Kenya has quarantined 10 people who had contact with the country’s first Ebola patient, while health authorities work to trace 57 others who may have been exposed to the virus.
The patient, who travelled from the Democratic Republic of Congo through Uganda before arriving in Kenya, died at a hospital in Nairobi on Monday.
The development has raised concerns over screening procedures in the region after the patient, who had reportedly been ill for about a month, passed through several cities and international borders without being detected.
The Africa Centres for Disease Control and Prevention chief, Jean Kaseya, said the patient travelled from Buta in northern DR Congo to Kisangani, flew to Beni, travelled by road to Uganda and later flew to Nairobi.
“We know that he left Buta, a city in [northern] DR Congo, to drive to Kisangani. And from Kisangani, he took a flight to Beni. From Beni, he drove to Uganda. And from Uganda, he took a flight to Nairobi,” Kaseya told the BBC’s Focus on Africa programme.
“What are symptoms he was presenting? Why was he not detected?” he asked.
Kenya’s Health Ministry official, Patrick Amoth, said the patient may have passed screening after taking medication that concealed his symptoms.
He was taken to hospital by a relative after arriving at the Kenyan capital and was later buried in accordance with health safety guidelines.
Kenyan authorities have appealed for calm and said surveillance had been strengthened at airports and border crossings.
However, Dr Dennis Miskellah, a representative of Kenya’s main doctors’ union, said he had observed lapses at border points involving Uganda and Tanzania as well as at Kenya’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?”
“That’s the question that most Kenyans are asking.”
The current Ebola outbreak in DR Congo, which began in May, is caused by the Bundibugyo species, a relatively rare strain for which there is currently no approved vaccine or treatment, although trials are ongoing.
Kaseya said the Africa CDC was investigating the case with Congolese authorities, while a team from the organisation was expected to meet Kenyan health officials.
Kenyan President William Ruto’s spokesman said the country had the capacity to detect, isolate and manage suspected cases. He added that more than 650,000 travellers had so far been screened and 267 samples tested.
Four hospitals have been designated to manage Ebola patients, including Nairobi Hospital, where Kenya’s first confirmed patient died.
Kaseya said Kenya was “well prepared” and was able to immediately receive the case, but warned that the same level of preparedness did not exist in every country in the region.
“It means the regional approach is more important today to stop this outbreak.”
He also said temperature checks at borders were unreliable because medication could suppress fever, while rapid Ebola testing was not available at border points.
“I have to make it clear – we don’t have diagnostics to test for Ebola. It’s just about temperature,” he said.
Dr Miskellah also expressed concern about relying on travellers to voluntarily disclose their health status, saying inadequate public education and stigma could encourage people to hide symptoms.
The Kenyan government said it had intensified containment measures through a joint response involving county administrations, humanitarian organisations and other partners.
The country’s Health Minister, Aden Duale, also said the government was considering converting an Ebola treatment facility planned at a military base in Nanyuki into what he described as the “first” infectious disease hospital in the region.
The proposal followed a court halt to the United States-backed plan to establish an Ebola treatment facility at the base after it triggered opposition among Kenyans over fears of cross-border infection.
More than 4,000 people have reportedly died from Ebola in DR Congo this year, making the outbreak the second deadliest known outbreak of the disease.
Uganda, which also reported Ebola cases after the DR Congo outbreak began, declared itself free of the disease in August.
Its health ministry said the Kenyan patient spent less than 24 hours transiting through the country and had a normal temperature when he departed.
