GENEVA (Biafra24) The international response to an Ebola outbreak in Democratic Republic of the Congo (DRC) is well underway but it is going to be “tough” and “costly”, a World Health Organization (WHO) senior official said today.

Peter Salama, Deputy Director-General of Emergency Preparedness and Response at the World Health Organization (WHO), told journalists in Geneva that the agency was preparing for all eventualities.

This included a “worst case scenario” according to the WHO official, who confirmed that the agency had been notified on Tuesday of the outbreak in Bikoro, Equateur province, western DRC, by authorities in the country.

He said “we have three healthcare workers infected and one, who is being reported as of yesterday, as having died and we know that healthcare workers can really be an amplification factor for these kinds of outbreak. And we know that the number of suspected probable and confirmed cases is significant. So, we are very concerned and we are planning for all scenarios, including the worst-case scenario.”

To date there have been 32 suspected cases of the viral disease, including two laboratory-confirmed cases, 18 probable cases and a dozen cases classified as “suspicious.”

WHO is working closely with authorities in DRC to scale up operations rapidly and mobilize health partners that have helped in recent Ebola outbreaks in Liberia, Guinea and Sierra Leone.

The agency is in discussions with the World Food Programme (WFP) to organise airlifted supplies to the affected area, and to clear ground so that planes can land. UNICEF, the UN Children’s Fund, has also mobilised doctors and water, sanitation and hygiene specialists to help contain the spread of the disease.

Meanwhile the UN Office for the Coordination of Humanitarian Affairs (OCHA), announced an immediate $2 million allocation from the Central Emergency Response Fund (CERF) to help humanitarian partners in the DRC fight the outbreak. The funds will be used for critical health responses such as surveillance, treatment, community mobilization and sensitization, safe and dignified burials, and supporting logistics services.

For the time being the outbreak appears confined to Bikoro Health Zone, which is more than 100 kilometres south of the provincial capital Mbandaka. It is a remote region of Equateur province in DRC where access is extremely limited.

Over the last four decades, DRC has seen eight Ebola outbreaks. The most recent epidemic took place in May 2017 in the health zone of Likati, in the central-northen province of Bas-Uele. This is the fourth time that an Ebola outbreak has been reported in the former province of Equateur, following those of 1976, 1977 and 2014. However, this is the first time that the Bikoro health zone has faced an Ebola outbreak.

Salama said that nine neighbouring countries are on alert although WHO says that there is currently a low risk of the disease spreading. Two of those countries – Central African Republic (CAR) and the Republic of Congo – have a slightly higher level of risk because of their river-based links to DRC.

The WHO official added that implementing an effective response will be dependent on ensuring access from the air and securing sufficient funding.

He said “it is absolutely a dire scene in terms of infrastructure. There are very few paved roads, very little electrification, very poor water and sanitation and as I mentioned, the only way we mount a serious response in this outbreak is through an air-bridge. To give you a sense, we are talking about an area that is 280 kilometers even from the provincial capital of Equateur, so it is going to be extremely challenging in terms of the response. So we need to make sure everyone is aware. This is going to be tough and it’s going to be costly to stamp out this outbreak.”

WHO now has a team on the ground along with UN-partner Médecins Sans Frontieres (MSF), and will have an additional team of between 20 – 40 specialists in epidemiology, logistics, contact-tracing, and vaccination programmes.

Having already deployed personal protective equipment on the ground, WHO plans to have a mobile laboratory up and running by this weekend, following approval from the DRC’s Ministry of Health. The initial focus will be on surveillance and understanding the extent of the outbreak; safe burials; case by case management; and preparing for any public health measures deemed necessary in terms of vaccination. Cold chain and vaccine stockpiles and an experienced team of doctors and epidemiologists are also on emergency standby.

But Salama emphasised that the vaccine “is not a licensed product and there are a lot of complications with using an experimental vaccine which requires to be kept in the long-term at between negative 60 and negative 80 degrees Celsius. This is not a simple logistical effort, it’s not like doing a polio campaign with oral polio vaccines where we get it immediately out to the field. This is a highly complex sophisticated operation in one of the most difficult terrains on earth.”

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