WHO Declares Ebola a Global Public Health Emergency

Megan Brooks

August 08, 2014

The Ebola outbreak raging in West Africa is a global public health emergency that requires a strong and immediate coordinated international response to stop it, the World Health Organization (WHO) said today. However, this does not mean that all, or even many, countries will see Ebola cases.

The current Ebola outbreak in West Africa is the "largest, most severe, and most complex outbreak in the nearly 4-decade history of this disease. [It's] moving faster than we can control it," Margaret Chan, MD, director-general of the WHO, said at a news conference in Geneva, Switzerland.

Guinea, Liberia, and Sierra Leone have been hit hardest by the current Ebola outbreak, which began in March. To date, more than 1700 people have been infected, and at least 932 have died.

Urgent Action Needed

"Countries affected to date simply do not have the capacity to manage an outbreak of this size and complexity on their own," Dr. Chan said. She urged the international community to provide this support on "the most urgent basis possible," saying the Ebola crisis is "a clear call for international solidarity."

The WHO's Public Health Emergency of International Concern (PHEIC) declaration on Ebola came after the first meeting of the International Health Regulations Emergency Committee on Ebola Viral Disease, held August 6 and 7 in Geneva.

The committee was unanimous in their conclusion that the Ebola outbreak meets the PHEIC criteria, defined in the International Health Regulations as "an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response."

"Our collective health security depends on support for containment operations in [affected] countries as soon as possible," Dr. Chan said.

The PHEIC declaration "alerts the world to the need for high vigilance for possible cases of Ebola virus disease, but by no means that all countries, or even many countries, will see Ebola cases," she noted.

Keiji Fukuda, MD, WHO assistant director-general for health security, noted that weak health infrastructures in affected countries are fueling the outbreak.

This outbreak is really the "poster child" for having strong healthcare systems, he said. It is occurring in areas with weak health systems with shortages in critical supplies and health workers, including people who care for patients, run the laboratories, and clean the hospital rooms. Basic needs such as running water and continuous electricity are unreliable in these areas.

Médecins Sans Frontières, or Doctors Without Borders, the organization providing direct patient care, has been "stretched to the limit," Dr. Fukuda said.

"It Can Be Stopped"

He noted that fear, misinformation, and anxiety are also playing a role in the outbreak locally and spreading to other countries. "We now have a lot of questions coming to WHO, and the level of anxiety is definitely high," Dr. Fukuda said.

He emphasized that although Ebola is highly infectious, it can be contained. "It is not mysterious, it can be stopped. We have to basically stop the chain of transmission," he said.

For countries with ongoing active transmission, the committee recommends that the head of state declare a national emergency, which will provide emergency funding and facilitate implementation of control measures, and reach out to opinion leaders in communities to increase awareness.

The committee also recommends that people who are leaving a country with active Ebola transmission be screened for symptoms that may be consistent with Ebola infection. As is appropriate, other measures can be considered, such as quarantine, Dr. Fukuda said.

People with Ebola should be in treatment and kept in isolation for 30 days, the committee recommends. Contacts of infected people should be monitored for 21 days, and during that period, they should not travel. Contacts are people who would have been exposed to the virus in unprotected conditions (not healthcare workers using protective gear), Dr. Fukuda emphasized.

Probable or suspect cases of Ebola should also be isolated until they have 2 blood tests at least 48 hours apart that are negative, he said.

The committee also calls on affected countries to ensure that burials and funerals rites are conducted in accordance with health regulations to reduce the risk for infection, but also in a way that is culturally sensitive.

The US Centers for Disease Control and Prevention currently recommends against traveling to West Africa because of the Ebola outbreak.

Although no Ebola cases have been reported in the United States, the agency asks healthcare providers to be alert for and evaluate suspected patients for Ebola virus infection who have both consistent symptoms and risk factors, which are detailed on the WHO Web site.

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