The Ebola outbreak in the Democratic Republic of the Congo does not currently qualify as a public health emergency of international concern, an expert panel convened by head of the World Health Organization announced Friday.
The emergency committee, established to give the WHO advice on the outbreak response, raised concerns about the situation, particularly the discovery of at least one case in major urban center, and the proximity of the outbreak to the Congo River, a major transit route in that part of the world. The difficulty of accessing places where cases have been reported also adds to the complexity of the response, said committee chairman Robert Steffen, a professor of infectious diseases at the University of Zurich, in Switzerland.
But he noted that the quick mobilization of the response, including establishing an airbridge to ferry in responders and equipment, the arrival of a mobile laboratory at the epicenter, and speedy deployment of an experimental vaccine to the country creates the possibility the outbreak will be brought under control.
The WHO estimates the response will cost $26 million over the next three months, and to date only has commitments of about $9 million from governments and organizations such as the Wellcome Trust. But WHO Director-General Tedros Adhanom Ghebreyesus suggested the early response of partners is heartening.
“We can see also the political mobilization, to be honest. You can see a consensus saying: What happened in 2014 should not happen. That commitment will mobilize resources,” he said, referring to the slow response to the disastrous West African Ebola outbreak that infected more than 28,000 people and killed more than 11,000.
The WHO has sent more than 7,000 doses of the vaccine, being developed by Merck, to the DRC. The plan is to employ a ring vaccination approach, offering vaccine to people who have been in contact with Ebola cases. Health workers will also be offered the vaccine. The idea is to establish immunity among people who are at risk, to prevent ongoing transmission of the virus.
The vaccination program will start in Mbandaka, the provincial capital of Equateur, where the outbreak is taking place, said Dr. Peter Salama, the WHO’s deputy director-general who heads its emergency response program. Vaccination is expected to start Sunday or Monday.
The WHO is exploring whether experimental therapies might be used in the outbreak, with Salama revealing that the DRC government has been asked if it would permit emergency use of ZMapp, a treatment of monoclonal antibodies. Approval may be given, he said, but Salama cautioned that it would be difficult to use ZMapp at Bikoro, the epicenter of the outbreak, given the state of the medical infrastructure there. ZMapp must be given by infusion.
To date there are 45 cases, and 25 of those people have died. Of the total cases, 14 have been confirmed by laboratory testing, 21 are listed as probable cases and 11 are suspected. Three health care workers have been infected, and one has died.