Congo Ebola outbreak spreads to city of 1 million

Congo's latest Ebola outbreak has spread to a city of more than one million people, a worrying shift as the deadly virus risks travelling more easily in densely populated areas.

Two suspected cases of hemorrhagic fever were reported in the Wangata health zones that include Mbandaka, the capital of northwestern Equateur province. The city is about 150 kilometres from Bikoro, the rural area where the outbreak was announced last week, said Congo's Health Minister Oly Ilunga.

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"We are entering a new phase of the Ebola outbreak that is now affecting three health zones, including an urban health zone," Ilunga said, adding he was worried because Mbandaka is densely populated and at the crossroads of Equateur province.

The city of almost 1.2 million is on the Congo River, a crucial travel corridor in the vast country and upstream from the capital, Kinshasa, a city of about 10 million.

"Since the announcement of the alert in Mbandaka, our epidemiologists are working in the field with community relays to identify people who have been in contact with suspected cases," Ilunga said. WHO said it was deploying about 30 experts to conduct surveillance in the city.

Those exposed to the suspected Ebola cases will for the first time in Congo receive Ebola vaccinations, the health minister said.

He said health experts already were tracing 500 contacts.

A ministry statement late Thursday said that the total number of Ebola cases is now 45, including 10 suspected, 21 probable and 14 confirmed. It said there has been one new death in Bikoro, where the Ebola outbreak was announced last week and where the first death took place. That new death had epidemiological ties to another case. The other death was a suspected case in Wangata.

It said of the now 25 dead, only one death has been confirmed as Ebola. The ministry says no new health professionals have been contaminated.

One nurse had died, and three others were among suspected cases since the outbreak began.

WHO has sent 4,000 doses of the experimental Ebola vaccine to Congo and said it will send thousands more in the coming days as needed. The vaccine was partially designed by the Canadian government and developed by Merck. 

'Concerning development,' WHO head says

"This is a concerning development but we now have better tools than ever before to combat Ebola," Tedros Adhanom Ghebreyesus, WHO director general, said of the new urban case.

The experimental vaccine has been shown to be highly effective against Ebola. It was tested in Guinea during the outbreak that killed more than 11,300 people in West Africa from 2014 to 2016. The vaccine is thought to be effective against the Zaire strain of Ebola found in Congo.

WHO has said it will use the "ring vaccination" method. It involves vaccinating contacts of cases and suspected cases, contacts of those contacts and health care and other front-line workers.

WHO will convene an emergency committee meeting on Friday to consider the international risks of an Ebola outbreak in Congo, WHO spokesperson Christian Lindmeier said on Thursday.
 
The expert committee will decide whether to declare a "public health emergency of international concern," which would trigger more international involvement, mobilizing research and resources, Lindmeier said.
 
Emergency Committees have been set up to advise on past outbreaks such as the 2016 Zika epidemic in Latin America and the huge West African Ebola outbreak that killed at least 11,300 people in Guinea, Sierra Leone and Liberia from 2014 to 2016.

This is the ninth Ebola outbreak in Congo since 1976, when the deadly disease was first identified.

There is no specific treatment for Ebola, which is spread through the bodily fluids of people exhibiting symptoms or those who have died from the disease. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding.

 Without preventive measures, the virus can spread quickly and is fatal in up to 90 per cent of cases.