Medical workers are seen disinfecting and performing medical checks inside the unconfirmed Ebola patients ward run by The Alliance for International Medical Action (ALIMA) on August 12, 2018, in Beni.
JOHN WESSELS—AFP/Getty Images
By Jamie Ducharme
Updated: October 17, 2018 3:42 PM ET

The World Health Organization (WHO) said Wednesday that a worsening Ebola outbreak in the Democratic Republic of the Congo (DRC) does not constitute an international public health emergency, but stressed in a statement that it remains “deeply concerned” about the situation.

The emergency meeting, which was held at the United Nations’ headquarters in Geneva, was called about a month after the WHO upgraded Ebola’s risk level in the DRC from “high” to “very high,” according to a UN statement. At that time, global risk was deemed low and the WHO did not recommend limiting travel or trade in and out of the DRC.

The outcome of Wednesday’s meeting could have changed that designation, but WHO officials decided that the situation is not currently a public health emergency of international concern. Nonetheless, officials urged “ongoing vigilance” from health workers in the DRC and neighboring countries, and recommended accelerated preparedness and surveillance efforts and potential vaccination of those at risk of contraction in surrounding areas.

Here’s what to know about the Ebola outbreak in the DRC.

How severe is the Ebola outbreak?

The DRC’s current Ebola outbreak, its 10th in 40 years, was officially declared on Aug. 1, shortly after the end of another outbreak in the country that claimed 33 lives. As of Oct. 15, the WHO had recorded 181 confirmed cases of Ebola, as well as 35 suspected cases. Nearly 140 deaths have been reported, including 104 confirmed to be a result of Ebola. About half of confirmed cases were reported in the Beni and Mabalako health zones, located in the country’s populous North Kivu Province, according to a recent WHO case report. The disease appears to be spreading in the Beni, Butembo and Mabalako health zones.

Fifty people had been successfully treated for Ebola and released back into their communities as of Oct. 7, the case report says.

Is Ebola spreading?

Ebola — a rare and severe virus that causes fatigue, muscle and stomach pain, vomiting, diarrhea and unexplained bleeding — can be quite contagious and is spread through direct contact with infected people or their bodily fluids, according to the Centers for Disease Control and Prevention. While no cases of the virus have been confirmed outside the DRC, according to the WHO’s most recent case report, one was confirmed near the Ugandan border in late September. The WHO and the Ministry of Health are keeping a close eye on countries that share borders with the DRC, including Uganda, Rwanda and South Sudan.

A number of factors could allow disease transmission to extend beyond the DRC’s borders, raising red flags. “The EVD outbreak in the Democratic Republic of the Congo remains at a critical juncture due to the prevailing security threats, community reluctance and increased geographical spread,” the WHO case report says. “Response teams continue to face challenges that require ongoing community engagement efforts, as well as the ability to adapt strategies according to context.”

One of the primary issues is a long-standing humanitarian crisis in the DRC that has worsened over the past year, forcing millions of people to flee their homes, according to the UN. More than 4 million people in the DRC are considered displaced — including more than a million in North Kivu Province alone — leading to “continuous movement of refugees to neighboring countries,” the WHO says. This movement, along with travel within the DRC, could increase the disease’s chances of spreading, the WHO says. Plus, security concerns and community resistance in North Kivu and Ituri provinces have stifled response and monitoring efforts in these areas, and made it more difficult to carry out “safe and dignified burials” that can curb disease spread.

Several other diseases are also currently circulating in the DRC, including polio, cholera, measles and monkeypox.

What’s being done about the Ebola outbreak?

The WHO continues to closely monitor and respond to affected and at-risk areas. Multiple hospitals in the DRC now have the capacity to confirm diagnoses of Ebola with laboratory testing, and procedures are in place for treating and isolating patients suspected or known to have the virus. (Nonetheless, the WHO says some hospital visitors still show “resistance” to containment procedures, another risk factor for disease transmission.)

Health workers have also been using a new, experimental Ebola vaccine to help stop the virus’ spread. More than 15,000 people have been vaccinated so far, including more than 6,000 health care or front-line workers and more than 3,000 children, the WHO says. The vaccine, which is made by Merck, has been shown in field testing to potentially reduce infection rates, and showed some success during the last outbreak in the DRC. Merck has provided thousands of the vaccines to health authorities for emergency use, but it’s still considered experimental since ethical concerns have barred scientists from performing the types of controlled clinical trials usually used to test new drugs.

Write to Jamie Ducharme at jamie.ducharme@time.com.

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