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Ten people who had contact with a man who died of Ebola in Kenya have been quarantined, while authorities seek to trace 57 more contacts, Reuters reported.
The patient travelled from the Democratic Republic of Congo (DR Congo) and died in a Nairobi hospital on Monday. His case is Kenya’s first confirmed Ebola infection.
Jean Kaseya, head of the Africa Centres for Disease Control and Prevention (Africa CDC), told the BBC that the man had been ill for about a month while travelling through several locations in DR Congo, Uganda and Kenya without being detected.
“What are symptoms he was presenting? Why was he not detected?” Kaseya said.
He said the patient left Buta in northern DR Congo for Kisangani, flew from there to Beni, travelled by road to Uganda and then flew to Nairobi. The Africa CDC is investigating the case with Congolese authorities, and a team was due to meet Kenyan health officials.
Kenyan health ministry official Patrick Amoth said medication might have masked the patient’s symptoms during screening. He was admitted to hospital and died there, and was buried on Tuesday in accordance with health safety guidelines.
The Ebola virus spreads through contact with infected bodily fluids, including blood and vomit. The outbreak in DR Congo, which began in May, is caused by the relatively rare Bundibugyo strain; there is no approved vaccine or treatment for it, although trials are under way.
Kenya’s health ministry says it has stepped up surveillance at airports and border crossings. President William Ruto said surveillance and rapid-response teams were operating, building on systems put in place after the outbreak began in DR Congo.
A spokesman for the president said Kenya had the capacity to detect, isolate and manage suspected cases. More than 650,000 travellers have been screened and 267 samples tested, he said. Four major hospitals have been designated to manage Ebola patients, including the Nairobi hospital where the man died.
However, Dr Dennis Miskellah, a representative of Kenya’s main doctors’ union, told the BBC that he had seen screening “lapses” at border points with Uganda and Tanzania and at the country’s main airport.
“How could you have been sick for almost a month plus in DR Congo, come all the way to the country through not just any small border point, but the main entry point, the main gateway into the country and pass unnoticed?” he said.
In June, a US proposal to establish an Ebola treatment facility at a military base in Nanyuki, central Kenya, drew public concern over the risk of cross-border infection. The plan was halted by the courts.
Health Minister Aden Duale told local broadcaster NTV on Wednesday that, pending the court case, the government was considering converting the proposed facility into the region’s first infectious disease hospital.
More than 4,000 people have died from Ebola in DR Congo this year, in what is the second-deadliest known outbreak of the disease. Uganda also reported cases after DR Congo declared its outbreak in May, with two deaths, but the World Health Organization declared Uganda free of the disease in August.
Uganda’s health ministry said on Tuesday that the country remained free of Ebola and continued to maintain surveillance. It said the Kenyan patient had spent less than 24 hours in transit in Uganda and had a normal temperature when he departed.
Kaseya said the Africa CDC was working with countries across the region to strengthen their response. He said Kenya was “well prepared” to receive the case, but added that regional coordination was essential to stop the outbreak.
He also said rapid Ebola testing was not available at border points and that temperature checks were unreliable because medication could suppress a fever. Miskellah said he was concerned that authorities relied on travellers to disclose their symptoms, while inadequate public health education and stigma could encourage people to conceal them.
