Ebola with no approved vaccine crosses into Uganda, WHO declares global health emergency

GENEVA – The World Health Organisation declared a Public Health Emergency of International Concern on Saturday after Bundibugyo virus, a distinct strain of Ebola, spread from the Democratic Republic of the Congo (DRC) to Uganda.

As of 18 May, DRC has reported 11 confirmed cases, 336 suspected cases, and 88 fatalities across Ituri Province, according to the U.S. Centers for Disease Control and Prevention (CDC). Uganda has recorded two confirmed cases, including one deceased, both in people who had travelled from DRC, with no further spread reported in Uganda.

However, the true scale of the outbreak may be larger than what is currently reported. This is because the initial laboratory samples in the DRC returned negative results before the Bundibugyo virus was correctly identified on 15th May using genetic fingerprinting, according to the CDC.

By then, 8 of 13 samples had tested positive, and two confirmed cases were admitted to intensive care units in Kampala, Uganda, on 15 and 16 May after travelling independently from Ituri Province, with no apparent epidemiological link to each other.

Additionally, at least four healthcare workers died in Ituri in circumstances consistent with viral haemorrhagic fever, raising concern about transmission within health facilities and gaps in infection prevention measures.

Bundibugyo virus is one of four types of orthoebolavirus known to cause Ebola disease in humans, according to the CDC. It spreads through direct contact with the blood or bodily fluids of an infected person, but not through the air.

The CDC notes that this specific strain has historically carried a mortality rate of between 25 and 50 per cent. Currently, there is no approved vaccine or treatment for the Bundibugyo strain, and management consists of supportive care only.

To manage this outbreak, WHO has urged the establishment of specialised treatment centres near outbreak epicentres, implement exit screening at all international airports and seaports, and initiate clinical trials for candidate therapeutics and vaccines as an immediate priority.

WHO advised all countries to implement exit screening for unexplained febrile illness at international points of entry, ensure contacts of confirmed cases do not travel internationally for 21 days after exposure, and activate rapid response teams capable of investigating and managing cases.

Singapore's Health Minister, Mr Ong Ye Kung, referenced the outbreak directly while speaking at a World Health Assembly Side Event on Pandemic Preparedness in Geneva on 18 May.

"Even as we meet today, the WHO has declared the Ebola outbreak in the Democratic Republic of the Congo and Uganda as a public health emergency of international concern," Mr Ong said. "These are timely reminders that infectious disease threats continue to emerge and evolve."

Mr Ong noted that Singapore's position as a major aviation hub carries specific responsibilities. "Pathogens will come through Singapore, and it will spread from Singapore elsewhere, if we are totally honest," he said. "What the world can be assured of is this, Singapore will share what we know, freely, quickly and transparently, with no strings attached.

Mr Ong then noted that Singapore's position as a major aviation hub carries specific responsibilities. "Pathogens will come through Singapore, and it will spread from Singapore elsewhere, if we are totally honest," he said. "What the world can be assured of is this, Singapore will share what we know – freely, quickly, and transparently, with no strings attached."

WHO said it will convene an Emergency Committee shortly to issue formal temporary recommendations. The agency confirmed the outbreak does not currently meet the criteria for a pandemic emergency, but cautioned that the situation remains fluid and case counts are subject to change.