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‘Explosive increase’ in Ebola cases is feared as outbreak in Congo spreads to a CITY and UN considers whether to declare a ‘health emergency of international concern’

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Experts fear an ‘explosive increase’ in Ebola cases after an outbreak in Congo entered a ‘new phase’ and spread to a city.

The deadly virus was detected in the northwest city of Mbandaka, with a population of about 1 million people, the country’s health minister revealed last night.

So far, the 23 deaths believed to have been caused by Democratic Republic of Congo’s latest Ebola outbreak were in more isolated areas, giving authorities a better chance of ring-fencing the virus.

The first urban case to be announced threatens to change that. The World Health Organisation, which on Wednesday deployed the first experimental vaccines in the vast central African country, will decide tomorrow whether to declare a ‘public health emergency of international concern’.

Such a declaration by the Emergency Committee would trigger more international involvement, mobilising research and resources, WHO spokesman Christian Lindmeier said. 

Experts fear an 'explosive increase' in Ebola cases after an outbreak in Congo entered a 'new phase' and spread to a city. Health workers are pictured pulling on protective clothing as they prepare to visit patients

Experts fear an ‘explosive increase’ in Ebola cases after an outbreak in Congo entered a ‘new phase’ and spread to a city. Health workers are pictured pulling on protective clothing as they prepare to visit patients

So far, the 23 deaths believed to have been caused by Democratic Republic of Congo's latest Ebola outbreak were in more isolated areas, giving authorities a better chance of ring-fencing the virus. Pictured: Liberian medics carry a dead body after an Ebola outbreak in 2014

So far, the 23 deaths believed to have been caused by Democratic Republic of Congo’s latest Ebola outbreak were in more isolated areas, giving authorities a better chance of ring-fencing the virus. Pictured: Liberian medics carry a dead body after an Ebola outbreak in 2014

Senior WHO official Peter Salama warned of an ‘explosive increase’ in cases calling the spread to a city ‘a major development in the outbreak.’ 

Adding to concerns is the city’s location on the banks of the Congo River, a major thoroughfare for trade and transport into the capital, Kinshasa. The Congo Republic is on the other side of the river.

‘We are entering a new phase of the Ebola outbreak that is now affecting three health zones, including an urban health zone,’ Health Minister Oly Ilunga Kalenga said in a statement. 

‘Since the announcement of the alert in Mbandaka, our epidemiologists are working in the field to identify people who have been in contact with suspected cases.’

He said authorities would intensify population tracing at all air, river and road routes out of the city.

It is the ninth time Ebola has been recorded in Congo since the disease made its first known appearance near its northern Ebola river in the 1970s.

Ebola is most feared for the internal and external bleeding it can cause in victims owing to damage done to blood vessels.

Before Wednesday’s announcement, there had been only two cases of the virus confirmed by lab tests.

The first batch of over 4,000 Ebola vaccines was sent by the WHO to Kinshasa on Wednesday. The Health Ministry said vaccinations would start by early next week, the first time the vaccine would come into use since it was developed two years ago.

WHAT IS EBOLA AND HOW DEADLY IS IT?

Ebola, a haemorrhagic fever, killed at least 11,000 across the world after it decimated West Africa and spread rapidly over the space of two years.

That pandemic was officially declared over back in January 2016, when Liberia was announced to be Ebola-free by the WHO.

The country, rocked by back-to-back civil wars that ended in 2003, was hit the hardest by the fever, with 40 per cent of the deaths having occurred there.

Sierra Leone reported the highest number of Ebola cases, with nearly of all those infected having been residents of the nation.

WHERE DID IT BEGIN? 

An analysis, published in the New England Journal of Medicine, found the outbreak began in Guinea – which neighbours Liberia and Sierra Leone.

A team of international researchers were able to trace the pandemic back to a two-year-old boy in Meliandou – about 400 miles (650km) from the capital, Conakry.

Emile Ouamouno, known more commonly as Patient Zero, may have contracted the deadly virus by playing with bats in a hollow tree, a study suggested.

HOW MANY PEOPLE WERE STRUCK DOWN? 

WHICH COUNTRIES WERE STRUCK DOWN BY EBOLA DURING THE 2014-16 PANDEMIC? (CDC figures)
COUNTRY                                               CASES DEATHSDEATH RATE (%) 
GUINEA3,8142,54466.7%
SIERRA LEONE 14,124 3,956 28.0% 
LIBERIA 10,678 4,810 45.0% 
NIGERIA 20 40.0% 
SENEGAL N/A 
SPAIN N/A 
US 25.0% 
MALI 75.0%
UK N/A
ITALY N/A 

Figures show nearly 29,000 people were infected from Ebola – meaning the virus killed around 40 per cent of those it struck.

Cases and deaths were also reported in Nigeria, Mali and the US – but on a much smaller scale, with 15 fatalities between the three nations.

Health officials in Guinea reported a mysterious bug in the south-eastern regions of the country before the WHO confirmed it was Ebola. 

