WHO declares Congo's Ebola outbreak an international emergency

The World Health Organization has deemed the Ebola outbreak in Congo a public health emergency of international concern.

The viral disease has killed more than 1,650 people with about 12 new cases reported every day. The current outbreak is largely confined to Congo apart from three deaths in Uganda last month.

Health officials and responders hope declaring the global health emergency will bring more international attention and aid.

"It is time for the world to take notice and redouble our efforts. We need to work together in solidarity with the DRC [Democratic Republic of Congo] to end this outbreak and build a better health system," Dr. Tedros Adhanom Ghebreyesus, WHO director general, said in a statement Wednesday declaring the emergency. 

"Extraordinary work has been done for almost a year under the most difficult circumstances. We all owe it to these responders — coming from not just WHO, but also government, partners and communities — to shoulder more of the burden."

Ebola is highly infectious and spread through bodily fluids.

Tracking people exposed, vaccinations needed

WHO defines a global emergency as an "extraordinary event" that requires a co-ordinated international response.

"This is still a regional emergency and by no means a global threat," Robert Steffen, head of the emergency committee on Ebola in Congo, told reporters. 

The rare but severe and often fatal illness in humans is transmitted from wild animals and spreads through human-to-human contact, says WHO.

WHO says early symptoms, which can be sudden, include:

• Fever.
• Fatigue.
• Muscle pain.
• Headache.
• Sore throat.
• Vomiting.
• Diarrhea.
• Rash.

As the disease progresses, there can be symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding. Lab findings could include low white blood cell and platelet counts, and elevated liver enzymes.

This week, the first Ebola case was confirmed in Goma, a major regional crossroads of almost two million people on the border with Rwanda with an international airport. 

Several factors complicate efforts to stamp out Ebola in Congo, including:

• Cases in remote areas of the country that are hard for health-care workers to access.
• Ongoing violence.
• Distrust of health-care and international responders. For instance, about a third of deaths have happened in the community rather than at Ebola treatment centres. 

Despite the emergency declaration, WHO stressed there should be no restrictions on travel or trade, and no entry screening of passengers at ports or airports outside the immediate region. 

Dr. Oly Ilunga, Congo's minister of health, said the country accepts the decision, but hopes the it "wasn't made under pressure of certain groups that want to use this as a way to raise funds for certain humanitarian actors."

Experimental vaccine involves Canadians

Health-care workers need to be able to implement basic infection prevention and control measures, said Marixie Mercado, a spokesperson for UNICEF.

There is no licensed Ebola treatment, but early care that includes rehydration helps to improve chances of survival. Some patients in this outbreak in Congo have received experimental treatments, including one involving Canadian scientists, but their effect has not been fully studied. 

The health response includes tracking down people who may have been exposed to the virus, and vaccinating them as well as anybody they've been in close contact with in the previous three weeks.

The experimental vaccine designed by Canadian scientists and developed by Merck has been effective in its first widespread use in Congo.

Dr. Joanne Liu, international president of Doctors Without Borders, said the epidemic is not under control. She called for communities and patients to be at the centre of the response.

"A year into the epidemic, it's still not under control, and we are not where we should be," Liu said. "We cannot keep doing the same thing and expect different results."

Liu said better access to vaccination and as well greater effort to build trust within communities are needed. 

The world's most serious Ebola outbreak, in West Africa (Guinea, Sierra Leone and Liberia) in 2013-2016, killed more than 11,000 people.