People living close to the epicentre of an Ebola outbreak which has killed 131 people have told BBC News of their fear, as a World Health Organization (WHO) representative warned cases may be spreading faster than originally thought.

An Ebola outbreak in the Democratic Republic of Congo has been declared a public health emergency of international concern, by the World Health Organization (WHO).

The latest outbreak is challenging because it involves a rare strain of Ebola for which there is no vaccine, and cases have been found in an area affected by conflict.

One man in the Democratic Republic of Congo’s Ituri province, the epicentre of the outbreak, said infected people were dying « very fast », and added: « Ebola has tortured us. »

Officials said more than 513 cases were suspected in DR Congo as of Tuesday, while one person has died in neighbouring Uganda.

The WHO’s Dr Anne Ancia told the BBC that the more the agency investigates the outbreak, the clearer it becomes cases have spread to other areas.

Modelling by the London-based MRC Centre for Global Infectious Disease Analysis released on Monday suggested there had been « substantial » under-detection, and that it could not rule out there had already been more than 1,000 cases.

The study suggested that the current outbreak is « larger than currently ascertained » and that its « true magnitude remains uncertain ».

A man who spoke to BBC News and identified himself as Bigboy said people are « really scared » and doing what they can to protect themselves.

He said locals are taking precautions such as washing hands with clean water, but added that he wished they could get access to other protective supplies such as face masks.

Another Ituri local, Alfred Giza, said people in the community are aware of the threat and waiting to receive face masks to protect themselves, but that he would not know what to do if a family member or friend contracted the disease.

The Red Cross warned that Ebola can escalate quickly if cases are not identified early, communities lack information and health systems are overwhelmed, adding that « we are seeing all those conditions » in the current outbreak.

On Tuesday, DR Congo President Félix Tshisekedi called for « calm » and urged Congolese citizens to remain vigilant, after holding a crisis meeting on Monday evening.

WHO chief Tedros Adhanom Ghebreyesus, who declared the outbreak an international emergency last week, said he was « deeply concerned about the scale and speed of the epidemic ».

It is feared the outbreak may have been ongoing for several weeks before it was first detected on 24 April.

There is no vaccine for the strain of Ebola virus fuelling the latest rise in cases, but the WHO is evaluating whether other drugs may provide protection.

Speaking to BBC Newsday, Ancia said DR Congo’s Ituri province was a « very unsecured area with lots of movement of population », making it difficult for the agency to investigate and help control the disease.

She continued: « The more we are investigating this outbreak, the more we realise that it has already disseminated at least a little bit across border and also in other provinces. »

The outbreak has spread to the province of South Kivu, where the population has been affected by a humanitarian crisis for many years, she added.

There has also been a case in eastern DR Congo’s biggest city, Goma, which has a population of around 850,000 people and under the control of Rwandan-backed rebels.

High levels of insecurity in several provinces mean people move around often, increasing the risk and spread of the virus, she said.

Several African countries are taking precautions by tightening border screenings and preparing health facilities. Neighbouring Rwanda has also closed its borders with DR Congo. Uganda has told people to avoid hugging and shaking hands.

An American citizen, believed to be missionary group doctor Peter Stafford, is being evacuated from DR Congo after developing symptoms over the weekend.

Germany’s health ministry told the BBC a US citizen was being taken to the country for treatment.

The US Centers for Disease Control and Prevention (CDC) said it was working to evacuate at least six other Americans who were exposed.

WHO and other agencies are working with governments and communities to try to stop the spread of the virus, urging residents to follow preventative measures and report to the nearest health facility if they experience any symptoms.

What is Ebola and how does it spread?

Ebola is caused by a virus and initially causes symptoms similar to the flu, with fever, headache and tiredness.

As the disease progresses, vomiting and diarrhoea develop and it can lead to organ failure. Some, but not all, patients develop internal and external bleeding.

The virus spreads from one person to another by contact with infected bodily fluids such as blood or vomit.

The Bundibugyo strain fuelling this rise in cases is rare, and has previously only caused two outbreaks, when it killed about a third of those infected.

Between 2014 and 2016, more than 28,600 people were infected by Ebola in West Africa, the largest outbreak of the virus since its discovery in 1976.

It was caused by the Zaire strain, for which there is an approved vaccine.

The disease spread to a number of countries in West Africa and beyond, including Guinea, Sierra Leone, the US, UK and Italy, killing 11,325 people.

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Free HIV tests that can be done at home are being offered this week to people in England.

It is part of a government drive to improve diagnosis, which dropped off during the Covid pandemic.

The kit is small enough to fit through the letterbox and arrives in plain packaging through the post.

It gives a result within 15 minutes by testing a drop of blood from a finger prick. A « reactive » result means HIV is possible and a clinic check is needed.

Support and help is available to arrange this.

