WHO chief visits Congo amid Ebola

Tedros Adhanom Ghebreyesus arrived in Kinshasa late on August 4 for meetings with Congolese officials and response partners as the Democratic Republic of the Congo’s Ebola outbreak moved toward 4,000 confirmed cases. WHO said it was his second visit since the outbreak was declared in mid-May. (lasvegassun.com) Congo’s health ministry data published overnight showed 3,874 confirmed cases and 1,751 deaths as of Monday, while WHO’s latest outbreak update had put the tally at 3,605 cases and 1,587 deaths as of July 30. The outbreak is being driven by the Bundibugyo species of Ebola, a rarer strain for which WHO says there is no licensed vaccine or specific treatment. WHO said on August 1 that transmission had expanded from Ituri province to five provinces and 49 health zones, making it the largest Ebola outbreak ever recorded in the DRC. (who.int) Tedros said on August 5 that the disease was still spreading faster than efforts to fight it. ### Why is Tedros in Congo now? WHO said Tedros was scheduled to meet President Félix Tshisekedi and other partners in Kinshasa during the visit. The trip came as the agency and aid groups sought to scale up operations in a response that WHO has described as under severe strain. (lasvegassun.com) Tedros said after meetings in Kinshasa that nearly three months into the outbreak, new cases were doubling in some hot spots. AP reported that some health workers were also striking over a lack of pay during the visit, adding pressure to an already stretched response. ### How fast is the outbreak growing? WHO said on August 1 that the most recent full reporting week recorded 567 cases and 296 deaths, both weekly highs for the outbreak. (who.int) The agency said the continued rise in cases, widening geographic spread and high mortality reflected a rapidly evolving emergency. CIDRAP reported on August 5 that the outbreak had sickened 3,895 people, including 1,753 deaths, citing WHO briefings to reporters in Geneva. (lasvegassun.com) Vasee Moorthy, acting head of WHO’s Research and Development Blueprint program, said the current emergency was the fastest-growing Ebola outbreak in history even as trials had begun more quickly than in past outbreaks. (usnews.com) ### What tools does WHO actually have against Bundibugyo Ebola? WHO said on May 28 that there were no licensed therapeutics or vaccines specifically approved for Bundibugyo virus disease. Its advisory groups recommended that candidate products be used only within clinical trials so researchers could generate safety and efficacy data. (who.int) The same WHO advisory process prioritized monoclonal antibodies MBP134 and Maftivimab, the antiviral remdesivir, and combination therapy for treatment research. For prevention after exposure, WHO said obeldesivir was a priority candidate for contacts of confirmed and probable cases, though experts noted that the approach depends on effective contact tracing in hard-to-reach areas. (cidrap.umn.edu) ### Is there a vaccine yet? WHO said the most promising vaccine candidate so far is IAVI’s single-dose rVSV Bundibugyo vaccine. On May 28, the agency said that candidate would likely need seven to nine months more development before it could be assessed in a clinical trial for its ability to prevent disease. (who.int) CIDRAP reported on August 5 that Moderna had started a phase 1 trial in Canada for its mRNA-1469 vaccine candidate, with 80 healthy adults expected to be enrolled. The report said CEPI is also funding three other vaccine candidates in parallel and that more than 50 confirmed patients in Congo had already been enrolled in experimental treatment studies. (who.int) ### Why are officials still warning that the response is behind? WHO said the outbreak was unfolding amid humanitarian crisis, insecurity, displacement, mobility and cross-border trade, all of which complicate surveillance, contact tracing and delivery of supplies. The agency said a substantial scaling up of response activities was still needed to get ahead of transmission. (who.int) Reuters reported on August 4 that Ebola response workers in eastern Congo had protested over salaries and allowances they said were nearly three months overdue. WHO’s next milestones include continued treatment enrolment in Congo, further vaccine development work, and monitoring after Uganda declared its own Bundibugyo outbreak over on July 28. (yahoo.com) (who.int) (cidrap.umn.edu)