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GENEVA – World health officials on Wednesday expressed deep concern at the spread of the Ebola virus in the Democratic Republic of the Congo, but concluded that it was not yet qualified as an emergency. international health emergency.
At least 139 people died in the epidemic centered on North Kivu province, bordering Uganda and Rwanda. The fight against infectious and deadly disease in the region is complicated by sporadic fighting between government forces and armed militias and attacks on medical personnel.
Last month, the World Health Organization announced that the risk of spreading Congo's disease to its neighbors had risen from high to very high. He mentioned the deterioration of security and indicated that nine countries were at risk of infection.
But the expert advisory panel convened on Wednesday agreed that this "is not an epidemic of global significance," committee chair Robert Steffen told reporters in Geneva.
Despite the threat of spreading the disease at the regional level, no cases of infection have yet been exported to Congo's neighbors, he said, and international support for the fight against the epidemic is in place.
"We are optimistic that this epidemic will be contained within a reasonable time," he said.
Declaring a public health emergency of international concern has drawbacks, experts said.
"It's a pretty crude tool, like an on / off switch," said Martin S. Cetron, Director of Global Migration and Quarantine for Centers for Disease Control and Prevention and a member of the W.H.O. committee of urgency. "Many epidemics are more nuanced."
Some countries impose travel restrictions when emergencies are formally declared. This not only removes more international trade than can be justified by an outbreak in a remote province, but can also prevent the affected country from getting the supplies and experts it needs to fight the epidemic.
According to other experts, a particular concern with this outbreak was that rebels in North Kivu could use a declared emergency to embarrass the government by hindering efforts to end it.
This could make the situation much more dangerous at a time when the W.H.O. has already asked the United Nations Security Council to send more peacekeepers to the region.
These fears "were briefly discussed but were not taken into account in the committee's decision," said Dr. Steffen.
The committee's concerns focused instead on the large number of new cases identified with no discernible link to already infected individuals and on attacks by armed groups in the region, which hinder the research and treatment work of the group. infection, said Dr. Steffen. who is a specialist in travel medicine at the University of Zurich.
Congo has long experience of the Ebola outbreak, having treated 10 epidemics since the discovery of the disease in 1976. This is particularly the case this year in the remote province of Ecuador. It resulted in 33 deaths but was under control in three months thanks to rapid international action, including the first use of a new vaccine against the Ebola virus.
Health authorities have also rolled out the drug to fight the epidemic in North Kivu, vaccinating more than 18,000 people since the month of August. This has helped slow the spread of the disease, said Tedros Adhanom Ghebreyesus, director general of the World Health Organization.
"We are better in terms of weapons this time around," he said.
To contain this epidemic, W.H.O. plans to change vaccination strategy. It now immunizes health workers and "vaccinates all contacts" of all known cases, but it could try to vaccinate everyone in the affected areas, said Dr. Peter Salama, head of emergency response for the WHO
But this would involve building a much larger stock of vaccines and the freezers needed to store it.
On Monday, Congolese health authorities had reported 216 cases since the beginning of the epidemic in August, an increase of 35 cases in eight days. Most of the new cases were in the vicinity of Beni, a town in northeastern Congo where active conflict between government forces and armed militia is taking place. The committee noted eight major security incidents in the past eight weeks.
Sporadic shots have blocked access to affected areas for days, making it difficult for health officials to track anyone who has been in contact with people infected with the disease – an essential part of preventing the spread of the disease, health officials said.
Community resistance to the burial teams of international organizations that interfere with traditional burial customs, which have delayed efforts to combat the Ebola epidemic in Africa. West in 2014, it also proved to be an obstacle to the response in North Kivu.
Health teams attempting to bury their victims safely were hit by stones last month. Three Red Cross workers were injured this month, two of them seriously, when they were attacked by villagers as they tried to bury a woman in Butembo town. Work has been temporarily suspended in the area.
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