Ghebreyesus released $500,000 USD from the organization’s contingency fund for emergencies to support the response efforts.
The director-general said priority actions include the following: risk communications and community engagement, detecting active cases, contact tracing, infection prevention and control, expanding access to safe clinical care, and increasing laboratory testing capacity.
“The outbreak is a reminder of the persistent threat to human health of disease outbreaks and the importance of cooperation and solidarity to continually strengthen global health security,” Ghbreyesus continued.
Instability in Ituri Could Put Response Efforts at Risk
Since both DRC and Uganda are affected by the virus, the Africa Centers for Disease Control and Prevention (Africa CDC) is required to assume leadership in coordinating a response to the outbreak that includes regional and continental collaboration.
“The affected area is characterised by high population mobility, insecurity, and intense cross-border connectivity with neighbouring countries, including Uganda,” said Dr. Jean Kaseya, the director-general at Africa CDC, in a May 17 statement. “This alert underscored the urgent need for coordinated continental action to prevent further spread and safeguard regional and continental health security.
Health professionals are concerned about containment efforts, given that the affected area is a business hub and migratory hotspot, as it borders Uganda and a small portion of South Sudan. The region has been riddled with insecurity and conflict since the beginning of the second war in DRC in August 1998, as fighting over control of the province has contributed to a large presence of armed groups.
Violence and instability in the area could hinder people’s access to medical treatment. Dr. Craig Spencer, an emergency medicine physician who has worked in DRC and contracted Ebola before, shared on X, formerly known as Twitter, that moving through the area is difficult due to transportation issues and the ongoing conflict.
“My initial reaction here is that this isn’t good, at all,” Spencer wrote. “I’m glad Africa CDC is on it, as is WHO. But delayed recognition means this has already gotten big, at a confluence of borders with a lot of instability, and for a strain that we don’t have any vaccine treatments for.”
While WHO has said the virus does not meet the criteria to be considered a pandemic, there are still warnings that it is an event of high regional risk due to the high population in the area.
The large number of suspected cases means that the virus had been spreading long before it was initially detected in early May. This could create an even more dire situation as it continues to spread throughout the urban area.
“This makes it harder to find contacts and all cases,” Spencer wrote. “Most outbreaks don’t get this big by the time they’re over, let alone this big by the time we even recognize them.”
On May 16, after the outbreaks in both countries were confirmed, the Africa CDC held a consultative meeting consisting of more than 130 participants, including representatives from at-risk and affected countries, donor partners, United Nations (UN) agencies, humanitarian agencies, pharmaceutical companies and other key stakeholders.
In the meeting, experts advised activating the continental Incident Management Support Team (IMST) to strengthen coordination for an efficient and effective response effort. The team would bring together key partners to support and ensure preparedness and response efforts run smoothly.
“Africa CDC remains fully committed to working with Member States and partners to protect lives, contain the outbreak, and strengthen Africa’s health security and preparedness architecture,” Kaseya said.
Ghebreyesus applauds the global collaboration in containing the recent hantavirus outbreak and hopes that international partners can use it as an example of how to respond to these kinds of public health emergencies.
“At a time of great division … we must respond jointly to common challenges that our global community faces in the spirit of cooperation,” Ghebreyesus said. “For as we at WHO always say, ‘solidarity is our best immunity.’”
