The World Health Organization has declared that the Ebola outbreak caused by the Bundibugyo virus in the Democratic Republic of Congo and Uganda constitutes an international health emergency, the highest level of alert provided for in the International Health Regulations before a potential pandemic emergency. The WHO specifies, however, that the outbreak does not meet the criteria for a pandemic.
The decision comes after the detection of cases in the Congolese province of Ituri and the confirmation of infections in Uganda. According to the WHO, as of May 16, 8 laboratory-confirmed cases, 246 suspected cases, and 80 suspected deaths had been reported in Ituri, spread across at least three health zones: Bunia, Rwampara, and Mongbwalu.
The organization has also reported two confirmed cases in Kampala, the capital of Uganda, including one death, in two individuals who had traveled from the Democratic Republic of Congo. Additionally, one confirmed case has been reported in Kinshasa, the Congolese capital, in a person from Ituri.
What exactly has the WHO declared
The WHO has determined that the outbreak constitutes a Public Health Emergency of International Concern, known by its English acronym PHEIC. In Spanish, the usual term is "emergencia de salud pública de importancia internacional" or "emergencia sanitaria internacional."
This does not mean that the world is facing a pandemic like COVID-19. The WHO itself emphasizes that the event does not meet the criteria for a pandemic emergency, but it does pose a significant risk of international spread and requires urgent coordination between countries.
The organization considers the event extraordinary for several reasons: the uncertainty about the actual number of infections, the appearance of cases in large cities like Kampala and Kinshasa, population mobility in border areas, and the absence of specific approved vaccines or treatments for this particular variant of the virus.
What is Ebola Bundibugyo
The outbreak is caused by the Bundibugyo virus, a species of Ebola virus distinct from the Zaire strain, which is the best-known and for which more developed medical tools exist.
The WHO recalls that Bundibugyo was first identified in 2007 in the Ugandan district of the same name. In that outbreak, 131 cases and 42 deaths were reported, with a fatality rate of 32%.
The difference matters a lot. Unlike with Ebola Zaire, the WHO warns that there are currently no approved specific vaccines or treatments for the Bundibugyo virus, which increases health concerns and the need to quickly cut off transmission.
Where the outbreak is centered
The main focus is in the province of Ituri, in the northeast of the Democratic Republic of Congo. Suspected cases and deaths have been reported there in several health zones, including Bunia, Rwampara, and Mongbwalu.
The area presents several risk factors: insecurity, intense population mobility, mining activity, cross-border movements, and the presence of informal health networks. All of this complicates epidemiological surveillance, contact tracing, and rapid isolation of cases.
The WHO had already announced on May 15 the deployment of additional support to the Congolese authorities, with specialized teams in epidemiology, diagnostics, infection prevention, risk communication, logistics, and clinical care. It also announced the shipment of five tons of supplies to Bunia.
Why Uganda is a concern
Uganda has confirmed cases linked to people who had traveled from the Democratic Republic of Congo. The WHO points out that the two cases in Kampala had no apparent link to each other and were reported within 24 hours of each other. One of them died.
This fact is especially relevant because it implies that international expansion is no longer just a theoretical risk. The WHO states that international spread has already been documented with the confirmed cases in Kampala.
Uganda has activated control, surveillance, and response preparedness measures, according to the WHO's African regional office. The immediate objective is to detect contacts, isolate cases, strengthen surveillance, and prevent new transmission chains.
What the WHO recommends
The WHO calls on the Democratic Republic of Congo and Uganda to activate national emergency mechanisms, strengthen surveillance, contact tracing, laboratory diagnosis, infection prevention in health centers, community communication, and patient care.
It also recommends immediate isolation of confirmed cases, monitoring of contacts for 21 days, and restricting the movement of cases or contacts, except for medical evacuation.
But the organization does not recommend closing borders or generally restricting international trade and travel. The WHO warns that closing borders can push the population towards informal, unmonitored crossings, which would further hinder health control.
How Ebola is transmitted
Ebola is transmitted through direct contact with blood, secretions, organs, or other bodily fluids of infected people, as well as through contaminated surfaces or materials. It can also be transmitted during funeral practices if there is contact with the bodies of people who have died from the disease.
Symptoms can include fever, generalized aches, weakness, vomiting, and in some cases, bleeding. In the current outbreak, WHO Africa notes that several patients deteriorated rapidly and died.
Early detection, supportive treatment, rapid isolation, and public health measures are key to improving survival and cutting transmission.