(KINSHASA, Congo) — Congo’s Ebola outbreak has spread to a crossroads city of more than 1 million people in a troubling turn that marks the first time the vast, impoverished country has encountered the lethal virus in an urban area.

“This is a major, major game-changer in the outbreak,” Dr. Peter Salama, the World Health Organization’s deputy director-general of emergency preparedness and response, warned on Thursday.

A single case of Ebola was confirmed in Mbandaka, a densely populated provincial capital on the Congo River, Congo’s Health Minister Oly Ilunga said late Wednesday. The city is about 150 kilometers (93 miles) from Bikoro, the rural area where the outbreak was announced last week.

Late Thursday, Congo’s Ministry of Health announced 11 new confirmed Ebola cases and two deaths tied to cases in the country’s northwest, including one in a suburb of Mbandaka.

A total of 45 cases of Ebola have now been reported in Congo in this outbreak: 14 confirmed, 21 probable and 10 suspected, the ministry said, after results from lab tests returned Thursday.

There has been one new death in Bikoro, where the first death took place. That new death had epidemiological ties to another case. The other death was a suspected case in Wangata, a suburb of Mbandaka on the Congo River, the ministry said. No details were given on the death’s links to the newly confirmed case.

Only one of the 25 dead has been confirmed as Ebola, it said, adding that no new health professionals have been contaminated. One nurse had died, and three others were among suspected cases since the outbreak began.

Medical teams have been rushing to track down anyone thought to have had contact with infected people, while WHO is shipping thousands of doses of an experimental vaccine.

Until now, the outbreak was confined to remote rural areas, where Ebola, which is spread by bodily fluids, travels more slowly.

“We’re certainly not trying to cause any panic in the national or international community,” Salama said. But “urban Ebola can result in an exponential increase in cases in a way that rural Ebola struggles to do.”

Mbandaka, a city of almost 1.2 million, is in a busy travel corridor in Congo’s northwest Equateur province and is upstream from the capital, Kinshasa, a city of about 10 million. It is an hour’s plane ride from Kinshasa or a four- to seven-day trip by river barge.

Salama also noted Mbandaka’s proximity to neighboring countries, including Central African Republic and Republic of Congo.

“The scenario has changed, and it has become most serious and worrying, since the disease is now affecting an urban area,” said Henry Gray, emergency coordinator in Mbandaka for Doctors Without Borders.

The aid organization said 514 people believed to have been in contact with infected people are being monitored. WHO said it is deploying about 30 more experts to the city.

Those exposed will for the first time in Congo receive Ebola vaccinations, the health minister said. WHO has sent 4,000 doses to Congo and said it will dispatch thousands more in the coming days as needed.

“This is a concerning development, but we now have better tools than ever before to combat Ebola,” Tedros Adhanom Ghebreyesus, WHO director-general, said of the new urban case.

The vaccine has been shown to be highly effective against Ebola. It was tested in Guinea during the outbreak that killed more than 11,300 people in West Africa from 2014 to 2016.

WHO has said it will use the “ring vaccination” method. It involves vaccinating contacts of those feared infected, contacts of those contacts, and health care and other front-line workers.

This is the ninth Ebola outbreak in Congo since 1976, when the disease was first identified. The virus is initially transmitted to people from wild animals, including bats and monkeys.

There is no specific treatment for Ebola. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding. The virus can be fatal in up to 90 percent of cases, depending on the strain. </s> iStock/Thinkstock(NEW YORK) — The current Ebola outbreak in the Democratic Republic of Congo has spread from rural areas to a city of nearly 1.2 million people, the country’s health ministry said Wednesday.

Situated along the Congo River, Mbandaka is a densely populated transit hub at the crossroads of Equateur province, the health ministry said, raising fears that the Ebola virus will be easily passed on. Ebola spreads through direct contact with bodily fluids of infected people.

Downstream from Mbandaka is the country’s capital, Kinshasa, which is home to roughly 10 million people.

“The arrival of Ebola in an urban area is very concerning and WHO and partners are working together to rapidly scale up the search for all contacts of the confirmed case in the Mbandaka area,” said Matshidiso Moeti, the World Health Organization’s regional director for Africa.

