WHO chief to meet Congo president as Ebola outbreak fears grow

KINSHASA: World Health Organisation Director-General Tedros Adhanom Ghebreyesus was expected to meet Democratic Republic of Congo President Felix Tshisekedi on Monday as concern mounted over an Ebola outbreak that aid officials say may be larger than the official caseload suggests.

According to an official programme, Tedros returned to Kinshasa after travelling to Ituri province, where the first cases were confirmed, and was due to meet Tshisekedi at his residence before flying back to Geneva. After arriving in Congo last week, he had called for greater international support to curb the spread of the disease.

In a joint statement issued on Sunday night, the WHO and the Congolese government described the situation as

a challenging time

and said efforts were under way to strengthen surveillance, testing and patient care. The statement added: "Persistent challenges include early detection and isolation of cases, contact tracing, safe and dignified burials, robust infection prevention and control in health facilities, and strong community awareness".

Cases spread across provinces

The WHO said on Friday that Congo had recorded 906 suspected Ebola cases, including 223 suspected deaths under investigation. Late on Sunday, the Congolese government said confirmed cases had risen to 282, with 42 deaths, after 19 new positive test results.

Data distributed by the communications ministry showed 264 confirmed cases in Ituri province, 15 in North Kivu and three in South Kivu. Ebola cases have also been confirmed in neighbouring Uganda.

The outbreak is the 17th recorded in Congo and the third-largest since Ebola was first identified about 50 years ago. Earlier this month, the WHO declared the outbreak in the DRC and Uganda, caused by the Bundibugyo strain of the virus, a public health emergency of international concern, while saying it does not meet the threshold for a pandemic emergency.

Undetected spread feared

The International Rescue Committee said on Monday that the outbreak was likely much bigger and further advanced than official figures indicate. The aid group said the virus may have circulated for as long as three months before the first official cases were identified in mid-May.

The IRC also said only 20% of contacts were currently being traced, hampering efforts to identify and isolate new chains of transmission. Rachel Howard, the organisation’s senior technical emergency health adviser, said:

When four out of five contacts are not being traced, it becomes incredibly difficult to contain the outbreak or even understand its true scale

While Congolese authorities have extensive experience in responding to Ebola, the current outbreak is being driven by the Bundibugyo strain, for which there is no approved vaccine. Global health organisation CEPI told Reuters it would provide about $60 million to Moderna and two other groups to speed up development of shots against Ebola Bundibugyo, and said vaccines could be ready for trials within a couple of months. China also said on Monday that it would send a team of medical specialists to Congo to help with the response.

Recoveries and suspected cases abroad

The WHO said on Sunday that four nurses being treated in Bunia had been discharged after recovering from Ebola caused by the Bundibugyo strain. It said a laboratory worker had also recovered earlier in the week, bringing the number of recoveries to five. Tedros said during a Saturday visit to Bunia, the capital of Ituri, that although there is currently no licensed vaccine or treatment for Ebola caused by the Bundibugyo virus,

it is not without hope.

because patients can survive with good medical care.

Suspected cases linked to travel from affected countries are also being examined outside Africa. In Brazil, health authorities said on Sunday that a suspected Ebola patient in Sao Paulo tested positive for meningitis, while another suspected case in Rio de Janeiro tested positive for malaria. They said neither diagnosis ruled out the possibility of Ebola. In the Sao Paulo case, the patient was a man from the DRC who developed a fever after recently visiting the country; in Rio, the patient had recently travelled to Uganda.

In Italy, protocols were activated in Cagliari, Sardinia, for a man who had returned from Congo on Saturday with symptoms, but the health ministry said early on Monday that he had tested negative. The ministry said:

We confirm that the risk [of Ebola] in Italy remains very low

Separately, an op-ed published by the Financial Times on Sunday quoted Africa Centres for Disease Control and Prevention director-general Jean Kaseya as saying:

The risk of regional spread is already happening

. That piece said more than 1,100 suspected cases were under investigation.