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Public mistrust after Congo election raises Ebola epidemic anxiety

FILE PHOTO: A healthcare worker sprays a room during a funeral of a person who is suspected of dying of Ebola in Beni, North Kivu Province of Democratic Republic of Congo, December 9, 2018. REUTERS/Goran Tomasevic/File Photo

By By, Kate, Kelland,, Health and and

LONDON, Jan 14 (Reuters) – Global health teams battling the world’s second largest Ebola epidemic in Democratic Republic of Congo fear an election dispute may deepen public mistrust and allow the epidemic to run out of control.

Fostering confidence in health authorities is essential when fighting a disease that can spread furiously through communities where local services are scant and patients are often scared to come forward to government or international response teams.

“When you have political instability, public health always suffers,” said Jeremy Farrar, an infectious disease expert who recently visited east Congo with a World Health Organization leadership team.

Without public trust, he said, the Congo epidemic could kill many hundreds more people.

The Dec. 30 election was supposed to mark Congo’s first uncontested democratic transfer of power after 18 years of chaotic rule by President Joseph Kabila.

But accusations of fraud and calls for a recount are threatening more volatility and violence after opposition leader Felix Tshisekedi was declared the winner.

“The worst case scenario is that political instability remains, mistrust grows … and then there’s nothing to stop the epidemic getting embedded into a big urban center and taking off as it did in West Africa,” said Farrar.

“GAINS COULD BE LOST”

Already, 385 people have been killed in the outbreak of Ebola in east Congo that began six months ago and has infected at least 630 people, according to WHO data. The death rate in this epidemic – by far the biggest Congo has seen, and the world’s second largest in history – is more than 60 percent.

Ebola spreads through contact with bodily fluids. It causes hemorrhagic fever with severe vomiting, diarrhea and bleeding. The outbreak is concentrated in North Kivu and Ituri provinces.

There are some signs case numbers in the North Kivu city of Beni may be leveling off, but WHO experts are cautious.

They say the apparent lull might be due to people getting ill but failing to seek proper diagnosis and treatment.

The West Africa Ebola outbreak Farrar referred to lasted for two years from 2014. It infected 28,000 and killed more than 11,300 people in an epidemic that devastated Sierra Leone, Liberia and Guinea and spread in sporadic cases to several other African countries as well as the United States and Europe.

The WHO says the risk of the disease spreading remains “very high” at national and regional levels and is working urgently with Congo and its neighbors – Uganda, Rwanda and South Sudan – to do everything to avoid that happening again.

WHO spokesman Tarik Jasarevic said 25 million people have already been screened for Ebola at border checks with Congo’s neighbors. Vaccination campaigns have also begun for health workers in Uganda and South Sudan.

Jasarevic also said multiple threats to response teams’ ability to find, treat and prevent cases of Ebola infection make the Congo situation particularly worrisome: “Gains could be lost if we suffer a period of prolonged insecurity,” he said.

(Reporting by Kate Kelland; Editing by Andrew Cawthorne)

As Ebola threatens mega-cities, vaccine stockpile needs grow

FILE PHOTO: Healthcare workers carry the coffin of a baby believed to have died of Ebola, in Beni, North Kivu Province of Democratic Republic of Congo, December 15, 2018. REUTERS/Goran Tomasevic/File Photo

By Kate Kelland

LONDON, Dec 20 (Reuters) – Doubts are growing about whether the world’s emergency stockpile of 300,000 Ebola vaccine doses is enough to control future epidemics as the deadly disease moves out of rural forest areas and into urban mega-cities.

Outbreak response experts at the World Health Organization (WHO) and at the vaccines alliance GAVI are already talking to the leading Ebola vaccine manufacturer, Merck, to reassess just how much larger global stocks need to be.

“We’re actively engaged with the World Health Organization and with groups like GAVI, the U.S. government and others to try to understand what will be an appropriate sized stockpile in the future,” Merck’s head of vaccines clinical research, Beth-Ann Coller, said in a telephone interview.

Supply of the Merck shot, which is currently being used to fight a large and spreading outbreak of Ebola in the eastern Democratic Republic of Congo, is not a problem right now, according to the WHO’s deputy director-general of emergency preparedness and response, Peter Salama.

But the nature of Ebola outbreaks is changing, he told Reuters. As the virus finds its way out of rural villages into populous urban settings, plans for how to contain it in future must change too.

