And why do we need the CDC???

Global scramble to contain new Ebola outbreak as US moves to limit entry from virus-hit region

By Helen Regan, Brenda Goodman

An international effort is underway to contain an Ebola outbreak in the Democratic Republic of Congo (DRC) and Uganda that has infected hundreds of people and caused dozens of suspected deaths, with the United States triggering a public health law to limit entry from the affected region.

On Sunday, the World Health Organization (WHO) declared the Ebola epidemic a “public health emergency of international concern.” The latest outbreak does not yet meet the criteria of a “pandemic emergency,” but WHO warned the high positivity rate and increasing number of cases and deaths across health zones point toward “a potentially much larger outbreak than what is currently being detected and reported.”

More than 100 suspected deaths have been linked to the outbreak in the DRC, the director-general of the Africa Centres for Disease Control and Prevention (Africa CDC), Jean Kaseya, told CNN on Monday.

Health workers at Bunia’s Universelle Clinic in eastern Democratic Republic of the Congo are taking preventative measures as concern grows over Ebola in the region. CNN

That same day the US Centers for Disease Control (CDC) and Prevention invoked Title 42 – a public health law that restricts entry into the US during outbreaks of communicable diseases – for at least 30 days starting Monday.

Title 42 has been on the books since 1944, but has only been used twice in the modern era. The first time was from March 2020 to May 2023 during Covid-19. Monday’s action on Ebola marks the second.

Dr. Jeanne Marrazzo, chief executive officer of the Infectious Disease Society of America, says restricting immigration can stem the spread of an infection, but only if measures are coupled with exit screening from affected countries and with attention to human rights.

“Singling out non-US passport holders singles out non-US citizens,” she said. “Pathogens don’t recognize passports.”

The CDC assessed the immediate risk to the US public as “low,” but added that officials would track the “evolving situation,” in a statement on Monday.

There have been 10 confirmed cases and 336 suspected cases in the DRC, the US CDC reported Sunday. WHO said the outbreak is affecting the country’s remote northeastern Ituri province. In neighboring Uganda, two laboratory-confirmed cases, including one death, have so far been reported in the country’s capital Kampala, WHO reported.

The latest outbreak is being driven by the Bundibugyo strain, one of several viruses that can cause Ebola disease, WHO said. The organizaton has called the outbreak “extraordinary” as there are currently no approved treatments or vaccines specific to the Bundibugyo virus.

Ebola symptoms include fever, muscle pain, rash and sometimes bleeding. The virus is transmitted through direct contact with bodily fluids, including the handling of contaminated materials or someone who has died from the disease.

Americans to be relocated

From Monday, US health officials will enforce a range of mechanisms to try and curb the Ebola outbreak, including enhancing public health screenings for those arriving from impacted regions and placing restrictions on non-US passport holders if they have traveled to Uganda, the DRC or South Sudan in the past three weeks.

The sweeping measures came after the CDC announced it was supporting interagency partners with efforts to relocate “a small number of Americans who are directly affected” by the outbreak. Several Americans in the DRC are believed to have been exposed to the virus, including some deemed high risk, health news outlet STAT reported Sunday.

CNN could not independently verify the reports and has reached out to the CDC for comment.

Dr. Satish Pillai, the CDC’s Ebola response incident manager, declined on Sunday to say whether any Americans were among those who had been infected. At a press briefing, he said the CDC was “actively assessing the situation on the ground and we aren’t going to comment on individual disposition.”

The US State Department did not confirm whether any Americans had been exposed to the virus in response to a CNN request for comment, but said the US government was “working with the governments of the DRC and Uganda to rapidly contain the virus.” On Sunday, the State Department issued new advisories warning against travel to the DRC and Uganda due to the outbreak.

The CDC said it was deploying resources from the agency’s offices — who were already in the country — to help with efforts including surveillance, contact tracing and laboratory testing, and would mobilize additional support from the agency’s headquarters in Atlanta.

Pillai said the CDC was unaware of any exposure on international flights and noted that both countries have exit screening measures in place to prevent spread of the virus through travel.

International coordination is being ramped up to prevent the epidemic’s spread as experts warn of “extremely concerning” conditions. The DRC’s health minister, Samuel Roger Kamba, said Sunday that three treatment centres were being opened in the affected region to increase capacity amid the outbreak.

About seven metric tons of emergency medical supplies, including protective equipment, tents and beds, arrived in the Ituri capital Bunia on Sunday to “help scale up frontline response efforts,” according to WHO.

And non-governmental organizations like MSF are also preparing to launch large-scale responses as quickly as possible.

Complicating the response is that the outbreak is occurring on top of a humanitarian crisis, where conflict in the DRC’s eastern provinces has displaced millions of people and weakened health systems.

In Uganda, the two confirmed cases in Kampala have no known connection to each other, which is “often a warning sign that the outbreak in the DRC is larger than health authorities can currently see,” Adrian Esterman, professor and chair of Biostatistics at Adelaide University, said in a statement.

As a result, the US embassy in Kampala announced Monday it had temporarily paused all visa services in light of the ongoing Ebola outbreak.

What we know about the latest Ebola outbreak after WHO declares global health emergency

Dr. Matt Mason, senior lecturer for the School of Health at the University of the Sunshine Coast in Australia, said this “raises serious concerns about gaps in infection prevention and control and the potential for amplification within health facilities, leading to the wider community.”

This is the 17th Ebola outbreak in the DRC since the virus was first identified in 1976, according to WHO. The country is particularly prone to Ebola outbreaks in part because the virus’ “natural reservoir” is the fruit bat, which are found within the DRC’s forested areas, public health expert Ahmed Ogwell, former deputy director-general of Africa CDC, told CNN. Locals in those areas are closely engaged with the forest, meaning they are very exposed to the bats and with them the virus, Ogwell said.