WHO upgrades Congo Ebola risk

The World Health Organization has escalated its assessment of the Ebola outbreak in the Democratic Republic of the Congo, and governments are already tightening travel controls far from the epicenter. WHO said on May 17 that the outbreak in Congo and Uganda met the threshold for a Public Health Emergency of International Concern after suspected cases and deaths mounted in northeastern Congo. The agency’s outbreak notices say the virus involved is the Bundibugyo species of Ebola, a strain for which there is no licensed vaccine or specific treatment yet. The U.S. Centers for Disease Control and Prevention and the Department of Homeland Security said on May 18 they began enhanced screening and entry restrictions aimed at keeping Ebola from entering the United States. U.S. embassy alerts issued on May 21 and May 22 said affected travelers would face added screening at Washington Dulles International Airport. ### What exactly did WHO change? WHO said on May 17 that its director-general determined the outbreak constituted a Public Health Emergency of International Concern, the agency’s highest formal alarm under international health rules. In a separate outbreak page published on May 23, WHO said the event was unfolding in a difficult setting marked by insecurity, humanitarian strain and densely populated areas. WHO’s May 16 disease-outbreak notice said the agency had been alerted on May 5 to a high-mortality outbreak of unknown illness in Mongbwalu Health Zone in Ituri Province. Laboratory analysis by Congo’s Institut national de recherche biomédicale confirmed Bundibugyo ebolavirus in samples taken from Rwampara Health Zone, according to the notice. ### How large is the outbreak that officials are counting? (who.int) As of May 16, WHO said Congo had reported eight laboratory-confirmed cases, 246 suspected cases and 80 suspected deaths across at least three health zones in Ituri Province: Bunia, Rwampara and Mongbwalu. Those figures are the clearest official counts available in WHO’s published notices reviewed on May 23. (who.int) Uganda is also part of the WHO emergency declaration. WHO’s outbreak materials say the event includes cross-border spread to Uganda, which is one reason the agency elevated the emergency under the International Health Regulations. ### Why are U.S. authorities using travel restrictions now? The CDC said on May 18 that it, DHS and other federal agencies announced enhanced travel screening, entry restrictions and public-health measures because of ongoing Ebola outbreaks in East and Central Africa. (who.int) The agency said those steps were meant to prevent Ebola disease from entering the United States. A CDC Health Alert Network advisory issued on May 19 said the risk of spread to the United States remained low, but it warned clinicians, public-health officials and travelers about the outbreak in Congo and Uganda. (who.int) That notice identified the virus as Bundibugyo virus and framed the U.S. measures as precautionary containment. ### What do the embassy alerts mean for travelers? The U.S. Embassy in Zambia said on May 21 that CDC and DHS Customs and Border Protection would apply enhanced public-health screening at Washington Dulles International Airport in response to the Ebola outbreak. (cdc.gov) The alert said the requirement applies to all passengers, including U.S. citizens and lawful permanent residents, who were present in affected countries. (cdc.gov) Embassy alerts posted on May 22 for U.S. missions in Africa repeated that travelers should prepare for flight changes or cancellations and review DHS guidance on enhanced screening. Those notices did not announce a blanket border closure, but they did set out a narrower arrival-control regime tied to recent presence in outbreak countries. (zm.usembassy.gov) ### Where do regional laboratories fit into this response? Reuters reported on May 22 that the Institut Pasteur de Dakar in Senegal helped identify the Andes strain during a separate hantavirus scare aboard a cruise ship off Cape Verde. Dr. Moussa Moise Diagne, the laboratory’s virology chief, told Reuters it is “crucial” to have the capacity in different parts of the world to detect pathogens quickly. (af.usembassy.gov) That reporting does not concern the Ebola outbreak directly, but it shows the same operational issue now facing health authorities in Congo and neighboring countries: outbreaks move faster when testing capacity is far from the field, and response speeds up when regional labs can process samples. That is an inference drawn from the Reuters account and WHO’s timeline showing how sample confirmation followed the initial alert in Ituri. (uk.news.yahoo.com) WHO’s outbreak page says response work is continuing in Congo and Uganda, while CDC guidance and embassy alerts indicate U.S. arrival controls remain in force as of May 23. The next public benchmarks are updated WHO case reports, CDC travel notices and any changes to screening rules at Dulles. (who.int) (devdiscourse.com)