If the result is negative it means the test did not detect HIV. If you think you are at risk of HIV, however, you should test every three months because it can take a while for the virus to show in the blood.

About 4,400 people in England are living with undiagnosed HIV, which comes with serious health risks.

HIV medication can keep the virus at undetectable levels, meaning you cannot pass HIV on and your health is protected.

Most people get the virus from someone who is unaware they have it, according to the Terrence Higgins Trust (THT) charity which campaigns about and provides services relating to HIV and sexual health.

HIV testing rates remain a fifth lower than before the Covid-19 pandemic – with heterosexual men in particular now testing far less than in 2019.

Testing among gay and bisexual men has increased but rates of testing among women have fallen by 22% compared to 2019, while there has been a 41% drop for heterosexual men.

Straight men and women are also far more likely to be diagnosed at a late stage.

THT has been working with the BBC drama EastEnders to raise awareness of HIV among heterosexuals through a storyline where a lead character called Zack Hudson is diagnosed with the virus.

Taku Mukiwa, head of health programmes at THT, said: « Gay and bisexual men and black African people continue to be the most impacted by HIV in the UK, but anyone who’s sexually active can be affected and should think about testing.

« As the EastEnders HIV storyline we’ve been advising on shows, the truth is it’s always better to know your HIV status, whether positive or negative.

« If it’s negative, you can make sure it stays that way.

« While, as Zack in EastEnders is learning, huge advances in HIV treatment mean you can live a long healthy life with the virus, have children who are HIV-negative and that HIV can’t be passed on to anyone else. »

People can live with HIV for a long time without any symptoms. Testing is the only way to know your HIV status.

Using a condom during sex can prevent infections.

Dr Alison Brown, interim head of HIV surveillance at the UK Health Security Agency, said: « HIV does not discriminate, no matter your gender or sexual orientation.

« Taking up a free and confidential HIV test regularly when having condom-less sex will ensure you’re diagnosed early and started on effective treatment, helping to reduce transmission of HIV and the number of people with undiagnosed HIV. »

It is recommended that anyone who is sexually active tests for HIV annually, and more regularly if you have a new or multiple partners.

The free testing initiative coincides with National HIV Testing Week and making progress towards the government’s goal of ending new HIV cases by 2030.

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Israel, Switzerland and Austria are the latest countries to confirm cases of monkeypox, bringing the total number of nations reporting outbreaks to 15.

Israel and Switzerland both said they identified one infected person who had recently travelled abroad. Israel is investigating other suspected cases.

Monkeypox does not tend to spread easily between people and the illness is usually mild.

The virus is most common in remote parts of Central and West Africa.

More than 80 cases have been confirmed in the recent outbreak in Europe, the US, Canada and Australia.

This outbreak has taken scientists by surprise, but the risk to the wider public is said to be low. Most people who catch the virus recover within a few weeks, according to the UK’s National Health Service.

The World Health Organization has said a number of other suspected cases are being investigated – without naming the countries involved – and warned that more infections are likely to be confirmed.

Asked about the outbreak as he finished a visit to South Korea, US President Joe Biden said that if the virus were to spread more widely it would be « consequential », adding that « it is something that everybody should be concerned about ».

He said the US was « working hard » on its response and what vaccines in might use.

After the outbreak was first identified in the UK, the virus began to be detected across Europe – with public health agencies in Spain, Portugal, Germany, Belgium, France, the Netherlands, Italy and Sweden all confirming cases.

The UK Health Security Agency has identified 20 cases so far and its chief medical adviser Dr Susan Hopkins told the BBC’s Sunday Morning programme: « We are detecting more cases on a daily basis. »

She said the virus is now spreading in the community – with cases detected which have no contact with anyone who has visited West Africa, where the disease is endemic.

But the risk to the general population remains « extremely low », with cases so far mostly found in some urban areas and among gay or bisexual men, Dr Hopkins said.

Although there is no specific vaccine for monkeypox, several countries have said they are stocking smallpox vaccines, which are about 85% effective in preventing infection because the two viruses are quite similar.

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Le représentant de l’OMS en Guinée a annoncé dimanche le déploiement rapide de moyens pour faire face à la résurgence de l’épidémie d’Ebola. Le pays a confirmé au moins sept cas dont trois mortels.

L’alerte intervient après la confirmation d’au moins sept, peut-être huit cas, dans le sud-est du pays région proche de la frontière avec le Libéria. Trois personnes en tout cas sont mortes, mais un quatrième décès est peut-être aussi imputable au virus.

Il s’agit de la première résurgence signalée de la maladie en Afrique de l’Ouest, d’où était partie la pire épidémie de l’histoire d’Ebola, qui avait fait plus de 11’300 morts entre 2013 et 2016.

