Health officials reported more than 130 suspected deaths and 540 cases in the Democratic Republic of Congo and Uganda, but experts say the figures could be much higher.
The number of people infected by Ebola in central Africa could be much higher than reported and the outbreak could last for months, global health officials warned on Tuesday.
The suspected death toll stood Tuesday at more than 130 people.
The outbreak is centered in the east of the Democratic Republic of Congo, where people, including migrant laborers working in gold mines, move across borders. The area is also in the grip of a conflict that has displaced more than a million people, gutted health clinics and slowed the public health response, officials said.
“The last outbreak in this area took two years,” to contain, Dr. Anne Ancia, a representative for the World Health Organization in Congo, said in a phone interview from Bunia, the capital of Ituri Province, where the first cases were identified.
“We hope it won’t be that long, but I’m foreseeing several months,” she said.
Dr. Ancia’s comments followed a news conference by Congo’s health minister, Dr. Samuel-Roger Kamba, at which he reported more than 135 suspected deaths and more than 540 suspected cases linked to the virus. Those numbers, he said, have been rising as health teams go into communities, inquire about the circumstances of recent deaths and illnesses, and trace contacts.
Tedros Adhanom Ghebreyesus, the director-general of the W.H.O., said at a meeting of the organization in Geneva that he was “deeply concerned” about the scale and speed of the outbreak.
Where Ebola outbreak was first identified
300 mi.500 km.
Democratic Republic of the Congo
Source: World Health Organization.Samuel Granados/The New York Times
Laboratory testing has confirmed 32 cases so far, according to Dr. Kamba. Experts have expressed alarm that the virus, a relatively rare species called Bundibugyo, appears to have been spreading unchecked for several weeks in an area where contact tracing is likely to be very difficult.
Dr. Kamba said that awareness of the virus had been delayed by a misunderstanding. Some people, he said, initially did not take protective precautions when burying the dead, allowing the virus to spread. The initial hesitation over reporting cases has abated since this weekend’s official declaration of a virus outbreak, he said.
Dr. Kamba emphasized that the country had been able to contain 15 previous outbreaks of Ebola without vaccines or treatments, suggesting that public health measures could suffice to contain this latest one.
At the same time, he said, the outbreak is a matter of international concern. “The virus knows no border and knows no race and knows no tribe,” he said.
A model of the outbreak published on Monday by the MRC Centre for Global Infectious Disease Analysis, at Imperial College in London, found that the current number of cases could be well over 1,000.
“Our analyses suggest that the true number of cases may be substantially higher than those confirmed to date,” said Dr. Anne Cori, an associate professor in infectious disease modeling.
Dr. Ancia said that W.H.O. officials had been in Bunia since Sunday and that while medical equipment, disinfectant and protective gear had arrived, it was not enough. “We need more people, more hands on the ground,” she said.
Moving equipment to the region became more difficult after rebels took over the city of Goma, home to the region’s main airport, she said.
Dr. Tedros said the deaths of health care workers and the absence of vaccines or therapeutics to treat the Bundibugyo species raised fears that the outbreak would spread further. Cases have already been reported in urban areas, including in Kampala, the capital of Uganda, and in Goma.
The W.H.O. supplies that were flown in since Sunday included diagnostic kits capable of identifying the Bundibugyo species, Dr. Ancia told reporters at a briefing on Tuesday. Additional laboratory equipment is expected this week, she said.
Health officials have not yet identified a so-called patient zero marking the start of the outbreak, she said.
A technical advisory group met in Geneva on Tuesday to weigh which vaccines would be prioritized for clinical trials. But experts say that relying on a potential vaccine will not be enough and that containment measures are key.
“At this point, it’s really a race against time,” said Alessandro Vespignani of the Center for Advanced Epidemic Analytics and Predictive Modeling Technology in the United States, known as EPISTORM. “Every day is important.”
There is not yet enough data to assess the outbreak’s spread, Dr. Vespignani said. “This a stage of fog of war,” he said. “In a few days we’ll hopefully understand better.”
A U.S. Centers for Disease Control and Prevention order issued on Monday allows the United States to bar foreigners from entering the country if they have been in the Democratic Republic of Congo, Uganda or South Sudan in the previous 21 days. On Tuesday, the State Department said it “strongly urges” Americans not to travel to those countries, and to reconsider travel to Rwanda.
President Félix Tshisekedi of Congo urged citizens to remain calm and to follow containment measures to curb the spread of the disease. But several countries in the region, including neighboring Rwanda, have started screening travelers or tightening border controls.
The Africa Centers for Disease Control and Prevention on Tuesday criticized the “use of broad travel restrictions as a primary public health tool.”
“Global health security cannot succeed if countries are penalized for transparency during outbreaks,” Dr. Jean Kaseya, the head of the organization, said on social media.
One of those infected in the outbreak is Dr. Peter Stafford, an American medical missionary who was exposed to the virus while working at a hospital in Ituri Province. He was evacuated for specialized treatment, Serge, an international Christian mission organization where he works, said on Tuesday.
A spokeswoman for German federal health authorities said on Tuesday that Germany was preparing to receive and treat “a U.S. citizen who contracted Ebola in the Congo” after the United States requested assistance, but she did not provide more details.
Two other physicians working in the Democratic Republic of Congo with the same organization as Dr. Stafford — his wife, Dr. Rebekah Stafford, and Dr. Patrick LaRochelle — may have been exposed to the virus. All three doctors have been quarantining.
Peter LaRochelle, Dr. LaRochelle’s father, said in a phone interview on Tuesday that he had spoken with his son that morning and that he, along with Dr. Stafford’s wife and four children, were asymptomatic.
Still, the father said: “We are losing sleep.
Source: The New York Times