A new suspected case of Ebola was recorded this week in Wangata, one of the three health zones of Mbandaka, the capital of the northwestern Equateur province. Laboratory tests on two samples from Wangata confirmed one specimen as positive for Ebola, while the other was negative.

It’s the first time in the region’s ongoing outbreak that a case has been detected in an urban health zone, with all other cases reported in remote, rural areas of Equateur province. And until now, all the confirmed cases of Ebola were in Bikoro health zone, some 90 miles south of Mbandaka.

“We are entering a new phase of the Ebola outbreak that is now affecting three health zones, including an urban health zone,” the Democratic Republic of Congo’s Minister of Health Oly Ilunga Kalenga said in a statement in French late Wednesday. “Since the announcement of the alert in Mbandaka, our epidemiologists are working in the field with community relays to identify people who have been in contact with suspected cases.”

As of Thursday, a total of 45 cases of hemorrhagic fever had been recorded in the Democratic Republic of Congo since the outbreak was announced on May 8. That number includes 14 confirmed cases of Ebola, 21 probable cases and 10 suspected cases. Health care workers have been among those infected, according to the country’s health ministry.

There have been 25 deaths among these cases, including one person who died from a confirmed case of Ebola.

There are several types of hemorrhagic fever in the Democratic Republic of Congo, the health ministry noted; thus, not all suspected cases are necessarily Ebola.

It’s the Central African nation’s ninth Ebola outbreak since 1976 when scientists first identified the deadly virus.

The health ministry said it had received 5,400 doses of Ebola vaccine Wednesday morning. Thousands more were expected to arrive in the coming days.

The World Health Organization (WHO), which is working with the Democratic Republic of Congo’s health ministry and its partners, announced Thursday that it has deployed 30 experts to conduct surveillance in Mbandaka, following news of the confirmed case there.

Doctors Without Borders, or MSF as its often called by its French acronym, said it too is stepping up its response to stop the spread of the current Ebola outbreak in the Democratic Republic of Congo.

“With the new case confirmed in Mbandaka, the scenario has changed, and it has become more serious and worrying, since the disease is now affecting an urban area,” said Henry Gray, MSF emergency coordinator in Mbandaka. “It is paramount to trace the suspect case in order to have a clearer view on how it reached the city.”

The International Federation of Red Cross and Red Crescent Societies, which is also assisting the country amid the current outbreak, said communities across Equateur province must be alerted of the rising risk of Ebola to stop the virus from spreading further.

“Local volunteers and health workers are the community’s alarm system,” said Ben Adinoyi, who heads the International Federation of Red Cross and Red Crescent Societies’ health unit for Africa. “They are our eyes and ears on the ground. They are critical to the early identification and containment of new cases.”

“They need to be activated across the province and even beyond,” he added. “If we don’t, then the virus may spread too far and too quickly.”

The latest Ebola case in the Democratic Republic of Congo comes amid an outbreak of violence that has spread rapidly in the country’s restive Kasai region. The violence was sparked by existing tensions between customary chiefs in Kasai-Central Province and the government in 2016, but the widening conflict has since pulled in militias, armed groups and security forces across an area the size of Germany.

The violence has forced families to flee their homes. About 3.8 million people in the Kasai region, including 2.3 million children, are in need of humanitarian assistance, according to the United Nations. </s> The Democratic Republic of Congo's Ebola outbreak has spread to a provincial capital, prompting the World Health Organization (WHO) to call an emergency meeting.

The outbreak was announced last week in the remote rural area of Bikoro. So far 45 cases have been reported and 25 people are known to have died.

But cases have also been confirmed in Mbandaka, about 150km away, which is home to almost 1.2 million people.

The city lies on the Congo River, a busy transport corridor to the capital Kinshasa, where more than 10 million people live. </s> The Ebola outbreak in the Democratic Republic of Congo has spread to a city, the World Health Organization said Thursday, raising concern the deadly virus may prove tougher to contain.

