WHO declares Ebola outbreak in DRC, Uganda global health emergency

The World Health Organisation has declared the Ebola outbreak in the Democratic Republic of Congo and Uganda a public health emergency of international concern.

The declaration follows cases of Ebola caused by the Bundibugyo virus in both countries.

WHO Director-General Tedros Adhanom Ghebreyesus made the declaration on Sunday in a statement after consulting with both countries.

The statement read, “The Director-General of WHO, after having consulted the States Parties where the event is known to be currently occurring, is hereby determining that the Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda constitutes a public health emergency of international concern, but does not meet the criteria of pandemic emergency.”

As of Saturday, eight laboratory-confirmed cases, 246 suspected cases and 80 suspected deaths had been reported in Ituri Province of the DRC across at least three health zones, Bunia, Rwampara and Mongbwalu.

Two confirmed cases, including one death, were also reported in Uganda’s capital, Kampala, on Friday and Saturday among travellers arriving from the DRC, while a confirmed case was recorded in Kinshasa on Saturday among a returnee from Ituri.

At least four healthcare workers had also died in circumstances consistent with viral haemorrhagic fever.

The statement said this raised “concerns regarding healthcare-associated transmission, gaps in infection prevention and control measures, and the potential for amplification within health facilities.”

Ghebreyesus cautioned that the outbreak was likely far larger than current figures showed, pointing to the high positivity rate of initial samples, cross-border confirmations and rising syndromic reports

He said, “The high positivity rate of the initial samples collected, the confirmation of cases in both Kampala and Kinshasa, the increasing trends in syndromic reporting of suspected cases and clusters of deaths across the province of Ituri all point towards a potentially much larger outbreak than what is currently being detected and reported, with significant local and regional risk of spread.”

He identified ongoing insecurity, a humanitarian crisis, high population movement and a dense network of informal health facilities as factors worsening the risk, conditions he likened to those that drove the deadly 2018-19 Ebola epidemic in the same region.

Critically, he noted that “unlike for Ebola-zaire strains, there are currently no approved Bundibugyo virus-specific therapeutics or vaccines,” making the situation especially dangero

On international spread, the statement said neighbouring countries sharing land borders with the DRC were “at high risk for further spread due to population mobility, trade and travel linkages, and ongoing epidemiological uncertainty.”

WHO advised the DRC and Uganda to activate national emergency mechanisms, scale up surveillance and contact tracing, and establish specialised treatment centres near outbreak epicentres.

It called for exit screening at all international airports, seaports and major land crossings, and directed that confirmed cases must not travel until two negative tests taken at least 48 hours apart are obtained.

On border closures, the statement was unequivocal. It read, “No country should close its borders or place any restrictions on travel and trade. Such measures are usually implemented out of fear and have no basis in science. They push the movement of people and goods to informal border crossings that are not monitored, thus increasing the chances of the spread of disease.”

WHO also called on affected countries to implement clinical trials for candidate therapeutics and vaccines and urged that mass gatherings be postponed “until BVD transmission is interrupted.”

Ghebreyesus said he would convene an Emergency Committee as soon as possible to refine the temporary recommendations issued alongside the declaration.