WHO raises DRC’s Ebola risk after confirming a case in a major city

GENEVA: Democratic Republic of Congo faces a “very high” public health risk from Ebola because the disease had been confirmed in a patient in a big city, the World Health Organisation (WHO) has warned.

The risk to countries in the region was now “high”, raised from “moderate”, but the global risk remained “low”.

The reassessment came after the first confirmed case in Mbandaka, a city of about 1.5 million on the banks of the Congo River in the north-west.

The case raised concerns that the virus, previously found in more rural areas, would be tougher to contain and could reach downstream to the capital Kinshasa, which has a population of 10 million.

It also followed the announcement by DRC’s health ministry of 11 newly confirmed cases in the smaller town of Bikoro, near the northwest village where the virus was first detected.

“The confirmed case in Mbandaka, a large urban centre located on major national and international river, road and domestic air routes, increases the risk of spread within the Democratic Republic of Congo and to neighbouring countries,” the WHO said.

Deputy director-general for emergency preparedness and response, Peter Salama, said on Thursday the risk assessment was being reviewed.

“Urban Ebola is a very dif- ferent phenomenon to rural Ebola because we know people in urban areas can have far more contacts, so urban Ebola can result in an exponential increase in cases in a way that rural Ebola struggles to do.”

The WHO yesterday convened an emergency committee of experts to advise on the international response to the outbreak and decide whether it constituted a “public health emergency of international concern”.

The nightmare scenario is an outbreak in Kinshasa, a crowded city where millions live in unsanitary slums not connected to a sewer system.

Jeremy Farrar, an infectious disease expert and director of the Wellcome Trust global health charity, said the outbreak had “all the features of something that could turn really nasty”.

“As more evidence comes in of the separation of cases in space and time, and health-care workers getting infected, and people attending funerals and then travelling quite big distances – it’s got everything we would worry about,” he said.

WHO spokesperson Tarik Jasarevic said yesterday DRC’s Ministry of Health had provided updated figures: 45 cases overall since April 4, including 14 confirmed, 10 suspected and 21 probable. There had been 25 deaths, but no new infections among health workers.

The WHO is sending 7 540 doses of an experimental vaccine to try to stop the outbreak. It will be used to protect health workers and “rings” of contacts around each case. That will be enough to vaccinate 50 rings of 150 people. Each ring represents the number of people, including health workers, who may have come into contact with an Ebola patient.

As of Tuesday, 527 contacts had been identified and were being followed up and monitored. – Reuters