“What I’m concerned about is the medium- to long-term stockpile. The figure of 300,000 was very much based on previous Ebola outbreaks where you never really had huge numbers of cases because they were in isolated, rural, populations. But now, we increasingly see Ebola in mega-cities and towns.”

“We need to view it now as an urban disease as well as a rural one – and therefore one requiring a different order of magnitude of preparations, including vaccines,” he said.

Merck’s experimental Ebola vaccine, known as rVSV-ZEBOV, is the furthest ahead in development. Another potential vaccine being developed by Johnson & Johnson could also eventually become part of the stockpile, global health officials say.

Congo’s two Ebola outbreaks this year illustrate the shifting nature of the threat.

The first was relatively contained, infecting up to 54 people and killing 33 of them in an area of DRC’s Equateur Province that is remote and sparsely populated.

Several of the eight outbreaks before this one in Congo – including one in 2014 and another in 2017 both also in Equateur – were also quickly contained and limited in size.

But this year’s second outbreak in Congo – and the country’s tenth since the virus was first identified there in 1976 – is concentrated not in rural villages but in urban areas of the North Kivu and Ituri provinces.

It has already infected more than 450 people, killed more than 270, and last month spread to Butembo, a densely populated city of about one million.

This kind of prospect means global health emergency responders must “review our assumptions around Ebola”, Salama said. “If it were to take off in Butembo, or Goma, or, even worse, Kinshasa, we’d be talking about a totally different issue in terms of … vaccine supplies required.”

Seth Berkley, chief executive of the GAVI vaccines alliance which has an agreement with Merck to ensure a current stockpile of 300,000 rVSV-ZEBOV doses, told Reuters that around 40,000 doses had been used so far in the Congo outbreak.

The emergency response is based on “ring vaccination” which aims to control an outbreak by identifying and offering the vaccine to contacts of anyone likely to be infected. This method uses relatively small numbers of vaccine doses and forms a human buffer of immunity to try to prevent spread of the disease.

For now, in Congo, Berkley said, there is no immediate need to boost the stockpile. But looking towards future inevitable outbreaks, the numbers would likely need to change.

“The challenge we would have – and this has been under discussion – is if we started to do community-based vaccination in urban and semi-urban areas. That’s when the numbers would start to get quite big quite quickly,” he told Reuters.

Merck’s shot has proven safe and effective in trials in West Africa but has yet to be approved for a license by U.S. and European regulators, so is being used in the Congo outbreak under special emergency rules for experimental products.

When it gets approval, which Coller hopes would be in 2019, it will be made at a newly built manufacturing plant in Germany.

Coller said Merck is not yet clear how many doses a year, or a month, the German facility could churn out once it is in production, but she stressed the company would “work collaboratively with the public health agencies to do our best to support their needs”.

(Reporting by Kate Kelland; Editing by Giles Elgood)

Ten die of MERS in Saudi Arabia among 32 cases in last three months: WHO

The headquarters of the World Health Organization are pictured in Geneva

By Kate Kelland

LONDON (Reuters) – Ten people have died among 32 infected with Middle East Respiratory Syndrome (MERS) in Saudi Arabia since June in a series of clusters of the viral disease, the World Health Organization (WHO) said on Wednesday.

The latest cases, recorded between June 1 and September 16, bring the global total of laboratory-confirmed MERS cases to 2,254, with 800 deaths, the United Nations agency said in a “disease outbreak” statement on its website.

MERS first emerged in humans in Saudi Arabia in 2012 and has since spread to cause outbreaks in dozens of countries around the world. The vast majority of the cases – around 1,800 of them – have been in Saudi Arabia.

The virus MERS can cause severe respiratory disease in people and kills one in three of those it infects. It is thought to be carried by camels and comes from the same family as the coronavirus that caused China’s deadly Severe Acute Respiratory Syndrome (SARS) outbreak in 2003.

Most of the known human-to-human transmission of the disease has occurred in healthcare settings, and the WHO has warned hospitals and medical workers to take stringent precautions to stop the disease from spreading.

The WHO said these latest cases did not change its overall assessment that the virus poses a risk of spreading both within and beyond the Middle East.

“WHO expects that additional cases … will be reported from the Middle East, and that cases will continue to be exported to other countries,” its statement said.

The disease spread into South Korea in 2015 and killed 38 people in a major outbreak. And in its first case in three years, South Korea said last month that a 61-year-old man had been diagnosed with MERS.

Among the 32 latest Saudi cases, 12 were part of “five distinct clusters”, the WHO said. Four of these were within households or families, and the fifth was in a hospital in Buraidah, a city in Qassim Province north of the capital Riyadh.

