Large outbreaks of Ebola “the new normal”, WHO warns

Large scale outbreaks of deadly diseases such as Ebola will soon become “the new normal”, the World Health Organisation has warned.

A health worker sprays disinfectant on his colleague after working at an Ebola treatment center in Beni, eastern Congo. Picture: AP Photo/Al-hadji Kudra Maliro

Medical staff in the Democratic Republic of Congo is currently battling the second largest outbreak ever, just three years after the world’s largest one ended.

There have been 2,025 cases of Ebola and 1,357 deaths from the virus during the outbreak in the Democratic Republic of Congo.

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The largest outbreak, in West Africa in 2014-16 affected 28,616 people mostly in Guinea, Liberia and Sierra Leone. There were 11,310 deaths.

This is a stark jump from previous outbreaks which affected relatively small numbers of people.

The 12 outbreaks between 2000 and 2010 averaged fewer than 100 cases.

Experts from the WHO have warned this is indicative of a “new phase” of deadly viral epidemics and said countries and professional bodies around the world needed to focus on preparing to deal with the consequences.

Michael Ryan, the executive director of the WHO’s health emergencies programme, said factors such as climate change, emerging diseases, exploitation of the rainforest, large and highly mobile populations, weak governments and conflict were making outbreaks more likely to occur - and more likely to rapidly grow in scale once they did.

Dr Ryan said the World Health Organization was currently tracking 160 disease events around the world. Of these, nine have been given the highest emergency level of risk.

“We are entering a very new phase of high impact epidemics and this isn’t just Ebola,” he said. “I don’t think we’ve ever had a situation where we’re responding to so many emergencies at one time. This is a new normal, I don’t expect the frequency of these events to reduce.”

He warned that countries needed to “get to grips with readiness [and] be ready for these epidemics”.

In the DR Congo, the rising number of people affected by the ongoing outbreak is continuing to cause extreme concern among health officials.

It took 224 days for the number of cases to reach 1,000, but just a further 71 days to reach 2,000. Tackling the disease has been complicated by conflict in the region - between January and May there were more than 40 attacks on health facilities.

Another problem is distrust of healthcare workers with about a third of deaths being in the community. It means people are not seeking treatment and risk spreading the disease to neighbours and relatives.

Dr Ryan warned that the Ebola epidemic was not under control and was spreading fast in certain areas, including the rural area of Mabalako, with violent unrest in the region preventing detection.

“We believe, let me be very cautious here, we believe we are probably detecting in excess of 75 per cent of cases – we may be missing up to a quarter of cases,” he said at a press conference in Geneva.

“We must get earlier detection of cases, have more exhaustive identification of contacts.”

The WHO was forced to temporarily halt response activities in April after Richard Valery Mouzoko Kiboung, an epidemiologist, was killed when armed militia attacked a hospital.

Dr Josie Golding, the epidemics lead at the Wellcome Trust, agreed the world needed to get better at preparing for such outbreaks.

“With Ebola in West Africa, that was the mobility of people and porous borders - that is now the world we live in, that won’t stop,” she said.

“Preparedness needs to be better, we can see movement of populations and climate change, a lot of this we can see coming, and we need more resources to plan and prepare.”