WHO chief concerned by ‘scale and speed’ of Ebola outbreak: NPR

BUNYA, Congo — The head of the World Health Organization expressed concern Tuesday at the “scale and pace” of an outbreak of a rare type of Ebola called Bundibugyo in eastern Congo, where officials reported 134 suspected deaths and more than 500 suspected cases.

Health experts and aid workers said the virus remained undetected for several weeks after the first known death because officials tested for the more common type of Ebola and reports came back negative. There is no approved medicine or vaccine for Bundibugyo virus.

In Bunia, the site of the first known death, health workers in protective gear moved among residents wearing cloth masks. “I know the consequences of Ebola, I know what it’s like,” said Noella Lumo, a worried resident.

Jean-Jacques Muyembe, a virus expert at the National Institute of Biomedical Research, said Congo was expecting a shipment from the United States and Britain of an experimental vaccine for a variety of Ebola developed by Oxford researchers.

“We will vaccinate and see who develops the disease,” he said. But experts say such efforts will take time.

WHO Director-General Tedros Adhanom Ghebreyesus said he was “deeply concerned about the scale and pace of the pandemic,” and pointed to the emergence of cases in urban areas, deaths of health workers and significant population movement.

In Congo, 30 cases have been confirmed, Tedros later told a meeting of the U.N. health agency’s emergency committee. Neighboring Uganda has reported two confirmed cases to WHO, including one death in its capital Kampala among people who traveled from Congo, he said.

WHO expects outbreak to last at least months

WHO has declared the Ebola outbreak a public health emergency of international concern, requiring a coordinated response. Resources were being sent to two affected provinces near Uganda. Parts of eastern Congo remain in the hands of armed rebels, making it difficult to send aid.

Dr. Anne Ensia, head of the WHO team in Congo, said authorities had not identified “patient zero.”

He also said the Ervebo vaccine, used against a different type of Ebola, was among those being considered for potential use, but it would be two months before anything approved would be available.

“I don’t think we will be able to deal with this outbreak in two months,” he said.

At the moment, neither the US Centers for Disease Control and Prevention nor the Africa Centers for Disease Control were on the ground, Ensia said, but others, including Doctors Without Borders and the Red Cross, were.

The UNICEF office in Bunia said it had been sent an initial 16 tonnes of relief supplies, mainly including disinfectants and soap, personal protective equipment and water purification tablets and water tanks.

UNICEF Bunia bureau chief Hella Skiri said the relief items would be distributed as needed to three treatment centers in Ituri province.

Cases have been confirmed in Bunia, the capital of Congo’s Ituri province; North Kivu’s rebel-held capital, Goma; and the areas of Mongbvalu, Nyakunde and Butembo – home to a total of more than one million people.

Dr. Peter Stafford, an American doctor, is one of the Bunya cases, said Serge, the Christian organization he works for. He was treating patients in a hospital.

Tedros said an American had tested positive and was transferred to Germany, but did not confirm the patient’s identity.

Panic is increasing among some residents

Ebola is a highly contagious virus and can be spread through bodily fluids such as vomit, blood or semen. The disease it causes is rare but serious and often fatal. Symptoms include fever, headache, muscle pain, weakness, diarrhea, vomiting, stomach pain, and unexplained bleeding or bruising.

More than 11,000 people died during an outbreak more than a decade ago, many infected while washing bodies for cremation.

“Ebola is very much a disease of compassion, it affects people who care for sick people,” said Dr. Craig Spencer, an associate professor at Brown University’s School of Public Health who survived being infected with Ebola a decade ago in Guinea.

Panic increased in Bunia locality on Tuesday. Local authorities urged people to remain calm and follow preventive measures, including adopting good hygiene and taking precautions during funerals.

“It’s really sad and painful because we’ve already gone through a security crisis and now Ebola is here,” said Justin Ndasi, a resident of Bunia. “To survive this pandemic, we have to protect ourselves.”

The most important challenge is breaking the virus transmission chain, said virus expert Muyembe, adding that most of Congo’s previous Ebola outbreaks “were brought under control simply by implementing public health measures.”

Delayed response from false negative tests

Congo said the first person died of the virus in Bunia on April 24, but it was not confirmed for several weeks. The bodies were sent back to the Mongbavalu health area, a heavily populated mining area.

“This led to an outbreak of Ebola,” said Congolese Health Minister Samuel Roger Kamba.

When another person fell ill on April 26, samples were sent to the Congolese capital Kinshasa for testing, according to the Africa CDC. Bunia is more than 1,000 kilometers (620 mi) away, in a country with the world’s worst infrastructure.

Congolese officials said samples from Bunya were initially tested for the more common strain of Ebola, known as Zaire. They came back negative, said Dr. Richard Kitenge, the health ministry’s incident manager for Ebola.

On 5 May, WHO was alerted to approximately 50 deaths in Mongbavalu, including four health workers. Ebola was first confirmed on 14 May.

“Our surveillance system did not work,” Muyembe said. “The Bunia laboratory … should have continued the search and sent the samples to the national laboratory. Something went wrong there. That’s why we ended up in this dire situation.”

Only laboratories in Kinshasa and Goma, now controlled by the Rwandan-backed M23 rebel group, have the capacity to test for the Bundibugyo variant of Ebola.

M23 permanent secretary Benjamin Mbonimpa said the rebel government had set up entry and exit points in Goma and would take responsibility for funeral services if the virus spread.

“Our priority is to protect the population within our jurisdiction and we urge people to resume their daily activities,” he said.

Matthew M. Kavanaugh, director of the Georgetown University Center for Global Health Policy and Politics, has criticized the Trump administration’s earlier decision to withdraw from the WHO and drastically cut foreign aid – saying “accurate surveillance systems were meant to catch these viruses early.”

The US State Department said it has provided $13 million for the response.

Dr. Enshia of WHO in Bunya said the funding cuts “have had a devastating impact on humanitarian workers.”

At the ground level, the response is complicated by a lack of resources.

Trish Newport, emergency program manager for the Doctors Without Borders aid group, said her team in Bunia identified suspected cases over the weekend at Salama hospital, which has no isolation ward. They tried unsuccessfully to place him in another health facility in Bunia.

“The team called other health facilities to see if they had isolation,” he said. “At every health facility they said, ‘We are filled with suspected cases. We have no room.’ “It shows you how crazy it is right now.”