(Reporting by Kate Kelland, Editing by William Maclean)

WHO extremely concerned about Ebola ‘perfect storm’ in Congo

FILE PHOTO: A medical worker wears a protective suit as he prepares to administer Ebola patient care at The Alliance for International Medical Action (ALIMA) treatment center in Beni, North Kivu province of the Democratic Republic of Congo September 6, 2018. REUTERS/Fiston Mahamba/File Photo

By Tom Miles

GENEVA (Reuters) – The World Health Organization (WHO) said on Tuesday an Ebola outbreak in northeastern Democratic Republic of Congo could worsen rapidly because of attacks by armed groups, community resistance and the geographic spread of the disease.

At least 100 people have died in the outbreak, out of 150 cases in North Kivu and Ituri provinces.

“We are now extremely concerned that several factors may be coming together over the next weeks and months to create a potential perfect storm,” the WHO’s head of emergency response, Peter Salama, told a news conference in Geneva.

The response is at a critical juncture and, although the weekly number of new cases has fallen from about 40 to about 10 in the past few weeks and more than 11,700 people have been vaccinated, major obstacles remain ahead, Salama said.

Attacks by armed opposition groups have increased in severity and frequency, especially those attributed to the Alliance of Democratic Forces, most dramatically an attack that killed 21 in the city of Beni, where WHO’s operation is based.

The city has declared a “ville morte”, a period of mourning until at least Friday, obliging WHO to suspend its operations.

Overnight on Monday, unidentified assailants entered the town of Oïcha, about 20 km (12 miles) north of Beni, burned houses, killed one man and kidnapped 14 children and one woman, according to two local officials. Oicha has two confirmed cases of the virus and one probable case.

On Monday 80 percent of Ebola contacts — people at risk of developing the disease and so requiring monitoring — and three suspected cases in and around Beni could not be reached for disease monitoring.

EXPLOITATION

Pockets of “reluctance, refusal, and resistance” to accept Ebola vaccination were generating many of the new cases, Salama said.

“We also see a very concerning trend. That resistance, driven by quite natural fear of this terrifying disease, is starting to be exploited by local politicians, and we’re very concerned in the run-up to elections, projected for December, that exploitation… will gather momentum and make it very difficult to root out the last cases of Ebola.”

Some people were fleeing into the forest to escape Ebola follow-up treatment and checks, sometimes moving hundreds of kilometers, he said.

There was one such case to the south of Beni, and another to the north, close to the riverbanks of Lake Albert. Both were inaccessible for security reasons.

Neighboring Uganda was now facing an “imminent threat”, and social media posts were conflating Ebola with criticism of the DRC government and the United Nations and “a range of conspiracy theories”, which could put health workers at risk.

“We will not yet consider the need to evacuate but we are developing a range of contingency plans to see where our staff are best located,” he said.

“If WHO and its partners had to leave North Kivu … we would have grave concerns that this outbreak would not be able to be well controlled in the coming weeks or months.”

(Reporting by Tom Miles; Additional reporting by Fiston Mahamba in Goma,; Editing by Andrew Heavens, William Maclean)

Alcohol abuse kills 3 million a year, most of them men: WHO

FILE PHOTO: Beer cans are displayed in a store in Ciudad Juarez, Mexico, July 31, 2018. REUTERS/Jose Luis Gonzalez/File Photo

By Kate Kelland

(Reuters) – More than 3 million people died in 2016 due to drinking too much alcohol, meaning one in 20 deaths worldwide was linked to harmful drinking, the World Health Organization (WHO) said on Friday.

More than three quarters of these deaths were among men, the U.N. health agency said. And despite evidence of the health risks it carries, global consumption of alcohol is predicted to rise in the next 10 years.

“It’s time to step up action to prevent this serious threat to the development of healthy societies,” the WHO’s director-general, Tedros Adhanom Ghebreyesus, said in a report. “Far too many people, their families and communities suffer the consequences of the harmful use of alcohol.”

FILE PHOTO: Suspects arrested over the production and sale of illegal alcohol which claimed the lives of more than 80 people this week in Jakarta and nearby West Java province, are seen during a police a press conference in Jakarta, Indonesia April 11, 2018. REUTERS/Willy Kurniawan/File Photo

In its “Global status report on alcohol and health 2018”, the WHO said that globally, an estimated 237 million men and 46 million women are problem drinkers or alcohol abusers. The highest prevalence is in Europe and the Americas, and alcohol-use disorders are more common in wealthier countries.

