DRC reports 139 Ebola deaths

The World Health Organization said on May 20 that the Ebola outbreak centered in the Democratic Republic of the Congo had reached nearly 600 suspected cases and 139 suspected deaths, with spillover into Uganda already confirmed. Tedros Adhanom Ghebreyesus, the WHO director-general, told reporters in Geneva that the outbreak involved the Bundibugyo virus species, a rarer form of Ebola for which there is no licensed vaccine or specific treatment. WHO declared the event a public health emergency of international concern on May 17 after cases were confirmed in DRC and Uganda. The outbreak was officially declared by Congolese authorities on May 15 after laboratory testing in Kinshasa confirmed Bundibugyo virus in samples from Ituri province. ### How large is the outbreak, and where is it centered? Ituri province in northeastern DRC is the center of the outbreak, according to WHO Africa and the WHO emergency determination. The first affected health zones publicly identified by WHO were Rwampara, Mongbwalu and Bunia, and the agency said the outbreak is DRC’s 17th since Ebola was first identified in the country in 1976. (news.un.org) Tedros said on May 20 that there were “almost 600 suspected cases” and 139 suspected deaths, adding that WHO expected those figures to rise because the virus had been circulating before the outbreak was detected. WHO’s May 17 emergency determination had earlier listed 246 suspected cases and 80 suspected deaths in Ituri as of May 16, showing how quickly the reported toll had climbed within days. (afro.who.int) ### Why is Bundibugyo drawing so much concern? Bundibugyo virus was first identified in Uganda in 2007, and WHO says no approved vaccine or specific treatment exists for this Ebola species. That distinguishes the current outbreak from outbreaks caused by Zaire ebolavirus, for which licensed vaccines and therapeutics are available. (news.un.org) WHO said response strategies therefore depend on supportive care and classic outbreak-control tools rather than a licensed shot. The agency listed early case detection, contact tracing, infection prevention and control, safe burials and community engagement among the main measures being used. ### How did the outbreak become an international emergency? (afro.who.int) WHO said the outbreak was officially declared by DRC on May 15 after the Institut National de la Recherche Biomédicale in Kinshasa confirmed Bundibugyo virus in tested samples. The agency said it had first been alerted on May 5 to an unknown illness with high mortality in Mongbwalu health zone, including deaths among health workers. (afro.who.int) On May 17, WHO said the director-general determined that the event in DRC and Uganda met the threshold for a public health emergency of international concern, or PHEIC, under the International Health Regulations. WHO also said the outbreak did not meet the criteria for a pandemic emergency. (afro.who.int) ### What role is Uganda playing in the outbreak? Uganda confirmed two imported cases in Kampala on May 15 and May 16, according to WHO. The agency said both cases involved travelers from DRC, making the outbreak a cross-border event almost immediately after confirmation in Ituri. (who.int) WHO said a further case initially reported in Kinshasa on May 16 later tested negative on confirmatory testing and was not counted as a confirmed case. That left the known confirmed spread outside Ituri focused on Uganda’s capital as of WHO’s latest emergency documentation. (who.int) ### What is making the response difficult on the ground? WHO said the outbreak is unfolding in a complex security and humanitarian environment in eastern DRC, with insecurity, mobile populations, cross-border trade and large refugee communities complicating containment. UN News, citing WHO officials, said more than two million people are internally displaced across Ituri and North Kivu. (who.int) Dr. Mohamed Yakub Janabi, WHO’s regional director for Africa, said outbreak detection in remote or insecure areas depends on community reporting, functioning health facilities and laboratory confirmation. Dr. Anais Legand, a WHO technical officer, said samples had to be transported about 1,700 kilometers to Kinshasa before Bundibugyo virus was confirmed. ### What happens next at WHO and in the field? (afro.who.int) WHO said national authorities in DRC and Uganda have activated emergency coordination mechanisms, while WHO and partners are deploying technical experts, supplies and laboratory support. The agency said surveillance cells are being established in affected and at-risk health zones, with intensified contact tracing and reinforced infection-control measures in health facilities. (news.un.org) The World Health Assembly in Geneva was debating emergency preparedness and financing on May 21, according to WHO’s daily update cited in the source briefings for this story. The next formal WHO milestone already listed is the record of the first IHR Emergency Committee meeting, which WHO says was convened on May 19 after the PHEIC declaration. (who.int) (afro.who.int)