Ebola outbreak in remote Congo presents huge challenge, WHO says

An Ebola outbreak affecting up to 20 people in an extremely remote area in the Congo presents a high risk at a national level, the WorldHealth Organization (WHO) said on Thursday.

In an update on an outbreak that officials believe began inlate April, the United Nations health agency said there weretwo confirmed and 18 suspected cases of Ebola infection.

Three people have died among the suspected and confirmedcases, including a 39-year-old man thought to be the first, orso-called "index" case.

Peter Salama, the WHO's executive director for healthemergencies, said the agency's risk assessment on the outbreakwas that it is high at a national level, medium at Africanregional level and low at global level.

However, he added: "We cannot underestimate the logistic andpractical challenges associated with this response in a veryremote and insecure part of the country.

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"As of now, we do not know the full extent of the outbreak,and as we deploy teams over the next few weeks, we will begin tounderstand exactly what we're dealing with," Salama toldreporters on a telephone briefing.

He said the immediate priority would be to trace the around400 recorded contacts of the suspected and confirmed cases.

This latest Ebola outbreak is eighth in Congo, also known asCongo-Kinshasa, the most ofany country. The deadly hemorrhagic fever was first detected inits dense tropical forests in 1976 and named after the nearbyriver Ebola.

The WHO said the outbreak is centred in the Likati HealthZone in the remote province of Bas-Uele in northeastern Congonear the border with Central African Republic.

Salama described the area, which is around 1,400 kilometresfrom the capital Kinshasa, as isolated and hard-to-reach, withvirtually no functioning telecommunications and few paved roads.

Asked about the potential for using an experimental vaccine,Salama said the logistics were "complex" but that the WHO wasworking with Congo's government and regulatory authorities.

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The vaccine, known asrVSV-ZEBOV,developed by the Canadian government and now Merck,is not yet licensed. Itwas shown to be highlyprotective against Ebola in clinical trials published lastDecember.

To use the vaccine, Salama said the WHO would need afully-approved protocol signed off by regulators, the governmentand ethics committees, as well as the logistics in place to gaininformed consent from all those offered it and to transport andstore it at the required minus 80 degrees Celsius.

"In an area without telecommunications, without road access,without large-scale electrification, this is going to be anenormous challenge," he said.

"But we are committed to working with partner agencies toimplement a vaccination campaign if the [Congo]government givesus a green light."

The three deaths so far are the "index" case the man whofell sick and sought medical care on April 22 a motorcyclerider who took him to hospital, and another person who cared forhim en route.