Of all deaths attributable to alcohol, 28 percent were due to injuries, such as traffic accidents, self-harm and interpersonal violence. Another 21 percent were due to digestive disorders, and 19 percent due to cardiovascular diseases such as heart attacks and strokes.

An estimated 2.3 billion people worldwide drink alcohol, with average daily consumption of people at 33 grams of pure alcohol a day. This is roughly equivalent to two 150 ml glasses of wine, a large (750 ml) bottle of beer or two 40 ml shots of spirits.

Europe has the highest per person alcohol consumption in the world, even though it has dropped by around 10 percent since 2010. Current trends point to a global rise in per capita consumption in the next 10 years, the report said, particularly in Southeast Asia, the Western Pacific and the Americas.

“All countries can do much more to reduce the health and social costs of the harmful use of alcohol,” said Vladimir Poznyak, of the WHO’s substance abuse unit. He said proven, cost-effective steps included raising alcohol taxes, restricting advertising and limiting easy access to alcohol.

Worldwide, 45 percent of total alcohol consumed is in the form of spirits. Beer is the second most popular, accounting for 34 percent of consumption, followed by wine at 12 percent.

The report found that almost all countries have alcohol excise taxes, but fewer than half of them use other pricing strategies such as banning below-cost sales or bulk buy discounts.

(Reporting by Kate Kelland, Editing by Alison Williams)

Congo Ebola outbreak poses high regional risk, says WHO

An ambulance from the Medecins Sans Frontieres (MSF) drives through a street in the town of Beni in North Kivu province of the Democratic Republic of Congo, August 2, 2018. REUTERS/Samuel Mambo

By Tom Miles and Fiston Mahamba

GENEVA/GOMA, Democratic Republic of Congo (Reuters) – An Ebola outbreak in eastern Democratic Republic of Congo is likely spread over tens of kilometers and poses a high regional risk given its proximity to borders, a World Health Organization (WHO) official said on Thursday.

Four people have tested positive for Ebola in and around Mangina, a town of about 60,000 people in North Kivu province, 100 km (62 miles) from the Ugandan border, the health ministry said. Another 20 people died from unidentified haemorrhagic fevers in the area, mostly in the second half of July.

Just last week, a previous outbreak on the other side of the Central African country was declared over after killing 33 people.

“It would appear that the risk, as we can surmise for DRC, is high. For the region it’s high given the proximity to borders, particularly Uganda,” said WHO’s emergency response chief Peter Salama.

“We are talking about tens of kilometers but I stress that this is very preliminary information at this stage.”

Ebola is believed to be transported long distances by bats and can find its way into bushmeat sold at local markets and eaten. Once present in humans, it causes haemorrhagic fever, vomiting, and diarrhea and is spread through direct contact with body fluids. Over 11,300 people died of an epidemic in West Africa from 2013 to 2016.

This is the vast, forested central African country’s 10th outbreak since 1976 when the virus was discovered near Congo’s Ebola river in the north. That is more than twice as many epidemics as any other country.

The response to Congo’s previous outbreak was considered a success despite the 33 deaths, as the use of a vaccine made by Merck helped contain the virus.

The kind of Ebola in the latest outbreak has been confirmed as the Zaire strain that the Merck vaccine protects against, Congo’s health ministry said late on Thursday. This should allow health officials to again use what has become the greatest weapon against Ebola epidemics to date.

Still, this outbreak poses new challenges. Eastern Congo is a tinderbox of conflicts over land and ethnicity stoked by decades of on-off war and this could hamper efforts to contain the virus.

About 1,000 civilians have been killed by armed groups and government soldiers around Beni since 2014, and the wider region of North Kivu holds over 1 million displaced people.

“FAST AS POSSIBLE”

Officials in Mangina rushed on Thursday to educate people about the risks of spreading the virus in a town that one local nurse told Reuters had no ambulance service.

Agents were deployed to warn people about the need for strict hygiene and the local radio station passed on messages about how to act, a local journalist said by phone.

“There is a great panic among the local population following the appearance of the Ebola epidemic,” said a nurse by phone, who asked not to be named.

The hospital where she works has already seen three people die recently of haemorrhagic fever. The hospital was awaiting help from the Red Cross to bury the bodies properly, she said.

Meanwhile, Uganda has set up screening at the land border it shares with Congo and at its Entebbe international airport.

“Ebola is highly infectious so we have put in place measures,” Uganda’s Junior Health Minister Sarah Achieng Opendi told Reuters.

