The head of the World Health Organisation (WHO) on Tuesday expressed concern at the speed and scale of the Ebola outbreak in central Africa — declared a “continental” emergency — as the number of deaths in the Democratic Republic of Congo (DRC) jumped to 131.

The toll from the Ebola outbreak in the DRC has risen to an estimated 131 deaths from 513 suspected cases, health minister Samuel Roger Kamba said. There has also been one death in neighbouring Uganda.

However, speaking to Congolese national television overnight, Kamba cautioned that the toll was an estimate and further research was needed to confirm whether all 131 suspected deaths were indeed linked to Ebola.

No vaccine or treatment exists for the Bundibugyo strain of Ebola behind the latest outbreak of the deadly disease, which has killed more than 15,000 people in Africa in the past half century.

The outbreak’s epicentre is in the northeastern Ituri province on the border with Uganda and South Sudan, whose status as a gold-mining hub leads to people regularly crisscrossing the region.

The virus has already spread into neighbouring provinces, as well as beyond DRC’s borders.

Suspected cases have been reported in the commercial hub of Butembo in neighbouring North Kivu province, some 200 kilometres away from the epidemic’s ground zero, Kamba said, without giving further details.

Another case has been recorded in Goma, a key provincial capital currently in the hands of the Rwanda-backed M23 militia.

“Unfortunately, the alert was slow to circulate within the community, because people thought it was a mystical illness, and so, as a result, the sick were not taken to the hospital,” Kamba said.

As few samples have been able to be tested in laboratories to date, the assessments are based mainly on suspected cases.

WHO Director-General Tedros Adhanom Ghebreyesus said he was “deeply concerned” by the raging Ebola outbreak.

“Early on Sunday, I declared a public health emergency of international concern over an epidemic of Ebola disease in the Democratic Republic of the Congo and Uganda,” Ghebreyesus told the World Health Assembly in Geneva.

“I did not do this lightly… I’m deeply concerned about the scale and speed of the epidemic,” he said.

‘Continental Public Health Emergency’

The Africa Centres for Disease Control and Prevention (Africa CDC) has declared the Ebola outbreak in DR Congo and Uganda a Continental Public Health Emergency, in a statement issued late on Monday.

Declaring a continental emergency empowers the Africa CDC, based in Ethiopia, to mobilise extra resources, including emergency response teams and surveillance operations.

“Africa CDC expresses deep concern about the high risk of regional spread due to intense cross-border population movements, mobility related to mining activities, insecurity in affected areas, weak infection prevention and control measures… and the proximity of affected areas to Rwanda and South Sudan,” it said.

The agency said it was working closely with WHO to strengthen coordination, as developed in response to recent mpox and cholera outbreaks.

“This outbreak is occurring in one of the continent’s most complex operational environments, marked by insecurity, population mobility, fragile health systems, and the limited availability of medical countermeasures for Bundibugyo strain Ebola virus disease,” said Africa CDC head Jean Kaseya.

Germany says to admit and treat US patient

Germany is preparing to admit and treat a US citizen who contracted Ebola in DRC, the German health ministry told AFP on Tuesday.

“US authorities have requested assistance from the German government in treating a US citizen who contracted Ebola in Congo,” a ministry spokesperson said.

“Preparations are currently underway to admit and treat the patient in Germany,” the spokesperson added, without saying where and when the patient would be treated.

“In Germany, there is a nationwide network of experts for the management and care of patients with diseases caused by highly pathogenic agents.”

The US Centres for Disease Control and Prevention said on Monday that the American had contracted the virus following exposure related “to their work” in DRC and had tested positive late on Sunday.

Vaccine options

An emergency committee, made up of international experts and led by the WHO, met on Tuesday to discuss whether there are any vaccine options to help tackle an Ebola outbreak in eastern DRC.

There are no approved vaccines or treatments for the Bundibugyo strain of Ebola, which has a fatality rate of up to 40 per cent.

However, there is a vaccine named Ervebo, manufactured by Merck, that is used for the Ebola Zaire strain but has shown evidence of providing some protection against Bundibugyo in animal studies.

The potential for testing this and other options will be on the agenda of the meeting of the WHO Technical Advisory Group, the WHO and other scientists said.

But the final decision will lie with the governments of Congo and neighbouring Uganda, where two confirmed cases have also been found. Potential treatments will also be discussed.

“When you have an outbreak with a strain that does not have countermeasures, we are going to advise on the best approach to take,” said Dr Mosoka Fallah, acting director of the science department at Africa CDC.

“We will look at what evidence we have and make a decision.”

The vaccine group Gavi holds a stockpile of Ebola vaccines. Its chief executive, Sania Nishtar, said 2,000 doses were already in Congo, if the experts decided it should be used in a trial there.

Some experts said the outbreak could still be difficult to control.

“Our concern about this outbreak is pretty high,” said Richard Hatchett, head of the Coalition for Epidemic Preparedness Innovations, which funds the development of new vaccines and is looking at potential candidates.

He said a 2018-19 outbreak in the same region of Congo, caused by Ebola Zaire, took two years to control because of the security situation there, even with a vaccine that was already approved and available for use.

“The security situation is very serious, and so testing things in clinical trials will be challenging, but will be necessary as well,” he said.