WHO declares Ebola emergency as rare strain spreads through central African cities

WASHINGTON, D.C. - The World Health Organization is warning that Ebola is spreading rapidly in the Democratic Republic of Congo — and that this outbreak is unlike ones the world has seen before.

More than 80 cases have been confirmed, but the number of suspected cases has climbed to nearly 750, with close to 180 suspected deaths. It marks only the third time in history the WHO has declared a public health emergency of international concern involving Ebola. The first was the 2014-2016 outbreak in West Africa. The second was in the DRC in 2019.

This one is different in ways that concern experts.

"This is an unusual strain," said Dr. Tyler Evans, a physician who worked on both prior outbreaks — first with Partners in Health in West Africa and later in the DRC. "We don't have the point-of-care tests to detect it. We don't have the therapeutics or vaccinations to really isolate spread."

The strain circulating now is not the Zaire or Sudan strains that drove previous outbreaks, making existing tools less effective. Ebola's case fatality rate typically ranges from 10% to 50%. For this strain, known as Bundibugyo, Evans said the rate is running between 25% and 50%.

Perhaps most alarming to health officials is where the virus has taken hold. It has now reached three major cities — Goma and Kinshasa in the DRC, and Kampala, Uganda.

"Getting into urban centers is really not great," Evans said. "This has not really happened before."

The outbreak is unfolding against a difficult backdrop. The DRC has been mired in conflict since the 1994 Rwandan genocide, with multiple armed groups still active in the region. Evans, who wrote about the connection between conflict and disease in his book "Pandemics, Poverty, and Politics," said instability creates ideal conditions for outbreaks to escalate.

Complicating the global response, Evans noted, is the rollback of U.S. funding for international health infrastructure, including cuts to USAID and CDC global surveillance programs. "The WHO is basically a mothership — coordination is its main strength," he said. "Without U.S. involvement, there have been a lot of challenges."

The U.S. State Department said it is funding up to 50 treatment clinics in Uganda and the DRC. The United Nations and World Bank are also contributing resources. Evans said it is too early to know whether that will be enough, adding that money alone won't solve the problem. "What we really need to focus on is improving our infrastructure of surveillance and response," he said.

For Americans, Evans said the immediate risk remains low. One American — a general surgeon — is known to have been infected, and those in his close contact are currently under quarantine. The U.S. National Quarantine Center in Nebraska is currently occupied due to a separate hantavirus situation, but Evans said quarantine units can be established elsewhere if needed.

"For the American viewers right now, I wouldn't provoke too much alarm," Evans said. "I think we are taking care of this pretty responsibly right now."