KINSHASA, DR Congo (AFP)—The World Health Organization declared an international health emergency on Sunday over an outbreak of an Ebola strain in the Democratic Republic of Congo that has killed more than 80 and for which there is no vaccine.

Fears of further spread grew when a laboratory on Sunday confirmed a case in the major eastern DRC city of Goma, which is controlled by the Rwanda-backed M23 militia.

A total of 88 deaths and 336 suspected cases of the highly contagious haemorrhagic fever have so far been reported, the Africa Centres for Disease Control and Prevention (CDC Africa) said in an update on Saturday.

“A positive case in Goma has been confirmed by tests carried out by the laboratory. It involves the wife of a man who died of Ebola in Bunia, who travelled to Goma after her husband’s death whilst already infected,” Professor Jean-Jacques Muyembe, director of the Congolese National Institute for Biomedical Research (INRB), told AFP.

WHO director general Tedros Adhanom Ghebreyesus expressed deep disquiet as the reported cases rise.

“I determine that the epidemic constitutes a public health emergency of international concern,” Ghebreyesus posted to X, albeit adding that as yet it “does not meet the criteria of pandemic emergency” as defined by existing international health regulations (IHR).

As things stand therefore, the Geneva-based WHO has declared its second-highest level of alert under IHR — a pandemic being the highest — with the global health body warning the scale of the current outbreak remains unclear.

“There are significant uncertainties to the true number of infected persons and geographic spread,” the WHO noted.

Medical aid group Doctors Without Borders (MSF) said it was preparing a “large-scale response”, calling the rapid spread of the outbreak “extremely concerning”.

“The Bundibugyo strain has no vaccine, no specific treatment,” DR Congo’s Health Minister Samuel-Roger Kamba said.

“This strain has a very high fatality rate, which can reach 50 percent.”

– Patient zero –

The strain — first identified in 2007 — has also killed a Congolese national in neighbouring Uganda, officials said Saturday.

Vaccines are only available for the Zaire strain, which was identified in 1976 and has a higher fatality rate of 60-90 percent.

Health officials had confirmed the latest outbreak Friday in Ituri province in northeastern DRC, bordering Uganda and South Sudan, according to CDC Africa.

“We’ve been seeing people die for the past two weeks,” said Isaac Nyakulinda, a local civil society representative contacted by AFP by phone.

“There is nowhere to isolate the sick. They are dying at home and their bodies are being handled by their family members.”

According to Kamba, patient zero was a nurse who reported to a health facility in Ituri’s provincial capital Bunia on April 24, with symptoms suggesting Ebola.

Symptoms of the disease include fever, haemorrhaging and vomiting.

“The number of cases and deaths we are seeing in such a short timeframe, combined with the spread across several health zones and now across the border, is extremely concerning,” says Trish Newport, MSF Emergency Programme Manager, which is mobilising medical and support staff to the area.

Large-scale transport of medical equipment is a challenge in the DRC, a country of more than 100 million people which is four times the size of France but has poor communications infrastructure.

– High risk of spread –

It is the 17th Ebola outbreak to hit the DRC, and officials warned of a high risk of spread.

With the outbreak largely concentrated in difficult to access areas few samples have been lab tested.

But the WHO said the high positivity rate of initial samples, the confirmation of cases in two countries, and the increasing reports of suspected cases “all point towards a potentially much larger outbreak than what is currently being detected and reported, with significant local and regional risk of spread”.

The previous outbreak of Ebola was last August in the region, with at least 34 people dying before it was declared eradicated in December.

The disease, over the past 50 years, has killed around 15,000 people in Africa, despite advances in vaccines and treatment.

Nearly 2,300 people died in the deadliest outbreak in the DRC between 2018 and 2020.

Ebola, believed to have originated in bats, can cause severe bleeding and organ failure.

Outbreaks over the past half century have seen a mortality rate among those affected of between 25 percent and 90 percent, according to WHO

The virus spreads from person to person through bodily fluids or exposure to the blood of an infected persons, who become contagious only once they display symptoms. The incubation period can last up to 21 days.