"One new case of Ebola virus disease has been confirmed in Wangata, one of the three health zones of Mbandaka, a city of nearly 1.2 million people in Equateur Province in northwestern Democratic Republic of the Congo," the UN's health agency said in a statement.

The outbreak, publicly declared on May 8, had previously been reported in a rural area of Equateur that lies roughly 150 kilometres (93 miles) from Mbandaka.

"This is a concerning development," WHO director-general Tedros Adhanom Ghebreyesus said in the statement.

The agency said it was deploying around 30 experts to Mbandaka "to conduct surveillance in the city."

Forty-four cases have been reported in the outbreak so far, including three confirmed, 20 probable and 21 suspected, according to the WHO's tally. </s> KINSHASA (Reuters) - Three new cases of Ebola were confirmed in northwest Congo’s regional capital of Mbandaka on Friday, in a part of the city lying next to the Congo River, the health ministry said.

The ministry statement late on Friday said the suspected cases had been reported in the neighborhood of Wangata, next to the river, on Thursday. Samples had been taken for testing. A further suspected case also arrived on Friday in the city of one million, it said. </s> Total of three cases confirmed in city of 1 million people, raising fears of wider outbreak

This article is more than 1 year old

This article is more than 1 year old

Two more cases of Ebola have been confirmed in the north-western city of Mbandaka in the Democratic Republic of the Congo, health officials have said.

The report brings to three the number of confirmed cases in the city of 1 million people, raising the prospect of a wider outbreak than feared.

The DRC is one of Africa’s most fragile states, with millions threatened by hunger, disease and low-level conflict. Political instability has intensified since the refusal of Joseph Kabila to step down as president when his second term ended in 2016.

International aid is pouring in to reinforce health services, with a campaign of vaccinations due to begin on Sunday. The health ministry declared it had activated an action plan in Mbandaka.

After visiting the city, which is 360 miles (580km) from the capital, Kinshasa, the health minister, Oly Ilunga, announced on television that all healthcare would be free. “Financial hurdles should not in any way be a brake to having access to healthcare, especially at a time of epidemic,” he said.

Prof Jean-Jacques Muyembe, the director general of the DRC’s National Institute for Biomedical Research, told the Guardian on Friday that “the situation had evolved overnight with the confirmation of two new cases” in the Wangata neighbourhood of Mbandaka.

“It is very concerning. It’s a big city. We are all doing everything we can, but nonetheless with Ebola there are always surprises,” said Muyembe.



The discovery of the first case in Mbandaka this week was described as a “major gamechanger” by the World Health Organization. An emergency meeting of experts was held on Friday to consider the danger of the disease spreading to other countries. “At the global level, the risk is currently low,” the WHO said.

Late on Thursday, the DRC health ministry confirmed 11 previously suspected cases of Ebola and two more deaths, taking the total number of cases, including 25 deaths, to 45.

All the deaths so far have occurred in Bikoro, a rural area about 75 miles from Mbandaka. The presence of the disease in more isolated areas has given authorities a better chance of preventing its spread.

Muyembe said laboratory results released late on Thursday had confirmed the two new cases. He was unable to give any further details about whether the individuals knew each other. The aid agency Médecins san Frontières, however, said it was aware of only one new laboratory-based confirmation from Mbandaka.

Mbandaka is located on the banks of the Congo river, a key trade and transport route into Kinshasa, though experts said water transport between the cities could take weeks, slowing any potential spread of the disease. Air transport is limited and expensive.

Ebola has twice made it to DRC’s capital in the past and was rapidly stopped.

Ilunga said epidemiologists were working to identify people who had been in contact with suspected cases, and authorities would intensify population tracing on routes out of Mbandaka.

This is a big task even for medical services in developed countries, but the DRC is one of the world’s poorest.

Four times the size of France, the DRC has been chronically unstable and episodically racked by violence since it gained independence from Belgium in 1960. Hospitals, roads and electricity have problems, especially in remote areas.

In Mbandaka, medical staff have been issued with infrared pistol thermometers to check travellers for high temperatures, as well as soap and basins of water, and logbooks for writing down visitors’ names and addresses.

