Kenya races to trace contacts after its first Ebola death, as the outbreak in DR Congo worsens

Nairobi — Kenya is tracing everyone who came into contact with a man who died of Ebola in Nairobi on Monday, the country's first recorded case of the disease. Health officials say no other infection has been confirmed in Kenya so far.

The World Health Organization's representative in Kenya, Dr Neema Rusibamayila Kimambo, told UN News that the coming days would be decisive in preventing the virus from spreading in the community. She described it as an imported case in which the patient went straight to hospital.

What is known about the case

The patient was a Kenyan man who had lived in the Democratic Republic of Congo for seven years. According to Kenya's health minister, Aden Duale, quoted by the Guardian, he fell ill about a month ago and was treated in DR Congo before travelling overland to Uganda and flying to Nairobi on Saturday 3 October.

A relative took him from the airport to the Nairobi Hospital, where he was isolated, tested positive and died on Monday night. He was buried on Tuesday under public health safety rules.

The search for contacts

The numbers have changed as tracing has widened. On Tuesday the health minister said 28 contacts had been listed. By Wednesday, the BBC reported that ten people had been placed in quarantine and that officials were trying to reach 57 others.

According to the WHO, those identified include about ten relatives, some of whom came forward voluntarily, and 21 health workers who cared for the patient. The authorities are also working with the airline to reach the roughly 23 passengers and four crew who were on his flight.

How did he get so far?

The head of the Africa Centres for Disease Control and Prevention, Jean Kaseya, told the BBC that the man travelled through several cities in DR Congo, crossed into Uganda by road and flew to Kenya without his illness being detected, and said investigators needed to establish why. His agency is examining the case with the Congolese authorities.

A senior Kenyan health official, Patrick Amoth, said the patient may have passed screening because medication had masked his symptoms. A representative of Kenya's main doctors' union told the BBC he had seen lapses at border points and at the country's main airport.

Kenya's response

The health ministry says it has stepped up surveillance at airports and border crossings, opened a hotline for reporting symptoms and set aside a dedicated gate at the main airport for passengers arriving from ten countries around the outbreak, Africanews and the Associated Press report. Five health facilities with a total of 241 isolation beds have been designated to treat patients.

President William Ruto's office says more than 650,000 travellers have been screened and 267 samples tested since the outbreak began. The government has urged the public not to panic.

The outbreak next door

The source of the case is an outbreak in eastern DR Congo that was announced in May and is the 17th in the country's history. As of 2 October, 4,082 people had died out of 8,463 confirmed cases, the Guardian reports. It has spread to seven provinces.

It is caused by the Bundibugyo strain of the virus, which is relatively rare. There is no approved vaccine or specific treatment for it, although trials are under way.

The medical charity Médecins Sans Frontières warned this week that the spread in North Kivu province is out of control. The province now accounts for nearly 40 per cent of newly confirmed cases, most of them from unknown chains of transmission, and three-quarters of Ebola deaths there happen at home rather than in treatment centres, a coordinator at its centre in Butembo told Africanews. The charity says treatment facilities are stretched beyond their limits and that fear of the disease is keeping people from seeking help.

Uganda recorded 20 cases and two deaths earlier in the outbreak, and was declared free of Ebola in August.

How Ebola spreads, and what to do

Ebola spreads through direct contact with the bodily fluids of an infected person, such as blood, vomit, sweat or saliva, and with contaminated bedding or clothing. It does not spread through the air.

The WHO's advice is to wash hands regularly, avoid unnecessary physical contact, and go to a health facility promptly if you feel unwell. Kenya's health ministry has asked anyone with symptoms, or who may have been in contact with a case, to use its Ebola hotline.

This report draws on reporting by the BBC, UN News, the Guardian and Africanews, including its report from North Kivu and on Kenya's preparations. Figures were correct at the time of those reports and may have changed.