Réaction immédiate de l’OMS

L’organisation mondiale de la Santé (OMS) va déployer rapidement des moyens, dont des doses de vaccins, pour aider la Guinée, a indiqué le représentant de l’agence de l’ONU à Conakry.

« Nous allons déployer rapidement les capacités nécessaires pour appuyer la Guinée, qui a déjà une grande expérience », a déclaré devant la presse le professeur Alfred George Ki-Zerbo à l’issue d’une réunion avec les autorités sanitaires du pays.

« L’arsenal est aujourd’hui plus étendu et nous devons en tirer profit pour pouvoir circonscrire cette situation le plus rapidement possible. L’OMS est alertée à tous les niveaux, au niveau du siège et en lien avec le fabriquant (de vaccins), pour que les doses nécessaires soient mises à disposition le plus rapidement possible pour aider à cette riposte », a-t-il ajouté.

Le Libéria en état d’alerte sanitaire

Le président libérien a ordonné dimanche aux professionnels de la santé de renforcer la vigilance épidémiologique dans le pays et de prendre « des mesures préventives ».

« George Weah, a demandé aux autorités sanitaires libériennes et à leurs partenaires du secteur de renforcer la surveillance épidémiologique et les mesures préventives en raison de la résurgence du virus mortel d’Ebola en Guinée voisine », a indiqué dans un communiqué la présidence libérienne.

Cette dernière assure cependant qu’aucun cas n’a encore été détecté sur le territoire du Libéria.

Résurgence aussi en RDC

La République Démocratique du Congo a également annoncé, le 7 février, une nouvelle « résurgence » de la maladie dans l’Est du pays, où l’OMS a dépêché une équipe d’épidémiologistes et se prépare à une campagne de vaccination dans la zone touchée. En date du 10 février, les autorités congolaises avaient enregistré deux décès dûs à cette nouvelle vague d’Ebola dans la province du Nord-Kivu.

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Le chef de l’Organisation mondiale de la santé (OMS) a salué ce lundi des « nouvelles encourageantes » sur le front des vaccins. Moderna a en effet annoncé, dans la journée, une efficacité de son vaccin contre le Covid-19 de l’ordre de 94,5%. Un record jusqu’ici, alors que Pfizer/BioNTech tablait sur une efficacité de 90%, contre 92% pour Spoutnik-V, le sérum russe. Tedros Adhanom Ghebreyesus a cependant souligné que « l’heure n’est pas à la complaisance ».

« C’est un virus dangereux, qui peut attaquer tous les systèmes du corps. Les pays qui laissent le virus circuler librement jouent avec le feu », a rappelé le directeur général de l’OMS, lors d’une conférence de presse. « Nous continuons à recevoir des nouvelles encourageantes sur les vaccins et restons prudemment optimistes quant à la possibilité que de nouveaux outils commencent à arriver dans les prochains mois », a-t-il dit.

L’UE approuve un contrat de vaccin avec CureVac

La Commission européenne a annoncé ce lundi avoir approuvé un nouveau contrat de vaccin contre la Covid-19, le cinquième de ce type, avec le groupe pharmaceutique allemand CureVac, pour 405 millions de doses, et espère en signer un sixième « bientôt » avec l’américain Moderna. 

Bruxelles avait annoncé mercredi un contrat avec l’américain Pfizer et l’allemand BioNTech prévoyant « jusqu’à 300 millions de doses » achetées. Trois autres contrats ont été conclus avec AstraZeneca, Johnson & Johnson (400 millions de doses chacun) et le duo le duo franco-britannique Sanofi-GSK (jusqu’à 300 millions de doses). 

De nouvelles restrictions aux Etats-Unis

Face à la flambée de nouveaux cas aux Etats-Unis, États et métropoles ont réintroduit des restrictions ces derniers jours. Le nombre de cas recensés aux Etats-Unis dépasse désormais les 11 millions, avec plus de 246 000 morts depuis le début de la pandémie. 

A l’approche de la fête de Thanksgiving, le 26 novembre, habituellement occasion de grandes réunions familiales, une série de mesures ont été annoncées, très variables selon les Etats, sans aller jusqu’au confinement sauf au Nouveau-Mexique, où la gouverneure démocrate Michelle Grisham a instauré un ordre de confinement pour deux semaines. A New York, où le taux de positivité des tests reste inférieur à 3%, le gouverneur Andrew Cuomo a imposé depuis vendredi un couvre-feu aux bars et restaurants, qui doivent fermer à 22h00.  

Différence notoire par rapport au printemps : une majorité d’Etats – 31 sur 50, dont des Etats aux gouverneurs républicains généralement plus hostiles aux restrictions que les démocrates – imposent désormais le port du masque. Y compris le très rural Dakota du Nord, où le républicain Doug Burgum a imposé la mesure samedi après s’y être longtemps refusé.  

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