In the privately run port of Menge, health ministry workers were systematically checking people’s temperatures with thermometers. But Joseph Dangbele, a port official, said: “We don’t have enough of the thermometers, so people are crowding up and getting annoyed.”

On Thursday, a doctor at Mbandaka general hospital, who requested anonymity, said more than 300 people in the city had either direct or indirect contact with Ebola.

Despite police being deployed in key areas, residents showed little confidence in authorities’ response.

Gaston Bongonga said: “Delegations come here and then go, but on the ground, you don’t see any change. They were all unable to hold back Ebola in Bikoro because they don’t do anything effective.”

Residents of Bikoro said there were only two checkpoints on a 60-mile stretch of road. One said: “This isn’t effective because many people travelling by motorbike or on foot evade inspection.”

Ebola has been recorded nine times in the DRC since the disease first appeared near the northern Ebola river in the 1970s. It can cause internal and external bleeding.

More than 4,000 shots of a newly developed vaccine were sent by the WHO to Kinshasa on Wednesday.

Congo enters uncharted territory as it faces gravest Ebola challenge to date Read more

The vaccine, developed by Merck, is not licensed but proved effective during limited trials in west Africa, where the biggest recorded outbreak of Ebola killed 11,300 people in Guinea, Liberia and Sierra Leone from 2014 to 2016. </s> An outbreak of Ebola, once confined to remote rural areas in the Democratic Republic of the Congo, now has spread to an area just outside of city of more than one million people, health officials said Thursday.

Dr. Peter Salama, the World Health Organization’s deputy director-general of emergency preparedness and response, called the new development “a major, major game-changer in the outbreak.”

The announcement came from the office of the Congo’s health minister late Wednesday night after it was learned that there was a single case of Ebola reported in Mbandaka, a densely populated city just under 100 miles from the site of the last reported case.

Since the outbreak began, there has been a total of 45 cases: 14 confirmed, 21 probable and 10 suspected. Only one of the 25 deaths actually has been confirmed by the health ministry as Ebola.

The fatal disease is spread by bodily fluids and can spread rapidly in densely populated regions.

“The scenario has changed, and it has become most serious and worrying, since the disease is now affecting an urban area,” said Henry Gray, emergency coordinator in Mbandaka for Doctors Without Borders.

The aid organization said 514 people believed to have been in contact with infected people are being monitored. WHO said it is deploying about 30 more experts to the city.

This is the ninth Ebola outbreak in Congo since 1976, when the disease was first identified. The virus initially is transmitted to people from wild animals, including bats and monkeys.

While there is no specific treatment for the deadly disease, which has a 90 percent fatality rate, WHO has shipped thousands of doses of an experimental vaccine to the region.

As the outbreak continues to grow, fears that it may spread abroad linger as many remember the West African Epidemic in 2014.

Eleven people were treated for Ebola in the United States in 2014, two of whom died, according to the Center for Disease Control and Prevention.

The Associated Press contributed to this report. </s> Three new cases of Ebola have been confirmed in the Democratic Republic of the Congo's (DRC) sprawling northwest, taking the number of suspected infections to 43, according to the health minister.

The outbreak, previously reported in a remote rural area of the country, recorded its first confirmed cases in Mbandaka, a city of 1.2 million, as the spread of the haemorrhagic fever raised alarm.

"Three new cases were reported (in Mbandaka) and tested positive for the Ebola virus," Health Minister Oly Ilunga said in the statement.

"In total, 43 cases of haemorrhagic fever have been flagged in the region of which 17 are confirmed, 21 are probable, and five are suspected cases," he said.

In Geneva, the United Nations's World Health Organization (WHO) put the death toll at 25 but said 45 cases have been recorded, 14 of which have been confirmed by lab tests.

The WHO on Friday said the latest Ebola outbreak did not warrant being labelled an emergency of "international concern", adding that Kinshasa's response along with its own had been "rapid and comprehensive".

The government announced the outbreak of the deadly virus in northwestern Equateur province on May 8.

