Democratic Republic of Congo faces a “very high” public health risk from Ebola with the disease confirmed in a big city, the World Health Organization (WHO) said, raising its assessment from “high”.
The risk to countries in the region was now “high”, up from “moderate”, with the global risk remaining “low”, the WHO said.
The reassessment came after the first confirmed case in Mbandaka, a city of around 1.5 million in the north-west. Previous reports of the disease had all been in remote areas where Ebola might spread be more easily contained.
“The confirmed case in Mbandaka, a large urban centre located on major national and international river, road and domestic air routes, increases the risk of spread within the Democratic Republic of the Congo and to neighbouring countries,” the WHO said.
WHO Deputy Director-General for Emergency Preparedness and Response Peter Salama had told reporters the risk assessment was being reviewed.
“We’re certainly not trying to cause panic in the national or international community,” he said.
“What we’re saying is urban Ebola is a different phenomenon to rural Ebola because we know people in urban areas have far more contacts so that means urban Ebola can result in an exponential increase in cases in a way rural Ebola struggles to do.”
The WHO will convene an Emergency Committee of experts to advise on international response to the outbreak and decide whether it constitutes a “public health emergency of international concern”.
Jeremy Farrar, an infectious disease expert and director of the Wellcome Trust global health charity, said the outbreak had “all the features of something that could turn really nasty”.
“As more evidence comes in of the separation of cases in space and time and healthcare workers getting infected, and people attending funerals and then travelling quite big distances – it’s got everything we would worry about,” he told Reuters.
The WHO statement said there had been 21 suspected, 20 probable and three confirmed cases of Ebola between April 4 and May 15, a total of 44 cases, including 15 deaths. Mbandaka had three suspected cases in addition to the confirmed case.
The WHO is sending 7,540 doses of an experimental vaccine to stop the outbreak and 4,300 doses are in Kinshasa. It will be used to protect health workers and “rings” of contacts around each case.
The vaccine supplies will be enough to vaccinate 50 rings of 150 people, the WHO said. As of May 15, 527 contacts were identified, being followed up and monitored.