WHO upgrades Congo Ebola risk 'very high'

The World Health Organization raised its assessment of the Ebola outbreak in the Democratic Republic of the Congo to “very high” at the national level on May 22 as suspected cases climbed and the outbreak spread beyond its initial focus in Ituri province. WHO said the outbreak involves Bundibugyo virus, a species for which there is no licensed vaccine or specific treatment, though candidate countermeasures are being explored. The agency has already declared the event a Public Health Emergency of International Concern, a step taken on May 16 and formalized through WHO emergency procedures announced on May 17. ### Why did WHO raise the risk level now? WHO said in its May 21 disease outbreak notice that the number of suspected and confirmed cases had “increased rapidly” in Congo and that the outbreak had expanded geographically into North Kivu and South Kivu. As of May 21, the agency reported 746 suspected cases and 176 deaths among suspected cases in Congo, alongside 85 confirmed cases across Congo and Uganda and 10 deaths among confirmed cases. (france24.com) The WHO Africa office said the response is being complicated by insecurity, population movements, trade flows and gaps in isolation, referral systems and contact follow-up. Those conditions, together with cross-border spread into Uganda, were part of the rationale for the earlier international emergency declaration. (who.int) ### What is different about this Ebola strain? WHO said the outbreak is caused by Bundibugyo virus disease, not the Zaire species linked to some previous Ebola outbreaks. The agency said there is no approved vaccine or specific treatment for Bundibugyo virus disease, making containment dependent on surveillance, contact tracing, infection-prevention measures, supportive care and community engagement. (who.int) WHO’s outbreak pages say authorities in Congo and Uganda are deploying rapid response teams, setting up treatment centers, strengthening laboratory confirmation and reinforcing infection-control practices in health facilities after reports of suspected healthcare-associated transmission and deaths among health workers. (who.int) ### How far has the outbreak spread beyond Congo? Uganda had reported two imported confirmed cases with no confirmed local transmission as of May 21, according to WHO. The agency also said an American national who had been working in Congo tested positive and was transferred to Germany for care. (who.int) WHO’s regional update describes the outbreak as Congo’s 17th since the virus was first identified in 1976 and says the current event is centered in northeastern Congo’s Ituri province, with cross-border spread to Uganda. ### What has the United States changed for travelers? The U.S. Centers for Disease Control and Prevention said on May 18 it issued an order suspending entry for certain foreign nationals who had been in Congo, Uganda or South Sudan within the previous 21 days. (who.int) U.S. citizens, U.S. nationals and lawful permanent residents are still permitted to enter. (afro.who.int) CDC said affected eligible travelers have been redirected to Washington-Dulles International Airport since 11:59 p.m. on May 20 for enhanced screening. The screening includes a questionnaire, temperature checks, observation for signs of illness and collection of contact information for possible follow-up by state and local health departments. (cdc.gov) ### What happens next in the response? WHO said Congo and Uganda have activated emergency coordination mechanisms and are expanding surveillance, laboratory testing, contact tracing and case management with support from WHO and other partners. The CDC said its U.S. entry restrictions are set to remain in effect for 30 days while it completes a public health risk assessment and coordinates mitigation measures with partner agencies. (cdc.gov) (afro.who.int)