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Ebola in Congo not yet a global health emergency, say health chiefs

The country has 14 confirmed cases, with dozens of others probable or suspected.

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Congo’s latest Ebola outbreak does not yet warrant being declared a global health emergency, the World Health Organisation has announced, as officials rushed to contain the virus that has spread to a city of more than a million people.

The vast, impoverished country now has 14 confirmed Ebola cases, with dozens of others probable or suspected.

WHO officials, speaking after an experts’ meeting on the outbreak, said vaccinations will begin on Sunday in a key test of an experimental vaccine.

The WHO called the risk to the public in the Democratic Republic of the Congo “very high” and the regional risk high, with the global risk low. The Republic of the Congo and Central African Republic are nearby.

Congo has contained several past Ebola outbreaks but the spread of the haemorrhagic fever to an urban area poses a major challenge.

The city of Mbandaka, which has one confirmed Ebola case, is an hour’s flight from the capital, Kinshasa, and is on the Congo River, a busy travel corridor.

For a health crisis to constitute a global health emergency it must meet three criteria stipulated by the WHO: it must threaten other countries via the international spread of disease, it must be a “serious, unusual or unexpected” situation, and it may require immediate international action for containment.

Ebola has twice made it to Congo’s capital in the past and was rapidly stopped. Congo has had the most Ebola outbreaks of any country, and Dr David Heymann, a former WHO director who has led numerous responses to Ebola, said authorities there have considerable expertise in halting it.

The Ebola vaccine proved highly effective in the West Africa outbreak a few years ago, although the vaccine was used long after the epidemic had peaked.

More than 4,000 doses have arrived in Congo this week, with more on the way. One challenge will be keeping the vaccine cold in a region with poor infrastructure and patchy electricity.

Just one Ebola death in the current outbreak has been confirmed so far. Congo’s health ministry late on Thursday said the total number of cases was 45, including 10 suspected and 21 probable ones.

The health ministry said two new deaths have been tied to the cases, including one in a suburb of Mbandaka. The other was in Bikoro, the rural area where the outbreak was announced last week, about 90 miles from Mbandaka.

“This is a major, major game-changer in the outbreak,” Dr Peter Salama, the WHO’s emergency response chief, warned on Thursday after the first urban case was announced.

“Urban Ebola can result in an exponential increase in cases in a way that rural Ebola struggles to do.”

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