Two hundred deaths is the threshold reached by the Ebola epidemic in the Democratic Republic of Congo. In recent days, the Congolese Ministry of Health has reported 204 deaths out of 867 suspected cases in three provinces of the country. The latest toll from the World Health Organization stood at 177 deaths out of approximately 750 suspected cases, even though Director General Tedros Adhanom Ghebreyesus himself had already expressed his opinion on the matter, stating that “the epidemic in the Democratic Republic of Congo is much more extensive” than just the 82 laboratory-confirmed cases.
The virus in circulation is Bundibugyo, a rare but lethal variant of the Ebola family. On May 15, Africa CDC officially declared the epidemic in the province of Ituri, in the east of the country, and the WHO proclaimed an international health emergency (PHEIC) on May 17, the organization’s maximum alert. Uganda has also reported cases imported from Congo: the first confirmed concerned a 59-year-old Congolese man hospitalized in Kampala on 11 May and died three days later.
Africa CDC: ten more countries at risk
The African Union health agency coordinated a high-level consultative meeting on May 16 with over 130 participants, including representatives of countries at risk, donor partners (USA, United Kingdom and European Union), UN agencies, humanitarian organizations and pharmaceutical companies. In the official statement from the Director General, Africa CDC took the lead in continental coordination of the response, as required by its mandate in the event that an outbreak exceeded the borders of a single Member State. The president of Africa CDC, Jean Kaseya, indicated during a press conference the countries most exposed to the risk of spread: South Sudan, Rwanda, Kenya, Tanzania, Ethiopia, Republic of Congo, Burundi, Angola, Central African Republic and Zambia. The common denominator is the strong cross-border mobility with the Congolese areas where the contagion is more intense, in a context already dramatically marked by insecurity and poor tracing capacity. In the east of the DRC, there are Doctors Without Borders teams in the field, deployed from the first hours of the emergency with hundreds of operators and protective equipment. MSF has reopened treatment centers in the region, underlining however that Ebola is not the only ongoing health crisis, given that in eastern Congo the main causes of mortality remain preventable diseases, such as malaria and measles.
The situation in Europe
On a European level, the official assessment leaves no room for alarm. The ECDC, the European Center for Disease Prevention and Control, has classified the risk of infection for the EU population as “very low”, specifying that any imported cases would be quickly identified and isolated. European Commission spokeswoman Eva Hrncirova confirmed the same assessment, extending it to people traveling to the region. Bundibugyo, like all variants of Ebola, is not transmitted by air: contagion requires direct contact with the body fluids of an already symptomatic person.
The risk for Italy
On May 18, the Italian Ministry of Health activated health surveillance on health and non-health personnel employed in cooperation activities in the Congolese areas affected by the outbreak. The circular, signed by the head of the Prevention Department Maria Rosaria Campitiello, provides for the obligation of a health declaration to be sent to the Ministry at least 48 hours in advance of departure from the affected areas, therefore no restrictions on travel and space for systematic tracking of returns.
Update – Two Italian aid workers at the Sacco in Milan
At dawn on May 25, the Italian healthcare system had its first direct contact with the epidemic. Two aid workers from the province of Como, a 30-year-old man and a 33-year-old woman, were placed in isolation at the Sacco hospital in Milan after returning during the night from Uganda via Addis Ababa, where they had spent three months with the Comboni missionaries in an area near the Congolese border. Symptoms include fever, nausea, vomiting and, in the woman, a slight neurological impairment, all elements that triggered the protocol: the two were picked up from their respective homes by the AREU and transferred to Sacco in full isolation. Eleven family members have been placed in fiduciary isolation awaiting the results. The most accepted hypothesis, however, is not Ebola. The Welfare Councilor of the Lombardy Region Guido Bertolaso declared: “At this moment we believe that it is malaria or something similar.” The Ministry of Health, in an official note issued on the same day, confirmed that the national system for responding to infectious emergencies is fully operational and that the risk for Italy remains very low.
