March 25, 2019
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Ebola outbreak in Congo surpasses 1,000 cases

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Tedros Adhanom Ghebreyesus 
Tedros Adhanom Ghebreyesus
Photo of Robert Redfield 
Robert R. Redfield

The Ebola virus outbreak in the Democratic Republic of the Congo, or DRC, has topped 1,000 cases, and officials have said it will be months at least — maybe even a year — before it is brought under control.

Sixteen new confirmed cases were reported over the weekend, bringing the total number of confirmed or probable cases to 1,009, according to the DRC health ministry. There have been 629 deaths, including 564 that have been confirmed, the ministry said.

WHO Director-General Tedros Adhanom Ghebreyesus, PhD, MSc, said this month that the outbreak was “contracting,” noting that there were half as many cases per week than in January and that the virus had been contained in 11 out of 28 communities that have had cases. He said ongoing violence — including attacks on treatment facilities — threatened to reverse the gains that had been made.

Still, Tedros said he thought the outbreak could be contained in 6 months — a declaration that has been met with some disagreement.

CDC Director Robert R. Redfield, MD, said “the practical reality” is that officials need to prepare for a longer outbreak, telling the website Stat that it could take another year or more to control.

Ebola survivors 
The current Ebola virus outbreak in the Democratic Republic of the Congo is the second largest in history behind only the West African epidemic.
Source: CDC/Rebecca Hall, MPH

“I think WHO has largely done superb work on this outbreak, but I thought it made a surprising mistake recently when it declared the outbreak nearly contained and suggested it would be over in a few months — an announcement that drew a rebuke even from the CDC,” Ronald Klain, who coordinated the United States’ Ebola response for the Obama administration, told Infectious Disease News.

Tedros has asked the global community for an additional $60 million to fill a funding gap to pay for the next 6 months of the response but said he would not convene an emergency meeting to discuss declaring a Public Health Emergency of International Concern (PHEIC) to get the additional funding.

“That’s not the purpose of the emergency committee,” he said. “It’s meant to assist if the outbreak constitutes a global threat” — if it will spread to other countries.

Klain suggested that Tedros withdraw his comment about how long it would take to contain the outbreak and that he “[re-escalate] global concerns.”

“It would be too sharp a shift to declare a PHEIC at this point, but it should be on the table for reconsideration in 30 to 60 days if the situation continues,” he said.

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So far, the outbreak has been contained to the DRC, although some neighboring countries have begun vaccinating health care workers and other front-line responders against Ebola, fearing cross-border spread.

In the DRC, more than 91,000 people have received the experimental Merck Ebola vaccine, which Tedros has credited with averting “a much larger outbreak.” Patients are also being treated with novel therapeutics under a pioneering randomized control trial, although no data are available on how the treatments are working.

“We’re happy that people are surviving,” Tedros said this month. – by Gerard Gallagher

Disclosure: Klain reports no relevant financial disclosures.