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 The risk to countries in the region was now "high", raised from
"moderate", but the global risk remained "low", the WHO said.
The reassessment came after the first confirmed case in Mbandaka, a
city of around 1.5 million on the banks of the Congo River in the
northwest of the country and close to the border with Cameroon.
The case raised concerns that the virus, previously found in more
rural areas, would be tougher to contain and could reach downstream
to the capital Kinshasa, which has a population of 10 million.
It also followed the announcement by Congo's health ministry of 11
newly confirmed cases in the smaller town of Bikoro, near the
northwest village where the virus was first detected.
"The confirmed case in Mbandaka, a large urban center located on
major national and international river, road and domestic air
routes, increases the risk of spread within the Democratic Republic
of the Congo and to neighboring countries," the WHO said.
WHO Deputy Director-General for Emergency Preparedness and Response
Peter Salama had told reporters on Thursday that the risk assessment
was being reviewed.
"Urban Ebola is a very different phenomenon to rural Ebola because
we know that people in urban areas can have far more contacts so
that means that urban Ebola can result in an exponential increase in
cases in a way that rural Ebola struggles to do."
Later on Friday, the WHO will convene an Emergency Committee of
experts to advise on the international response to the outbreak, and
decide whether it constitutes a "public health emergency of
international concern".
The nightmare scenario is an outbreak in Kinshasa, a crowded city
where millions live in unsanitary slums not connected to a sewer
system.
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Jeremy Farrar, an infectious disease expert and director of the
Wellcome Trust global health charity, said the outbreak had "all the
features of something that could turn really nasty".
"As more evidence comes in of the separation of cases in space and
time, and healthcare workers getting infected, and people attending
funerals and then traveling quite big distances - it's got
everything we would worry about," he told Reuters.
WHO spokesman Tarik Jasarevic said on Friday that Congo's Ministry
of Health had provided updated figures: 45 cases overall since April
4, including 14 confirmed, 10 suspected and 21 probable. There had
been 25 deaths, but no new infections among healthworkers, Jasarevic
told reporters.
The WHO is sending 7,540 doses of an experimental vaccine to try to
stop the outbreak in its tracks, and 4,300 doses have already
arrived in Kinshasa. It will be used to protect health workers and
"rings" of contacts around each case.
The vaccine supplies will be enough to vaccinate 50 rings of 150
people, the WHO said. Each ring represents the number of people
including health workers who may have come into contact with an
Ebola patient.
As of 15 May, 527 contacts had been identified and were being
followed up and monitored.
(Additional reporting by Kate Kelland in London; Writing by Tom
Miles and Edward McAllister; Editing by Matthew Mpoke Bigg)
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