An international delegation including officials from the United Nations, the World Bank and the WHO is in Beni, 30 km from Mangina.

(Reporting by Tom Miles in Geneva and Fiston Mahamba in Goma, Additional reporting by Elias Biryabarema in Kampala, Writing by Edward McAllister and Tim Cocks, editing by William Maclean and Rosalba O’Brien)

WHO says Ebola team arrives in Congo

FILE PHOTO: Medecins Sans Frontieres (MSF) workers talk to a worker at an isolation facility, prepared to receive suspected Ebola cases, at the Mbandaka General Hospital, in Mbandaka, Democratic Republic of Congo May 20, 2018. REUTERS/Kenny Katombe

By Tom Miles and Fiston Mahamba

GENEVA/GOMA (Reuters) – An international delegation has arrived in the town of Beni in Democratic Republic of Congo, 30 km (18 miles) from where an Ebola outbreak was declared, the World Health Organization and Congolese officials said on Thursday.

Officials from the United Nations, the World Bank, the WHO and Democratic Republic of Congo’s Ministry of Health, including Health Minister Oly Ilunga, will support a team already on the ground.

Congo declared the new outbreak on Wednesday, just days after another outbreak that had killed 33 people in the northwest was declared over.

Twenty people have died from haemorrhagic fevers in and around Mangina, a densely populated town in North Kivu province about 30 km (18 miles) southwest of the city of Beni and 100 km from the Ugandan border.

The ministry has not made public when the deaths occurred. Another six who are still living are showing signs of fever, of which four tested positive.

“The Government-Partner delegation is holding its first meeting to organize the response,” North Kivu governor Julien Paluku tweeted. “Already a … team from Kinshasa is installing a laboratory and a single coordination center.”

But eastern Congo is a tinderbox of conflicts over land and ethnicity stoked by decades of on-off war and this could hamper efforts to contain the virus.

About 1,000 civilians have been killed by armed groups and government soldiers around Beni since 2014, and the wider region of North Kivu holds over 1 million displaced people.

(Writing by Tim Cocks; editing by Matthew Mpoke Bigg)

First Ebola vaccines given as WHO seeks to beat Congo outbreak

FILE PHOTO: A Congolese child washes her hands as a preventive measure against Ebola at the Church of Christ in Mbandaka, Democratic Republic of Congo May 20, 2018. REUTERS/Kenny Katombe/File Photo

By Kate Kelland

LONDON, (Reuters) – A vaccination campaign aimed at beating an outbreak of Ebola in Congo began on Monday in the port city of Mbandaka, where four cases of the deadly disease have been confirmed.

Use of the VSV-EBOV shot – an experimental vaccine developed by Merck – marks a “paradigm shift” in how to fight Ebola, said the World Health Organization’s head of emergency response, and means regions with Ebola outbreaks can in future expect more than just containment of an outbreak with basic public health measures such as isolation and hygiene.

The shot is designed for use in so-called ring vaccination plans. When a new Ebola case is diagnosed, all people who might have been in recent contact with the patient are traced and vaccinated to keep the disease from spreading.

“It’s the first time in the midst of an outbreak … that we’re using this as a way to stem transmission,” WHO’s Peter Salama said in a telephone interview. “It’s an important moment that changes the way we’ve seen Ebola for 40 years.”

The same strategy was used to test Merck’s vaccine in Guinea in late 2015, towards the end of an Ebola outbreak in West Africa from 2013 to 2016. The trial results showed it was safe and gave very high levels of protection against Ebola.

Around 30 Guinean health workers who were directly involved in that 2015 vaccine trial have travelled to Congo and will help with the immunizations there, Salama said.

Ebola causes hemorrhagic fever, vomiting and diarrhea and spreads through contact with the bodily fluids of an infected person. More than 11,300 people died in the West Africa epidemic.

This latest outbreak has killed 25 people since early April, according to the WHO. It is Congo’s ninth since the disease made its first known appearance near the country’s Ebola river in the 1970s.

Cases in Mbandaka, a port city on the Congo river, have raised concern that the virus could spread downstream to the capital, Kinshasa, which has a population of 10 million.

Salama, who visited Congo after the Ebola outbreak was first reported on May 8, said up to 1,000 people – first in Mbandaka and then in Bikoro and other affected areas -could be vaccinated within the next week.

Some 7,300 doses are already in Congo, and hundreds of thousands more are available in a stockpile built up by Merck.

