Potential spread of Ebola 'warrants serious concern,' WHO chief says

KAMPALA, Uganda — The head of the World Health Organization said Tuesday the scale and speed of the deadly Ebola outbreak in the Democratic Republic of Congo and Uganda "warrants serious concern," as healthcare workers struggle to reach hundreds of thousands of people displaced by conflict in hard-to-reach in parts of the region.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus said that more than 130 deaths are thought to be linked to the outbreak, with more than 500 suspected cases.

Tedros declared the outbreak a public health emergency of international concern on Saturday, the first time a WHO chief has done so before convening an emergency committee.

In an address to members of the World Health Assembly in Geneva on Tuesday, Tedros pointed to worrying factors that he said could allow the outbreak to spread further and cause more deaths.

Cases have been reported in urban areas including Kampala, the city of Goma in the Congo and Bunia, "which is a big city," he said.

There are also signs of healthcare-associated transmission of the virus, after deaths were reported among health workers, he said.

Furthermore, Tedros said that insecurity due to conflict in the remote Congo province of Ituri – where the virus was first detected in early May – has intensified over the past two months, causing significant population movement in the area. "Over 100,000 people have been newly displaced," Tedros said, warning that the movement of people during an Ebola outbreak could "increase the risk of further spread."

Finally, Tedros noted that the epidemic is caused by the Bundibugyo strain, "a species of Ebola virus for which there are no vaccines or therapeutics."

The WHO chief's statement comes amid a U.S. deployment of a disaster assistance response team to the Congo and Uganda, according to a senior State Department official on Tuesday.

Ebola has an average fatality rate of 50%, according to the WHO. The disease is spread through direct contact with the bodily fluids of an infected person, according to the Africa Centers for Disease Control and Prevention (Africa CDC). It can also be passed through contact with contaminated materials or a person who has died from the disease.

Symptoms include fever, fatigue, muscle pain and headaches, to vomiting, diarrhea, abdominal pain and diminished kidney and liver functions, according to WHO. Some patients may have internal and external bleeding, including oozing from the gums and blood in the stool.

There are no approved treatments or vaccines specific to the Bundibugyo virus. Medical workers are trying to develop a monoclonal antibody therapy as a potential treatment, Dr. Satish Pillai, a deputy director in the Division of Preparedness and Emerging Infections at the U.S. CDC Centers for Disease Control and Prevention (CDC), said Monday without stating a timeline.

The initial round of detections was slowed down because local tests in Bunia – where the first patient thought to have caught this strain of Ebola died – showed negative results for the more common Zaire strain, according to the WHO's representative in Congo, Dr. Anne Ancia.

Genetic fingerprinting from the outbreak "is similar" to those from outbreaks in 2007 and 2012, according to the US. CDC, meaning medical workers have the diagnostic equipment to detect this strain of the Ebola virus.

War, displacement stifle relief efforts

Regional aid and health officials say years of war, crippling aid cuts and acute malnutrition in parts of the DRC have hindered response efforts as the viral flareup tore through communities in Ituri province.

One relief staffer warned that children are "most vulnerable" in the wake of the outbreak. Philippe Guiton, the national director for the global nonprofit World Vision in the DRC, said they are "already heavily affected by conflict and where humanitarian assistance remains insufficient due to lack of resources."

The East Zone Director at World Vision, David Munkley, added that "Ituri is already facing an alarming situation of acute malnutrition, which further weakens people's immune systems, combined with extremely limited access to healthcare in remote areas."

In Ituri, 11,000 South Sudan refugees need "preventive assistance," the UN's refugee agency reported Tuesday. Elsewhere, in the Democratic Republic of Congo's North Kivu province, in the rebel-held city of Goma, more than 2,000 Rwandan and Burundian refugees need sanitary supplies, the agency added.

Secretary of State Marco Rubio conceded that areas in the Congo where cases had been reported were "a little tough to get to." "It's in a rural area, so it's kind of confined in a hard-to-get-to place in a war-torn country, unfortunately," he said Tuesday in his first remarks since the outbreak began.

Others voiced concern over why authorities took so long to identify and track initial cases after a string of Ebola outbreaks in the past several years. The largest outbreak occurred in West Africa from 2014 to 2016, when 11,325 people died and more than 28,600 were infected, according to the WHO.

"I've been saying the most concerning thing to me has been how much we learned, how quickly we learned it," Dr. Craig Spencer, a doctor who survived an Ebola infection in 2014, told CNN on Monday. "There's no doubt that this is probably much worse than what we think right now. I suspect the true case total is much higher than what's being reported."

In response to the growing epidemic, the U.S. invoked a public health law on Monday to limit entry into the country from the affected region just as one US national tested positive for the strain in the DRC. The American citizen is being transported to Germany for treatment at Berlin's Charité University Hospital, the German health ministry said Tuesday.

Ugandan authorities sought to reassure visitors on Tuesday, insisting that there has been no local transmission within the country despite the two cases, which the Uganda Tourism Board said involved Congolese nationals "who entered Uganda from the DRC."

The Africa CDC criticized the U.S.' travel restrictions, saying "broad travel bans can disrupt lives and economies."

Later Tuesday, the State Department warned Americans against all travel to the DRC, South Sudan and Uganda, and to reconsider travel to Rwanda due to the outbreak in the region.

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