Boy, 5, and Grandmother Die in Uganda as More Ebola Cases Emerge

https://www.nytimes.com/2019/06/12/world/africa/ebola-uganda-congo.html

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Fears worsened on Wednesday that the year-old Ebola outbreak in the Democratic Republic of Congo could spread to neighboring countries, as a boy in Uganda died from the disease and two of his close relatives there were infected.

The boy, 5, from a Congolese family who had crossed into western Uganda on June 9, was the first confirmed case of Ebola outside the Democratic Republic of Congo since the highly infectious illness erupted last summer in the eastern part of the vast African country.

Signaling his concern, the director-general of the World Health Organization, Dr. Tedros Adhanom Ghebreyesus, announced that he was convening a meeting of a group of outside expert advisers on Friday to assess whether the Ebola spread had become an international public health emergency.

It will be the third such meeting on the Ebola outbreak by the group of experts, known as the International Health Regulations Emergency Committee.

The W.H.O., which reported the first Uganda case on Tuesday, said on Wednesday that the afflicted child had died and that his 50-year-old grandmother and 3-year-old brother were confirmed to have tested positive for Ebola. The organization said that a hospital in a Uganda border town, Bwera, was treating them in isolation and that at least eight people may have been in contact with the first victim, raising the risk of further infections.

“This first death, of a child, is a sickening reminder of the dangers of this disease,” said Brechtje van Lith, the Uganda director for Save the Children, an international charity. In a statement, the charity said that “governments, donors and agencies must act immediately to prevent further deaths.”

On Thursday, a spokesman for Uganda’s Health Ministry, Emmanuel Ainebyoona, confirmed the death of the 50-year-old woman overnight, according to The Associated Press.

Ebola, a viral disease that causes internal bleeding, is spread through bodily fluids of infected people and is extremely contagious.

Infectious disease experts expressed alarm about Ebola’s spillover into Uganda, even though that country has long anticipated that possibility and administered a promising new vaccine to thousands of health workers, as have the health authorities in Congo.

“The confirmation of new Ebola cases in Uganda is tragic but unfortunately not surprising,” Dr. Jeremy Farrar, director of the Wellcome Trust, a London-based health research institution, said in a statement. “This epidemic is in a truly frightening phase and shows no sign of stopping anytime soon.”

Some Ebola experts also expressed concern about the potential spread of Ebola to South Sudan, which like western Uganda also shares a porous border with the afflicted region of Congo. But unlike Uganda, South Sudan has been roiled by instability for years and is not considered well prepared to handle any possible outbreak.

“South Sudan is a whole different ballgame,” Adrian Ouvry, humanitarian adviser at Mercy Corps, an international charity, said by phone from South Sudan, where he was on a working visit. “It is much less developed than Uganda or even the D.R.C.”

The Congo outbreak is the second-deadliest on record, infecting more than 2,071 people and causing at least 1,396 deaths in the country as of June 10, according to the W.H.O. Its epicenter in a conflict zone has complicated efforts to contain the disease.

Health workers, including doctors, have been attacked and killed, and some treatment centers have been destroyed. In April, the Islamic State claimed its first assault in the affected area.

International health experts also have expressed worry about an acceleration in the number of Ebola infections. While it took about eight months to reach 1,000 cases, it has taken only a few months to surpass 2,000.

The W.H.O.’s Emergency Committee has twice before concluded that the outbreak does not represent a global health threat, partly because it had not spread across borders.

“Now that there is confirmed international spread, I think they have no choice but to make the declaration,” said Dr. Rebecca Katz, director of the Global Center for Health Science and Security at Georgetown University.

Declaring the outbreak as such a health threat, known as a Public Health Emergency of International Concern, would increase the level of attention that the W.H.O.’s member countries devote to combat it.

After the committee’s most recent conclusion, in April, its chairman, Robert Steffen, said the experts were optimistic that the outbreak could be brought under control “within a foreseeable time.”

The largest Ebola outbreak in history ravaged the West African nations of Guinea, Liberia and Sierra Leone from 2014 to 2016, killing more than 11,300 people.

The current outbreak is the most severe in the Democratic Republic of Congo since the disease was discovered there in 1976, when the country was known as Zaire. During that outbreak, the virus infected 318 people and killed 280 in an area near the Ebola River.

In the United States, confirmation of the current outbreak’s spread into Uganda led the Centers for Disease Control and Prevention to announce new actions on Wednesday.

The C.D.C., which has been providing health officials in Congo and the surrounding region with Ebola expertise, said it was activating an emergency operations center at its Atlanta headquarters that would provide “increased operational support for the response to meet the outbreak’s evolving challenges.”

While the risk of a global spread “remains low,” the C.D.C. said in the announcement, it wanted to “ensure the response to this outbreak is robust and well-coordinated to stop the spread of disease and end the outbreak.”