“If we need any more we can ship it within days,” he said. “We’re fine for vaccine supply; that’s not an issue. The issue is going to be making sure we find every contact, track them down and get them vaccinated if they agree.”

Congolese health ministry data show four cases of Ebola confirmed in Mbandaka’s Wangata neighborhood and two suspected cases. One patient has died. For every case, up to 150 contacts will be offered the vaccine.

Salama said he was particularly concerned about the “unknowns” of the outbreak – namely the potential numbers of cases in the village of Ikobo, where no roads go and even helicopters have trouble landing.

“I’m actually very worried about Ikobo because we have four new suspected cases there and it’s very, very remote. We’ve tried to land helicopters there several times, but we need the community to clear the airstrip, and they haven’t fully cleared it yet,” Salama said.

“And when you haven’t got people on the ground, it’s very hard to assess the extent of the outbreak. I’m worried there are many more cases than we’ve been able to identify so far.”

(Reporting by Kate Kelland; Editing by Larry King)

WHO says Congo faces ‘very high’ risk from Ebola outbreak

FILE PHOTO: Congolese Health Ministry officials carry the first batch of experimental Ebola vaccines in Kinshasa, Democratic Republic of Congo May 16, 2018. REUTERS/Kenny Katombe/File Photo

By Tom Miles and Fiston Mahamba

GENEVA/KINSHASA (Reuters) – Democratic Republic of Congo faces a “very high” public health risk from Ebola because the disease has been confirmed in a patient in a big city, the World Health Organization (WHO) said on Friday, raising its assessment from “high” previously.

The risk to countries in the region was now “high”, raised from “moderate”, but the global risk remained “low”, the WHO said.

The reassessment came after the first confirmed case in Mbandaka, a city of around 1.5 million on the banks of the Congo River in the northwest of the country.

The case raised concerns that the virus, previously found in more rural areas, would be tougher to contain and could reach downstream to the capital Kinshasa, which has a population of 10 million.

It also followed the announcement by Congo’s health ministry of 11 newly confirmed cases in the smaller town of Bikoro, near the northwest village where the virus was first detected.

“The confirmed case in Mbandaka, a large urban center 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 neighboring countries,” the WHO said.

WHO Deputy Director-General for Emergency Preparedness and Response Peter Salama had told reporters on Thursday that the risk assessment was being reviewed.

“Urban Ebola is a very different phenomenon to rural Ebola because we know that people in urban areas can have far more contacts so that means that urban Ebola can result in an exponential increase in cases in a way that rural Ebola struggles to do.”

Later on Friday, the WHO will convene an Emergency Committee of experts to advise on the international response to the outbreak, and decide whether it constitutes a “public health emergency of international concern”.

The nightmare scenario is an outbreak in Kinshasa, a crowded city where millions live in unsanitary slums not connected to a sewer system.

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 traveling quite big distances – it’s got everything we would worry about,” he told Reuters.

WHO spokesman Tarik Jasarevic said on Friday that Congo’s Ministry of Health had provided updated figures: 45 cases overall since April 4, including 14 confirmed, 10 suspected and 21 probable. There had been 25 deaths, but no new infections among healthworkers, Jasarevic told reporters.

The WHO is sending 7,540 doses of an experimental vaccine to try to stop the outbreak in its tracks, and 4,300 doses have already arrived 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. Each ring represents the number of people including health workers who may have come into contact with an Ebola patient.

As of 15 May, 527 contacts had been identified and were being followed up and monitored.

(This story corrects to clarify location of Mbandaka.)

(Additional reporting by Kate Kelland in London; Writing by Tom Miles and Edward McAllister; Editing by Matthew Mpoke Bigg)

WHO says 19 dead, 39 infected so far in Congo Ebola outbreak

A health worker is sprayed with chlorine after visiting the isolation ward at Bikoro hospital, which received a new suspected Ebola case, in Bikoro, Democratic Republic of Congo May 12, 2018. REUTERS/Jean Robert N'Kengo

GENEVA (Reuters) – Democratic Republic of Congo reported 39 suspected, probable or confirmed cases of Ebola between April 4 and May 13, including 19 deaths, the World Health Organization said on Monday.

It said 393 people who identified as contacts of Ebola patients were being followed up. Information about the outbreak in Bikoro, Iboko and Wangata health zones in Equateur province was still limited, the WHO said in a statement.

At present the outbreak did not meet the criteria for declaring a “public health event of international concern”, which would trigger the formation of an emergency WHO committee.

(Reporting by Tom Miles, Editing by William Maclean)

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