WHO declares Ebola outbreak public health emergency of international concern

WHO Director-General Margaret Chan, MD, declared the ongoing Ebola outbreak in West Africa a public health emergency of international concern, according to a press release.

The decision was based on the advice of the WHO emergency committee, which was convened for the first time on Wednesday under the International Health Regulations. Members of the emergency committee, along with health officials from affected countries, discussed the worsening outbreak and recommended strategies to control further spread of the disease. The outbreak began in Guinea in December 2013 and has since spread to Liberia, Nigeria and Sierra Leone. With 1,711 cases and 932 deaths, it is the largest Ebola outbreak recorded.

After deliberating for 2 consecutive days, the committee advised that the Ebola outbreak is an “extraordinary event” and poses health risks to other countries. The threat of international spread is serious given the virulence of the virus and its transmission patterns in the community and health care facilities. A coordinated international response is critical to stopping and reversing the spread of Ebola, they said.

Margaret Chan

However, the committee noted that the affected countries’ weak health systems and their lack of financial and material resources were inhibitive to mounting an adequate response to the outbreak. In some communities, health officials are inexperienced in dealing with the disease and misperceptions of how it is transmitted are common, they said. The committee also noted that the affected populations are highly mobile and there have been several instances of infected travelers crossing borders. Additionally, a high number of infections have been identified in health care workers, suggesting weak infection prevention and control practices in medical facilities.

The committee made several recommendations to countries with Ebola transmission, including:

Heads of state should declare a national emergency, address the public about the situation and access emergency funds for outbreak response operations;
Monitor Ebola control measures, which must include infection prevention and control, community awareness, surveillance, accurate laboratory diagnostics, contact tracing and case management;
Engage community through local and religious leaders to assist in identifying cases of Ebola, contact tracing and education about the risks of acquiring the disease;
Establish a steady supply chain for medical provisions, particularly protective equipment, for those who need them;
Educate health care workers about Ebola virus and infection prevention and control measures;
Conduct exit screening of all individuals at international airports, seaports and major land crossings to identify cases;
Prohibit international travel of Ebola cases and contacts;
Postpone any mass gatherings until transmission is interrupted.

WHO recommends that unaffected states with land borders adjoining states with Ebola transmission should establish surveillance for clusters of unexplained fever or deaths due to febrile illness. They added that all states should be prepared to detect and manage cases of infection with Ebola virus.

Recently, the CDC issued a Level 3 travel warning to avoid nonessential travel to countries affected by the outbreak.

The emergency committee will reconvene in 3 months to reassess the situation and advise the director-general.