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Decoding Ebola as a Public Health Emergency of International Concern

On July 17, 2019, the Ebola outbreak in the Democratic Republic of the Congo (DRC) was declared a Public Emergency of International Concern (PHEIC) by the World Health Organization (WHO).

Following is information about the Ebola virus, why it was declared a PHEIC and what this means for the U.S. and other countries.

What Is Ebola Virus Disease?

Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal disease in humans. Ebola virus is a member of the Filoviridae family of viruses, which are lipid-enveloped RNA viruses.

Ebola virus is transmitted through direct contact with blood and body fluids of an infected, symptomatic person, or through exposure to objects (e.g., needles) that have been contaminated with infected fluids. 

Typical Ebola virus symptoms include: fever, severe headache, muscle pain, diarrhea, vomiting, abdominal pain and unexplained hemorrhaging. Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.

During Ebola outbreaks, the disease can spread quickly within healthcare settings (e.g., a clinic or hospital) if staff and other workers are not wearing protective equipment, such as masks, gowns and gloves.

The Centers for Disease and Control Prevention (CDC) recommend 21 complete days of monitoring for symptoms in exposed individuals.

What Is a Public Health Emergency of International Concern?  

The WHO defines a (PHEIC) as an extraordinary event that poses a public health risk to other countries through international spread and potentially requires a coordinated international response. However, it is not necessarily indicative of a worldwide emergency.

The WHO’s announcement was a catalyst to bring more international government attention to the issue, not a declaration that the Ebola outbreak is, or will be, spreading around the globe. Indeed, Ebola is a crisis in the DRC and a real risk to nearby countries. However, the risk of global spread remains low.

PHEIC is a tool to help the WHO manage difficult situations related to transmissible diseases. PHEICs are not new and have been declared with prior outbreaks, such as the 2009 H1N1 flu pandemic and the 2017 Zika virus outbreak. 

During a PHEIC, the WHO can issue temporary recommendations to global governments and public health organizations, such as guidance to keep borders open, allow for ongoing airline travel and continue importation of goods from the affected countries — all in an effort to not penalize the affected nation.

The main intent of issuing a PHEIC for the DRC Ebola outbreak was to raise public health awareness and gain support (financial, humanitarian aid, etc.) from governments around the world.

What Does This Mean for Ebola Cases in the United States?  

A CDC press release supports the WHO’s decision to declare the outbreak a PHEIC. The CDC is currently working with medical and public health organizations and agencies and professionals in affected and neighboring countries to bring an end to Ebola outbreaks. 

Currently, there are no Ebola virus cases in the U.S., and the CDC believes the risk to the U.S. is low based on travel patterns and volume from the outbreak area. 

For health practitioners and public health professionals in the U.S., the CDC’s Ebola website contains a wealth of information and guidelines on diagnosis, prevention and treatment to help prepare people in healthcare to respond to any potential or confirmed Ebola cases.

For more information, visit the WHO Ebola website or the CDC Ebola website.