Reacción a "The WHO has declared the Ebola outbreak in the Democratic Republic of the Congo and Uganda a public health emergency of international concern"

How concerning is this development?

“This is a concerning outbreak for several reasons. First, the number of suspected cases reported before confirmation suggests transmission may have been ongoing for several weeks before the outbreak was formally recognised. Second, the outbreak is occurring in a region affected by insecurity, population displacement, and high population mobility, all of which can complicate surveillance, contact tracing, and delivery of healthcare.

“A previous Ebola outbreak affecting North Kivu and Ituri provinces between 2018 and 2020 lasted for nearly two years, with insecurity and community mistrust repeatedly disrupting contact tracing, vaccination, and response activities.

“In addition, the outbreak is now thought to becaused by Bundibugyo virus, a rare Ebola-causing virus for which there are currently no licensed vaccines or therapeutics specifically approved. There are also no vaccines in late-stage clinical development that could be readily deployed during the outbreak.

“However, it is important to emphasise that DRC has extensive experience responding to Ebola outbreaks, and outbreak response capacity is significantly stronger today than it was a decade ago.

What is a Public Health Emergency of International Concern (PHEIC)? How does this change our understanding of the situation or the public health response?

“A Public Health Emergency of International Concern, or PHEIC, is the highest level of international public health alert that WHO can declare under the International Health Regulations.

“A PHEIC does not mean the outbreak has become a global pandemic. Rather, it reflects that the event is considered serious enough to require coordinated international action, enhanced surveillance, resource mobilisation, and cross-border collaboration.

“In practical terms, the declaration helps mobilise international attention, funding, technical support, and coordination between countries and public health agencies.

How concerning is this? When was the last time a PHEIC was declared for Ebola?

“WHO previously declared a PHEIC during the large Ebola outbreak in North Kivu and Ituri provinces in DRC between 2018 and 2020, and before that during the 2014–2016 West Africa Ebola epidemic.

“The current declaration reflects concern about the operational complexity of the outbreak, including insecurity, population movement, delayed detection, and the involvement of Bundibugyo virus disease, for which there are currently no licensed vaccines or therapeutics and no vaccines in advanced clinical development that could be readily deployed during the outbreak.

The WHO say it does not meet the criteria of a pandemic emergency. What is the difference between a PHEIC and a pandemic emergency?

“A PHEIC is a formal legal mechanism under the International Health Regulations designed to trigger international coordination and support for serious public health events.

“A pandemic refers to sustained global spread of a disease across multiple countries or continents.

“Ebola outbreaks can be extremely serious and devastating locally and regionally, but Ebola does not spread in the same way as respiratory viruses such as influenza or COVID-19 and is generally much less transmissible. Transmission usually requires direct contact with bodily fluids or contaminated materials from an infected person, which makes sustained global spread much less likely. 

Do we know any more about the strain causing this outbreak and does that affect the response?

“Current evidence suggests the outbreak is caused by Bundibugyo ebolavirus (BDBV), a rare Ebola-causing virus previously identified in only two documented outbreaks, in Uganda in 2007 and DRC in 2012.

“This is important because currently licensed vaccines and therapeutics developed for Ebola virus (formerly Zaire ebolavirus) are not expected to provide protection against Bundibugyo virus disease.

“As a result, response efforts rely heavily on classical public health measures such as rapid case detection, isolation, contact tracing, infection prevention and control, safe burials, and community engagement. These measures were critical in eventually controlling the 2014–2016 West Africa Ebola epidemic, the largest Ebola outbreak ever recorded, and if implemented rapidly and effectively they can also help control this outbreak.

Any other comments?

“This outbreak highlights both the progress and the remaining gaps in global epidemic preparedness. Considerable advances have been made in Ebola surveillance, diagnostics, outbreak response systems, vaccines, and therapeutics over the past decade. However, preparedness remains uneven across different filoviruses, particularly for rarer Ebola-causing viruses such as Bundibugyo ebolavirus.

“It also highlights how insecurity, displacement, and fragile health systems can continue to complicate outbreak response efforts, even when scientific tools and public health expertise are available.