The World Health Organization (WHO) has announced a laboratory-confirmed Ebola case in Kinshasa, the capital of Congo, which is approximately 1,000 kilometers away from the outbreak’s center in the eastern Ituri province. This development suggests the virus may be spreading further afield.
According to the WHO, the individual diagnosed in Kinshasa had traveled to Ituri. There are also suspected Ebola cases in North Kivu province, one of Congo’s most densely populated regions neighboring Ituri.
Ebola is a highly infectious virus, transmitted through contact with bodily fluids such as vomit, blood, or semen. Although Ebola outbreaks are relatively rare, the disease is severe and often results in fatalities.
The WHO’s emergency declaration is intended to mobilize donor agencies and countries to respond promptly. This declaration underscores the seriousness of the situation, highlights the risk of international transmission, and calls for a well-coordinated global response.
Historically, responses to WHO emergency declarations have varied. In 2024, when the WHO declared mpox outbreaks in Congo and other African nations as global emergencies, experts criticized the delayed delivery of critical resources like diagnostic tests, medicines, and vaccines to the affected regions.
Health officials report that the current outbreak, officially recognized last Friday, is caused by the Bundibugyo virus, a rare Ebola strain with no approved treatments or vaccines. While more than 20 Ebola outbreaks have occurred in Congo and Uganda, this marks only the third detection of the Bundibugyo virus.
Health authorities say the current outbreak, first confirmed on Friday, is caused by the Bundibugyo virus, a rare variant of the Ebola disease that has no approved therapeutics or vaccines. Although more than 20 Ebola outbreaks have taken place in Congo and Uganda, this is only the third time the Bundibugyo virus has been detected.
Congo accounts for all except two of the cases, both of which were reported in Uganda, the WHO said.
The Bundibugyo virus was first detected in Uganda’s Bundibugyo district during a 2007-2008 outbreak that infected 149 people and killed 37. The second time was in 2012, in an outbreak in Isiro, Congo, where 57 cases and 29 deaths were reported.
Conflict and migration complicate effort to track outbreak
Africa Centres for Disease Control and Prevention director-general Dr Jean Kaseya said on Saturday that a high number of active cases remain in the community, particularly in Mongwalu, where the first cases were reported, “significantly complicating containment and contact tracing efforts”.
Violent conflict with militants, some backed by the Islamic State group, as well as constant population movement due to mining, both within Congo and across the border in Uganda, have also posed a major challenge to response efforts.
Officials first reported the spread of the disease in Ituri province, close to Uganda and South Sudan, on Friday. On Saturday, the Africa CDC reported 336 suspected cases and 87 deaths in Congo.
“There are significant uncertainties to the true number of infected persons and geographic spread associated with this event at the present time. In addition, there is limited understanding of the epidemiological links with known or suspected cases,” WHO director-general Tedros Adhanom Ghebreyesus said.
The two cases in Uganda include one person whom officials said had travelled from Congo and died at a hospital in Uganda’s capital, Kampala, and another the WHO said had also travelled from Congo.
The WHO said the high percentage of positive cases among samples tested, the spread to Kampala and Uganda and the clusters of deaths across Ituri “all point toward a potentially much larger outbreak than what is currently being detected and reported, with significant local and regional risk of spread”.
Congo outbreak killed 50 before it was detected
Kaseya said slow detection delayed the response and gave the virus time to spread.
“This outbreak started in April. So far, we don’t know the index case,” Kaseya said, using a term for the first detectable case of an epidemic.
“It means we don’t know how far is the magnitude of this outbreak.”
The earliest known suspected case, a 59-year-old man, developed symptoms on April 24 and died at a hospital in Ituri on April 27.
By the time health authorities were first alerted to the outbreak via social media on May five, 50 deaths had already been recorded, the Africa CDC said.
The WHO said at least four deaths have been reported among healthcare workers who showed Ebola symptoms.
Diagnostics and vaccines have been a major problem for Africa
Shanelle Hall, principal adviser to the head of Africa CDC, told reporters on Saturday that there were four therapeutics under consideration for the Bundibugyo virus, but no vaccine was being actively considered.
A bigger issue is that even existing vaccines and therapeutics for other Ebola viruses are not manufactured in Africa. Africa’s struggle to get vaccines from richer countries during the COVID-19 pandemic spurred different efforts to accelerate its capacity to manufacture shots, but resources remain scarce.
Kaseya said the demand for a vaccine for a rare virus like Bundibugyo, which is not as deadly as the Ebola Zaire prominent in Congo’s past outbreaks, has been the recurring issue in discussions with pharmaceutical companies over vaccine manufacturing,
“If we are serious in this continent, we need to manufacture what we need,” he said.
“We cannot every single day look for others to come to tell us what they are doing.”
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