Kenya’s first confirmed Kenya Ebola case has set off a race to trace everyone who came near a 40-year-old man who traveled from the Democratic Republic of the Congo to Nairobi before he was diagnosed. He died on Oct. 5, and Kenyan authorities have now identified 66 people who may have been in contact with him after he arrived, the BBC reported.
The patient carried the Bundibugyo species of Ebola, the same strain behind the large outbreak in eastern Congo that began in May. As of Oct. 6, Congo had recorded 8,728 confirmed cases and 4,205 confirmed deaths, according to the World Health Organization (WHO).
How the Kenya Ebola case slipped through
According to the WHO, the patient was a Kenyan citizen who had lived in Congo and fell ill there about a month before reaching Kenya, receiving care at several health facilities. The BBC reported that on Oct. 1 he traveled to Beni and then to Kasindi, a town on the Ugandan border. He then went by road to Kampala, Uganda’s capital, and flew from Entebbe International Airport to Nairobi on Oct. 3.
He was not flagged at airport health screening in Uganda or at Nairobi’s Jomo Kenyatta International Airport (JKIA). A relative collected him and drove him straight to Nairobi Hospital, a private facility, where he was isolated. A sample taken on Oct. 5 tested positive at both the National Virology Reference Laboratory and the Kenya Medical Research Institute, the WHO said. He died that day despite supportive care and was buried the next day under strict infection-control rules. The BBC noted that the case raised serious questions about screening in all three countries; the WHO said it is still unclear whether and when he had symptoms while traveling.
Contact tracing and airport screening
The contact count has grown as investigators widened their search. Early WHO reporting cited 28 contacts, including relatives and health workers. Kenya’s Ministry of Health said on Oct. 7 that it was tracing 57 people, Capital FM reported, and the BBC put the figure at 66, including fellow passengers, crew, airport staff and hospital workers. The WHO has said the number is likely to rise as tracing continues in Uganda and Congo.
“I think these next few days are critical,” Dr. Neema Rusibamayila Kimambo, the WHO representative in Kenya, told UN News. She said listing every contact and placing them in quarantine “will be the key to really contain and stop any community spread.”
Kenya has designated Gate 16 at JKIA for all passengers arriving from 10 countries it considers higher risk: Congo, Uganda, Rwanda, Burundi, South Sudan, Ethiopia, Angola, Zambia, Tanzania and the Central African Republic. Health officials have stressed that Kenya has not declared an Ebola outbreak and describe the situation as a single imported case. On Oct. 8, a suspected case in Wajir County in northeastern Kenya tested negative in preliminary results, the county governor said, according to Al Jazeera. Africa CDC’s head of emergency response teams, Dr. Wessam Mankoula, praised Kenya’s quick work tracing the patient’s route.
Congo’s Bundibugyo outbreak by the numbers
The WHO’s latest outbreak update shows a crude fatality rate of 48.2% among confirmed cases. Infections have been reported in 64 health zones across seven of Congo’s 26 provinces: Bas-Uélé, Haut-Uélé, Ituri, North Kivu, South Kivu, Sud-Ubangi and Tshopo. The outbreak has also spread to a new health zone, Alimbongo in North Kivu, which had four confirmed cases and two deaths as of Oct. 6.
The picture is uneven. The WHO said there are clear signs of slowing in some areas while cases are still climbing in others, and new weekly cases nationwide rose 2.5%, from 475 to 487, over the past three completed weeks. Uganda restricted movement across its border with Congo shortly after the outbreak began. Eastern Congo is also the scene of ongoing armed conflict, described in our report on eastern Congo M23 fighting.
What to watch next
The coming days will show whether any of Kenya’s contacts develop symptoms, which would turn a single imported case into local transmission. The WHO, the United Nations and partners are supporting surveillance, screening and tracing in Kenya, Congo and Uganda. Ethiopia, which is on Kenya’s higher-risk list, is separately dealing with renewed fighting in the north, covered in our story on the Ethiopia-Eritrea conflict at the UN.
Sources
- World Health Organization: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo
- BBC: Kenya’s first Ebola case, questions remain after man travelled across three nations undetected
- UN News: Kenya races to trace all contacts after first Ebola death
- Al Jazeera: Ebola spreads in eastern DRC as Kenya confirms imported case
- Capital FM: Arrivals from 10 African countries face enhanced Ebola screening at JKIA’s Gate 16