The WHO emergency committee was yesterday to decide whether to declare a raging Ebola epidemic an international threat, after an outbreak that began in the Democratic Republic of the Congo (DR Congo) crossed into Uganda.
The WHO panel, which was formed in 2005, has used the label “public health emergency of international concern” for only four previous epidemics.
Those emergencies included an H1N1, or swine flu, pandemic in 2009; the spread of poliovirus in 2014; an Ebola epidemic that devastated parts of west Africa from 2014 to 2016; and a surge of the Zika virus in 2016.
The current Ebola crisis, which began in the DR Congo’s east in August last year, has recorded more than 2,000 cases, two-thirds of them deadly.
The WHO panel has met twice already on the current outbreak in the DR Congo.
It held off making the emergency call at previous meetings in October last year and April, in part because the virus had not spread internationally.
That changed this week with confirmation that Ebola had reached western Uganda, where it has claimed two lives so far.
A Congolese woman — who is married to an Ugandan — as well as her mother, three children and their nanny had traveled to the DR Congo to care for her ill father, who later died of Ebola.
The WHO said that 12 members of the family who attended the burial in Congo were placed in isolation in the DR Congo, but six “escaped and crossed over to Uganda” on Sunday.
The next day, a five-year-old was admitted to a hospital in Bwera, a border town, vomiting blood before he died. Tests confirmed that he had Ebola and his family was placed in an isolation ward.
His three-year-old brother was also confirmed to have Ebola, as was their grandmother, who died late on Wednesday.
That cases have crossed a border does not automatically compel the WHO panel to make the emergency declaration, especially as the epidemic is still confined to one contiguous region.
However, invoking the emergency provisions would entail additional measures to manage the outbreak, including a possible call for “immediate international action,” the WHO said.
Health officials had initially hoped that a new vaccine would help contain the outbreak, but chronic violence and militia activity in the affected the DR Congo’s eastern provinces of Ituri and North Kivu, as well as hostility to medical teams among some people in the region, have hampered the response.
Some of the latest violence has hit the Ituri’s Djugu territory, where clashes have killed at least 50 people since Friday last week, a regional official said.
The cause of the flare-up was not immediately clear, but it occurred in a region where tens of thousands died in clashes between the Hema and Lendu ethnic groups from 1999 to 2003.
Meanwhile, new research from the University of Cambridge released on Thursday indicated that half of all Ebola outbreaks have gone undetected since the virus was discovered in 1976.
The research, published in PLOS Neglected Tropical Diseases, said that more efforts are needed to identify early-stage Ebola outbreaks.
“The unfolding epidemic in the [DR Congo] demonstrates how difficult it is to stop the disease once it has got out of control, even with international intervention,” Department of Veterinary Medicine graduate student Emma Glennon said in a statement.
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