WHO rep: ‘Significant uncertainty’ about how far Ebola has spread

 The World Health Organization’s (WHO) representative in the Democratic Republic of the Congo (DRC), Anne Ancia MD, MPH, told reporters today there were at least 500 suspected cases and 130 suspected deaths in a growing Ebola outbreak in the DRC and Uganda. 

“We have significant uncertainty about the number of infections and how far the virus has spread,” Ancia said. “I don't think that we have the ‘patient zero’ for now.”

Ancia shared what’s known: A person died in Bunia, in Ituri province, in late April. The body was returned to Mongbwalu, a mining area, where the family switched coffins for the person and then had a large funeral. On May 5, dozens of cases developed after that funeral, and the WHO was alerted. Initial testing in Bunia was negative for Ebola because tests could detect only Ebola Zaire, not this species, Ebola Bundibugyo. 

Once samples arrived for testing in Kinshasa last week, officials were able to detect Ebola Bundibugyo. Ancia said the WHO has 40 health professionals on the ground in the region, working in what she called a “highly complex epidemiological, operational and humanitarian context.”

Ancia also said the virus has now been confirmed in North Kivu, with cases in Butembo and Goma. North Kivu last saw a large Ebola outbreak in 2018-19. The current outbreak is the seventeenth in the DRC since the virus was first identified in 1976. Ebola Bundibugyo was first identified in Uganda in 2007.

During his opening remarks at the WHO’s Emergency Committee on the Ebola epidemic today, WHO Director-General Tedros Adhanom Ghebeyesus, PhD, said several factors warrant serious concern, including documented cases among healthcare workers, spread in urban centers, and a population with at least 100,000 displaced residents. 

“The area is also a mining zone, with high levels of population movement that increase the risk of further spread,” he said. 

CDC says threat to Americans is low 

Yesterday, the US Centers for Disease Control and Prevention (CDC) said it was issuing a travel ban on foreigners with recent travel to the DRC, Uganda, and South Sudan. The move garnered some pushback from Jean Kaseya, MD, the Africa Centres for Disease Control and Prevention (Africa CDC) director general. 

Global health security cannot be achieved through borders alone.

“The fastest path to protecting all countries in the world is to aggressively support outbreak control at the source,” said Kaseya in a statement. “Global health security cannot be achieved through borders alone. It is achieved through partnership, trust, science and rapid investment in preparedness and response capacity.”

The Africa CDC said the Bundibugyo species was identified nearly two decades ago, yet no licensed vaccines or therapeutics specific to this strain exist. “Africa CDC believes that if this disease had predominantly threatened wealthier regions of the world, medical countermeasures would likely already be available,” the organization said. 

Ancia commented on using the existing Ebola Zaire vaccine, Ervebo, in the current outbreak, given some evidence of possible cross-protection, but warned “it would take two months for it to be available.”

Today during a media briefing, Satish Pillai, MD, MPH, the incident manager for the US CDC’s Ebola response, said the risk to Americans from this outbreak is low and that the CDC would actively work with World Cup officials on monitoring travelers coming to the United States for the tournament. 

The US CDC also said it would send on-the-ground support to the DRC but did not give specifics. The CDC also published a new Health Alert Network on the outbreak today. 

https://www.cidrap.umn.edu/ebola/who-rep-significant-uncertainty-about-how-far-ebola-has-spread