The United Nations health agency assessed Wednesday that there is a high risk from the Bundibugyo strain nationally and regionally, but a low risk globally.
Low pandemic risk – so far
However, the UN agency’s emergency committee believes that at this stage, it does not meet the criteria for a pandemic emergency.
To date, 51 cases have been confirmed in the Congolese provinces of Ituri and North Kivu, although the scale of the epidemic is much greater. The WHO has so far recorded nearly 600 suspected cases and 139 suspected deaths, including two cases linked to the outbreak detected in Kampala, Uganda.
Because no approved vaccine or specific treatment currently exists for this rare strain, health authorities are seeking to quickly interrupt transmission in a region marked by insecurity and population displacement.
With the support of the UN peacekeeping mission MONUSCO, the World Food Program (WFP), Médecins Sans Frontières (MSF) and other partners, experts and medical equipment have already been deployed to affected areas, while treatment centers are being set up.
Talk to PK Press ClubDr Marie Roseline Belizaire, WHO Emergencies Director for Africa, stressed the importance of a response built on community trust. “Speed of response in the early days is essential to interrupt transmission and prevent wider spread of this outbreak.“, she stressed.
Supplies intended to bolster the response to the Ebola outbreak in Ituri province arrive in the town of Bunia.
Community Centered
For the WHO, public trust is at the heart of the response. Health authorities are working particularly hard to prevent people with symptoms from being too afraid to come forward or refusing to isolate.
“Every emergency, every epidemic begins in a community and ends in a community,” recalls Dr. Bélizaire. “If we don’t have that community trust, no matter what actions we take, they won’t be accepted..”
WHO insists on a participatory approach based on lessons learned from previous epidemics in the region. “We are not going to come and dictate our science… but rather work with them“, she explains.
Lessons learned
WHO aims to bring the response to the community, learning lessons from previous outbreaks where many families were reluctant to report cases or let loved ones go to treatment centers.
Care and monitoring structures must be establish ourselves as close as possible to the affected populations ensure the care of confirmed patients, monitor suspected cases and contacts and maintain links with families.
“Families could visit their patients hospitalized in these treatment centers,” emphasizes Dr. Bélizaire.
According to her, the objective is to ensure comprehensive care including medical care, psychosocial support and the dietary needs of patientswhile also supporting families and contacts being monitored as part of the response.
Aid intended to strengthen the response against the Ebola epidemic arrives in Ituri, in the eastern Democratic Republic of Congo.
“A complex security context”
The epidemic is evolving in a region marked by insecurity, population movements and high mobility linked to mining areas.
These factors complicate early detection of cases, contact tracing and rapid implementation of control measures.
Delivering aid also represents a major logistical challenge. “We work with other partners to facilitate the transport of equipment by air“, says Dr Bélizaire. More than 11 tonnes of equipment have already been shipped to Bunia to support the response.
The WHO considers the experience acquired during the 2018-2020 Ebola epidemic in this same region, contained despite a similar security context, as a major asset. “This is not the first time (…) we already have outbreaks in this region and they have been brought under control,” recalls Dr Bélizaire.
Challenges of a rare strain, no vaccine
Unlike the Zaire strain, which is more frequent, more virulent and causes more regular epidemics, the Bundibugyo strain remains poorly known and currently has no approved vaccine or specific treatment.
“You have to find the right formula to explain to the community that the vaccine you received in 2018, 2020 only protects you against that. [Zaire] strain. And now you are no longer protected against it,” she explains.
Drawing on his extensive field experience responding to Ebola outbreaks in Africa, Dr Belizaire notes that discussions have already begun within the WHO research and development program to accelerate potential medical developments.
Research efforts had previously focused on the Zaire strain, responsible for the most frequent Ebola epidemics and for which vaccines and therapeutic tools are now available.
Self-protection
The WHO says several simple measures should be adopted at the community level to limit the risk of transmission: avoiding contact with the bodily fluids of a sick or deceased person and rigorously applying hygiene measures, including regular hand washing.
The health agency also emphasizes the importance of quickly reporting any suspected cases and immediately consulting a health center if symptoms appear suddenly, in particular “high fever, severe fatigue, muscle pain”, as well as vomiting or diarrhea.
Dr Bélizaire also emphasizes the importance of enabling health teams to carry out contact tracing in communities as soon as a suspected case is reported, as well as the need to protect health workers.
Those who are ill must also be protected from feeling stigmatized. Only trust information from health authorities, she warns, and avoid rumors “which can really complicate the response and put their lives in danger.”
