Ebola risk now at highest level in DR Congo, says WHO

VIRUS “RAMPANT”

Ebola is a deadly viral disease spread through direct contact with bodily fluids. It can cause severe bleeding and organ failure.

The WHO upgraded its risk assessment level from high to very high for the DRC, while keeping the regional risk level at high and the global risk level at low.

The assessment determines the potential impact of a public health threat and the necessary response measures, with WHO advice set to follow.

“The potential of this virus spreading rapidly is very high, and that changed the whole dynamic,” said the WHO’s emergency alert and response director Abdi Rahman Mahamud.

Speaking from the field, Anne Ancia, the WHO’s representative in the DRC, said the case numbers would keep rising until all the response operations could be put in place.

The virus has been “rampant and silently disseminating for a few weeks already”, she said.

“We are sprinting behind” playing catch-up, with the spread “not yet under control”, she added.

With no treatments or vaccines available, finding contacts and isolating them for 21 days was the only way to disrupt transmission, she said.

WHO’s Africa regional director Mohamed Yakub Janabi said Ebola had had a silent early phase, when symptoms resemble malaria or typhoid, meaning transmission can remain undetected.

Ancia said rising case numbers at this stage was a “good sign” because it showed that surveillance and active discovery of cases were working.

TREATMENT TRIALS PLANNED

There have only been two previous outbreaks of Bundibugyo, in Uganda in 2007 and the DRC in 2012.

With no approved treatments or vaccines for Bundibugyo, WHO chief scientist Sylvie Briand said the UN agency was prioritising all existing tools that might be useful in combating the outbreak.

The WHO research and development branch’s technical advisory group on treatments has prioritised two monoclonal antibodies for clinical trials: Regeneron 3479 and Mapp Biopharmaceutical’s MBP134.

It also recommended evaluating the oral antiviral obeldesivir in clinical trials as post-exposure prophylaxis for people who are high-risk contacts.

Briand said it looked “promising” as something that might be able to prevent infected contacts from going on to develop disease from that infection.

As for vaccines, the Ervebo vaccine works against the Zaire strain of Ebola but there is “very little evidence of cross-protection for Bundibugyo”, said Briand.

While a Bundibugyo-specific equivalent has been worked on, even if prioritised, it could take six to nine months to develop.