WHO Keeps Congo Ebola Emergency Status as Outbreak Reaches 60 Zones

The World Health Organization has kept the Democratic Republic of the Congo’s Bundibugyo Ebola epidemic classified as a public health emergency of international concern as the outbreak expands and conflict, displacement and restricted humanitarian access hinder containment.

WHO published the report of its second International Health Regulations Emergency Committee review on August 28, after the committee met August 18. The WHO director-general agreed that the epidemic continues to meet the criteria for a public health emergency of international concern, or PHEIC, but not for a pandemic emergency. Temporary recommendations were issued August 24.

Outbreak reaches 60 health zones

WHO’s latest Disease Outbreak News update said the outbreak had expanded from 54 to 60 affected health zones since the agency’s previous update on August 14. Six additional zones reported cases: Ganga and Viadana in Bas-Uélé province; Biena, Manguredjipa and Mutwanga in North Kivu; and Tshopo in Tshopo province.

The affected zones are spread across six of the Democratic Republic of the Congo’s 26 provinces: Bas-Uélé, Haut-Uélé, Ituri, North Kivu, South Kivu and Tshopo.

As of August 26, WHO reported 5,794 confirmed cases, including 2,786 deaths. It reported a crude case-fatality ratio of 48.1%. The figures point to a rapidly expanding and severe outbreak, while delays in detecting cases and limited access to care make it harder to interrupt transmission.

Ituri remains the epicenter

Ituri province remains the main center of the epidemic, with 28 affected health zones and 4,802 confirmed cases as of August 26. North Kivu had 15 affected health zones and 775 confirmed cases.

WHO cautioned that the geographic picture may understate the outbreak’s true extent. Some affected areas are outside government control or difficult to reach because of insecurity, limiting surveillance and other response operations.

Conflict is obstructing containment

The epidemic is unfolding during a severe humanitarian crisis. WHO said armed conflict, insecurity, population displacement, attacks on health care, supply disruptions and restricted access are endangering residents and responders.

Those conditions make it harder to engage communities, identify cases, trace contacts, provide safe and timely care, maintain infection-prevention measures and manage deaths safely. WHO also warned that disruption of essential health services could increase preventable deaths from malaria, diarrheal diseases, maternal causes and other conditions.

The Emergency Committee called for an immediate, unified and fully resourced intensification of the response. Its priorities include community-based surveillance, faster case detection and isolation, stronger contact tracing, more treatment capacity, infection prevention in health facilities and communities, timely laboratory diagnosis and accessible clinical care.

Reported totals may not show the full scale

The committee said modelling suggested substantial under-ascertainment. At the time of its August 18 review, the true number of infections could have been three to four times higher than the reported total. That is a modelled estimate, not a confirmed case count.

WHO said the response has been outpaced by the epidemic’s growth. The committee’s assessment found that insecurity, displacement, logistical disruptions and limited resources were creating gaps in treatment, staffing, supplies and other response capabilities.

Regional concern, not a pandemic emergency

WHO assessed the risk of spread to countries sharing land borders with DRC provinces affected by transmission as significant. It identified South Sudan as facing the highest risk among those countries because of its connectivity with the DRC, while also noting the possibility of reintroduction into Uganda.

WHO said active cases were reported only in the DRC as of its August 12 assessment. It said Uganda had controlled transmission, with no new cases detected since July 16, and that an imported case in France had not caused onward transmission. The assessment did not establish sustained transmission outside the DRC.

For travelers and the general U.S. public, the findings do not by themselves indicate a broad community-transmission threat in the United States. The immediate concern is humanitarian access, regional preparedness and whether response teams can reach people in affected areas.

The next indicators will be whether more health zones report cases, whether secure access improves, whether contact tracing becomes more complete and whether neighboring countries detect additional imported or local infections.

Sources

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