Ebola was first identified by scientists in 1976, but the most recent outbreak dwarfed all other ones recorded in history, figures show.

HOW DID HUMANS CONTRACT THE VIRUS? 

Scientists believe Ebola is most often passed to humans by fruit bats, but antelope, porcupines, gorillas and chimpanzees could also be to blame.

It can be transmitted between humans through blood, secretions and other bodily fluids of people – and surfaces – that have been infected.

IS THERE A TREATMENT? 

The WHO warns that there is ‘no proven treatment’ for Ebola – but dozens of drugs and jabs are being tested in case of a similarly devastating outbreak.

Hope exists though, after an experimental vaccine, called rVSV-ZEBOV, protected nearly 6,000 people. The results were published in The Lancet journal. 

The World Health Organisation had expressed concern about the disease reaching Mbandaka, which would make the outbreak far harder to tackle. Pictured: A health worker wearing protective clothing at Bikoro Hospital - the epicentre of the latest Ebola outbreak in the Democratic Republic of Congo

The World Health Organisation had expressed concern about the disease reaching Mbandaka, which would make the outbreak far harder to tackle. Pictured: A health worker wearing protective clothing at Bikoro Hospital – the epicentre of the latest Ebola outbreak in the Democratic Republic of Congo

Congolese Health Ministry officials carry the first batch of experimental Ebola vaccines in Kinshasa, Democratic Republic of Congo

Congolese Health Ministry officials carry the first batch of experimental Ebola vaccines in Kinshasa, Democratic Republic of Congo

The vaccine, developed by Merck and Co Inc, is still not licensed but proved effective during limited trials in West Africa in the biggest-ever outbreak of Ebola, which killed 11,300 people in Guinea, Liberia and Sierra Leone from 2014 to 2016.

Before the latest confirmed case, Salama said the current number of suspected, probable or confirmed cases stood at 42, with 23 deaths attributed to the outbreak. He said another 4,000-vaccine batch was expected soon.

Health workers have recorded confirmed, probable and suspected cases of Ebola in three health zones of Congo’s Equateur province, and have identified 432 people who may have had contact with the disease, the WHO said.

How Ebola has kept coming back

Following is a recap of past epidemics of Ebola as the Democratic Republic of Congo (DRC) battles a new outbreak of the deadly tropical disease:

1976: First known outbreak

Ebola was first identified in central Africa in 1976 and named after a river in northern Democratic Republic of Congo (DRC).

It claimed 431 lives that year: 280 in the DRC (then known as Zaire) and 151 across the border in Sudan, in an area that is today part of South Sudan, according to the US Centers for Disease Control (CDC).

Three years later the virus reemerged in the same region of southern Sudan, killing 22.

1995: DRC again

In May 1995 Ebola struck again in the DRC, in the forested region of Kikwit in its southwest. It spread quickly and lethally, killing 250 people from 315 reported cases.

2000-2001: Uganda

In September 2000 the Sudan strain of Ebola fever spread for the first time to Uganda, infecting 425 people in the northern and western regions, of whom 224 died.

2001-2003: Gabon, Congo

Affected by the Zaire strain of Ebola on three occasions between 1994 and 1997 with nearly 100 people dying in total, Gabon saw a sudden rise in cases between October 2001 and May 2002.

The epidemic hit the province of Ogooue-Ivindo in the northeast, an area which had previously been infected. Fifty-three of 65 people reported to have been infected eventually died.

The virus spread to neighbouring Republic of Congo where it killed 43 in 2001 and more than 150 over 2003.

2013-2015: Biggest outbreak

The most deadly epidemic broke out in West Africa in December 2013 and lasted more than two years, killing more than 11,300 of the 29,000 recorded cases.

Around 99 percent of the victims came from three neighbouring countries. In Guinea, where the epidemic started, more than 2,500 died, while in Sierra Leone more than 3,900 perished and Liberia lost 4,800 people.

This toll, which the World Health Organization (WHO) says is an underestimate, was seven times the total number of deaths in previous epidemics since the virus was identified.

DRC: Ninth outbreak

The DRC is now facing its ninth Ebola outbreak since 1976.

The latest episode, publicly declared on May 8, has seen 44 reported cases so far with 23 deaths, according to UN figures. Its epicentre is in the Bikoro area in remote Equateur province.

On Thursday the WHO said a case had been recorded in Mbandaka, a city roughly 150 kilometres (90 miles) from Bikoro.

In 2007, the virus killed 187 people in the DRC, and 43 in 2012. 

Supplies sent to Congo included more than 300 body bags for safe burials in affected communities. The vaccine will be reserved for people suspected of coming into contact with the disease, as well as health workers.

The vaccine requires storage at a temperature between -60 and -80 degrees C, tricky in a country with unreliable electricity.

‘We are now tracing more than 4,000 contacts of patients and they have spread out all over the region of northwest Congo, so they have to be followed up and the only way to reach them is motorcycles,’ Salama said. 

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