WHO calls Ebola high regional risk

The World Health Organization said on May 17 that the Ebola outbreak in eastern Democratic Republic of Congo and Uganda had become a Public Health Emergency of International Concern, the agency’s highest alert under international health rules. The outbreak is being driven by the Bundibugyo strain of Ebola virus, a rarer form for which there is no licensed vaccine, according to WHO. WHO and U.N. officials said the immediate response is centered on surveillance, isolation, contact tracing and community engagement in Ituri province in Congo and in Uganda, where imported cases have been confirmed. Cases and deaths are expected to rise as investigations continue, WHO said. ### What exactly did WHO decide? WHO Director-General Tedros Adhanom Ghebreyesus determined on May 16, after consulting an emergency committee, that the event in Congo and Uganda met the threshold for a Public Health Emergency of International Concern, according to a WHO disease outbreak notice. That designation is used when an outbreak is considered an extraordinary event that may require a coordinated international response under the International Health Regulations. The WHO notice said the agency assessed the public health risk as high at regional level and low at global level. The agency cited insecurity, humanitarian pressures, population movement and transmission in urban or semi-urban settings among the factors increasing the risk of further spread. (who.int) ### How large is the outbreak right now? As of May 20, WHO said there had been almost 600 suspected cases in Ituri province in eastern Congo, including 51 confirmed infections, according to a London School of Hygiene & Tropical Medicine summary based on WHO data. The same update said 139 suspected deaths had been reported in Congo. The U.S. Centers for Disease Control and Prevention said four days ago that Congo had reported 10 confirmed cases and 336 suspected cases including 88 deaths, while Uganda had reported two confirmed imported cases including one death. (who.int) WHO has said case and death counts are subject to revision as laboratory testing and field investigations continue. ### Why is the Bundibugyo strain complicating the response? (lshtm.ac.uk) Bundibugyo virus disease is one of the species that can cause Ebola disease, but it is less common than the Zaire strain that has driven several past outbreaks in Congo. WHO said there is no licensed vaccine specifically for Bundibugyo virus. London School of Hygiene & Tropical Medicine experts said a vaccine tailored to the Bundibugyo strain could take about nine months to develop. (cdc.gov) That timeline means health authorities are relying now on established outbreak-control measures rather than an immediate vaccination campaign of the kind used in some previous Ebola emergencies. ### What is WHO and the U.N. doing on the ground? (who.int) U.N. News reported on May 21 that WHO is using what it called a rapid, community-centered response in affected areas. The report said health teams are focusing on early detection, safe care, infection prevention, risk communication and work with local leaders because, as WHO officials put it, transmission is stopped in communities as well as clinics. WHO’s Africa office said rapid response teams had been deployed to Mongbwalu and Rwampara health zones in Congo and that Ugandan authorities had activated surveillance, screening and readiness measures after confirming imported cases. (lshtm.ac.uk) The agency said Congo declared its 17th Ebola outbreak on May 15. ### Where do pandemic-agreement talks fit into this? (news.un.org) The World Health Assembly said this week that member states would continue negotiating the Pathogen Access and Benefit Sharing annex to the WHO Pandemic Agreement. WHO has said that annex is meant to govern how pathogen information is shared quickly and how benefits are distributed more equitably. The next step is the continued work of the Intergovernmental Working Group on the pandemic agreement, which the World Health Assembly tasked with finalizing the pathogen-sharing annex. (afro.who.int) In the outbreak itself, WHO said updated case counts and operational reports will continue to come from Congo, Uganda and the agency’s emergency situation updates. (who.int)