Ebola outbreak strains eastern Congo

The World Health Organization and aid groups are confronting a fast-moving Ebola outbreak in eastern Democratic Republic of the Congo while delegates in Geneva debate how to strengthen global outbreak preparedness. WHO said the outbreak in Ituri Province was confirmed on May 15 and involves Bundibugyo virus, a species of Ebola for which there is no licensed vaccine or specific treatment. The agency said its director-general determined on May 16 that the outbreak in Congo and linked cases in Uganda constituted a public health emergency of international concern. Health workers in eastern Congo have separately warned that the response is short of staff and supplies in an area already destabilized by insecurity and displacement. ### Why are health workers saying this outbreak is especially hard to contain? Ituri Province is the center of the outbreak, and WHO said the response is unfolding in a “complex epidemiological, humanitarian and security backdrop” marked by insecurity, mobile populations, cross-border trade and large refugee communities. WHO said response operations are under way in affected and at-risk health zones, with surveillance, laboratory testing, infection prevention and control, contact tracing and case management being reinforced. (who.int) Aid workers in Bunia said they need more people and more material to keep up with the outbreak. Associated Press reported on May 21 that healthcare workers and aid groups in eastern Congo were seeking urgent supplies and staff as the outbreak gained momentum, while armed groups continued to threaten the region. (afro.who.int) ### What do officials know about the outbreak so far? WHO said it was alerted on May 5 to an unknown illness with high mortality in Mongbwalu Health Zone, including deaths among health workers. Laboratory analysis by the Institut national de recherche biomédicale in Kinshasa confirmed Bundibugyo virus in eight of 13 samples on May 15, WHO said. The Congolese health ministry declared the country’s 17th Ebola outbreak the same day. (wtop.com) As of May 16, WHO said eight laboratory-confirmed cases, 246 suspected cases and 80 suspected deaths had been reported in Ituri across at least three health zones: Bunia, Rwampara and Mongbwalu. WHO also said two laboratory-confirmed cases, including one death, were reported in Kampala, Uganda, on May 15 and May 16 among travelers from Congo. A reported case in Kinshasa later tested negative on confirmatory testing, according to WHO. (who.int) ### Why does the Bundibugyo strain matter? Bundibugyo virus is a species of Ebola, but WHO said it differs from the better-known Ebola virus disease outbreaks because there is no licensed vaccine or specific therapeutic for it. WHO said the case fatality rate in the past two Bundibugyo outbreaks ranged from 30% to 50%, making early supportive care and rapid detection central to the response. (who.int) WHO said current control measures therefore rely on public-health basics: rapid response teams, medical supplies, surveillance, infection prevention, safe treatment centers, safe burials and community engagement. The agency said healthcare-associated transmission is a concern after suspected transmission in medical settings and deaths among health workers. (who.int) ### What is happening in Geneva while Congo fights the outbreak? The Seventy-ninth World Health Assembly is being held in Geneva from May 18 to May 23, according to WHO. WHO said the assembly’s strategic roundtables included discussions on the evolution of the WHO Health Emergencies Programme, lessons from COVID-19, institutional reforms and stronger national, regional and global preparedness. (who.int) WHO’s assembly agenda includes public health emergencies, implementation of the International Health Regulations and work on health-emergency prevention, preparedness, response and resilience. Those discussions are taking place as the Congo outbreak and a separate hantavirus cluster have renewed attention on whether countries have built durable response capacity since the COVID-19 pandemic. (who.int) ### Who is arguing that these outbreaks expose broader gaps? Helen Clark, former New Zealand prime minister and co-chair of the Independent Panel for Pandemic Preparedness and Response, said recent Ebola and hantavirus outbreaks show the world is still not adequately prepared for major health threats. In remarks reported from Geneva, Clark said improvements had been made in crisis response under updated international health regulations, but warned preparedness still lagged. (apps.who.int) Matthias Götte, a University of Alberta virologist, said the outbreaks show the need for stronger pandemic preparedness as deadly viruses continue to adapt and spread. That assessment was echoed in WHO’s own assembly programming, which framed this week’s discussions around lessons from COVID-19 and the need to strengthen emergency systems before the next crisis. (firstpost.com) WHO’s World Health Assembly continues through May 23 in Geneva, while response teams remain deployed in Ituri and cross-border preparedness efforts continue in Uganda. WHO said the next steps include stronger surveillance, contact tracing, laboratory support and emergency coordination in affected and at-risk health zones. (who.int) (ualberta.ca)