In the WHO's parlance, "a public health emergency of international concern" is an "extraordinary event" in which a disease may spread across borders and requires a vigorous international response.

Ebola is both lethal and highly contagious, which makes it difficult to contain, especially in urban environments where people are mobile and come into contact with others more often.

It is notorious for its high fatality rate and extreme symptoms, which can include internal and external bleeding.

The current outbreak, the ninth to hit the DRC since Ebola was identified in 1976, involves the same strain of the virus that struck three West African countries in 2013-2015 and sparked an international panic.

It went on to kill more than 11,300 people in the deadliest ever Ebola epidemic. </s> The Ebola outbreak in the Democratic Republic of Congo made the long-feared jump across borders with three cases confirmed Wednesday in Uganda, including the death of a 5-year-old boy who had the virus.

The World Health Organization and Ugandan health authorities said Tuesday the Congolese boy had traveled from Congo on Sunday, entered Uganda with his family and sought medical care.

The other two confirmed cases are the boy’s 3-year-old brother and his grandmother, 50. They are being treated under isolation at the Bwera Hospital Ebola Treatment Unit, in the west of Uganda, the country’s Ministry of Health said.

In a tweet Wednesday, WHO said the boy died Tuesday night.

“The young patient – 5- year-old index case of #Ebola died last night. Two more samples were sent to UVRI and have tested positive. We, therefore, have three confirmed cases of #Ebola in #Uganda,” the tweet said, referring to the Uganda Virus Research Institute.

The ministry added that eight people who had been in contact with the family were being traced.

The Congo outbreak is both the second largest and second deadliest Ebola outbreak in history.

More than 1,300 people have died since it began in August. The epicenter is in North Kivu and Ituri provinces, among the most populous in the Congo and bordering Uganda, Rwanda and South Sudan.

Concern had been mounting that the infectious disease would cross the border, underscored by an increase in the number of cases in recent weeks.

Pressure on WHO to declare international emergency

Dr. Jeremy Farrar, director of Wellcome Trust, a UK medical research charity, said that while Uganda was well-prepared to cope with the disease, global health authorities should be ready for more cases in the Democratic Republic of Congo and other neighboring countries.

“This epidemic is in a truly frightening phase and shows no sign of stopping anytime soon,” he said in a statement.

“There are now more deaths than any other Ebola outbreak in history, bar the West Africa Epidemic of 2013-16, and there can be no doubt that the situation could escalate towards those terrible levels.”

Uganda’s Health Ministry said the boy and his grandmother had been vomiting blood, a severe symptom of Ebola, when they had presented themselves to doctors.

“Ebola is a horrific illness that ravages the human body,” said Brechtje van Lith, Save the Children’s country director in Uganda. “This first death, of a child, is a sickening reminder of the dangers of this disease.”

WHO is likely to come under pressure to declare the outbreak an international health emergency. In April, the health body said it did not constitute a “public health emergency of international concern.”

WHO defines a public health emergency of international concern as “an extraordinary event” that constitutes a “public health risk to other States through the international spread of disease” and “to potentially require a coordinated international response.”

Unlike the outbreak in West Africa that killed more than 11,000 people, there are now vaccines and experimental treatments to help stop the spread of the disease.

However, the Congo outbreak has proven difficult to bring under control because of community mistrust and violent attacks on health care workers.

“A step up in the national response with full international support is critical if we’re to contain the epidemic and ensure the very best protection for the communities at risk and for the health workers working to protect lives,” Farrar said. “This needs to be championed at the highest political levels, including at the UN and the upcoming G20.”

Uganda’s health ministry said it was vaccinating front-line health workers and people who had been in contact with the family. It said people should report any symptoms including unexplained bleeding from any body opening, vomiting of blood, bloody diarrhea and muscle pain.

It appealed to the public to “suspend social norms like shaking hands and hugging” and called on border districts to suspend mass gatherings such as weddings and markets and in places of worship.
Two more cases of ebola reported in the city of Mbandaka in the Democratic Republic of the Congo. 25 people have died this year in the country from the disease, with a wider outbreak feared.