By Caroline Kimeu

The World Health Organization declared a global health emergency over an Ebola outbreak in the Democratic Republic of Congo and Uganda, warning that the epidemic could still be spreading undetected.

Around 80 deaths and over 200 possible cases have been recorded so far, including four deaths among health workers, the United Nations health agency said.

Concerns over a wider regional outbreak have grown after the detection of a positive case in Congo’s capital Kinshasa, the country’s most densely populated city, and two cases in neighboring Uganda’s capital Kampala. One of the two people, who had traveled separately from Congo, has died.

The outbreak began in Ituri Province, a tropical-forest region of roughly 5.7 million people in Congo’s far northeast, where health facilities are few and far between, and conflict has caused people to flee their homes. The WHO warned these conditions “further compound the risk of spread.” An Ebola outbreak in the region spanning 2018 to 2020—the second-largest on record—caused over 2,000 deaths.

The WHO said the most recent outbreak is likely larger than official figures suggest, pointing to unusual clusters of community deaths in Ituri and the cases discovered in Kinshasa and Kampala.

“The number of cases and deaths we are seeing in such a short time frame, combined with the spread across several health zones and now across the border, is extremely concerning,” said Trish Newport, emergency programs manager for the medical nonprofit Doctors Without Borders.

The recent cases involve the rare and highly contagious Bundibugyo virus, which is less known than the Zaire strain responsible for several past outbreaks. There are currently no approved vaccines or treatments for it.

Ebola, a viral fever, is transmitted through bodily fluids, and has no known cures. Symptoms include fever, fatigue, muscle pain and headaches, typically progressing to vomiting, diarrhea or bleeding.

The virus was first identified in Congo in 1976. The world’s worst outbreaks occurred between 2013 and 2016, beginning in Guinea and sweeping through Sierra Leone and Liberia and leading to more than 11,000 deaths.

The WHO has urged Congo and Uganda to isolate confirmed cases and the people they came in contact with. It advised neighboring countries to take precautionary measures but advised against border closures, saying such steps increase unmonitored irregular crossings that make it harder to contain the disease. The outbreak doesn’t yet represent a pandemic, the agency said.