Kenya’s first Ebola patient went undetected for six weeks
Africa CDC’s reconstruction shows a Kenyan businessman sought care for weeks in DR Congo and passed two airport checks before his diagnosis in Nairobi.
By
Kwame Asante
Kenya’s first confirmed Ebola patient, a 40-year-old businessman, travelled through DR Congo, Uganda and Kenya for nearly six weeks before anyone identified his infection, according to a reconstruction by Africa CDC.
In brief
- He was diagnosed only after reaching a Nairobi hospital in a serious condition, and he died two days later, on 5 October.
- Ebola can take anywhere from two to 21 days to produce symptoms after exposure, and it passes through direct contact with the bodily fluids of a person who is already symptomatic, or through contaminated materials.
- “When you reveal any Ebola-related symptoms early, you’re not only preventing the virus spreading to other countries but you’re also protecting yourself first,”
He was diagnosed only after reaching a Nairobi hospital in a serious condition, and he died two days later, on 5 October. As BBC News reported, the timeline assembled by the continental agency shows that the illness escaped notice at several Congolese health facilities and at airport screenings in both Uganda and Kenya.
From a clinic in Bondo to a flight into Nairobi
The man had been based in DR Congo for seven years and moved between three of its provinces for his work. Kenya’s Health Minister Aden Duale confirmed he held Kenyan citizenship. His route after falling ill can be traced date by date.
- First symptoms appear. He receives antibiotics and is sent home.
- He is admitted to the Tongo Etandi Health Centre in Bondo. Despite fever and a rash, staff diagnose a skin infection.
- He flies to Kisangani and spends more than 10 days looking for medical care there.
- He flies to Beni, continues to the border town of Kasindi in North Kivu and crosses into Uganda the same day.
- He travels by road to Kampala and on to Entebbe.
- He flies to Nairobi and is driven by a relative to Nairobi Hospital.
- He dies.
Two stretches of that journey remain blank. Which facilities treated him in Kisangani, and what drugs he was given, is not known. North Kivu, where he spent part of 1 October, has so far logged 1,755 cases of Ebola and upwards of 1,000 fatalities.
Where the warning signs were missed
The Uganda crossing is the first gap. That frontier runs for hundreds of kilometres through remote country, and whether the businessman went through an official health checkpoint is still unclear.
The airports are the second. Ugandan officials said his temperature was within the normal range when he was screened before boarding. Dr Wessam Mankoula, emergency director at Africa CDC, said investigators were looking into whether medication he had taken might have masked a fever; it is also possible he simply had no fever at the moment of the checks. In Nairobi, staff at Jomo Kenyatta International Airport did not flag him as a suspected case either. By the time a relative drove him to Nairobi Hospital, a private facility, he had fever, chills, muscle pain, a sore throat and bleeding.
Timing compounds the difficulty. Ebola can take anywhere from two to 21 days to produce symptoms after exposure, and it passes through direct contact with the bodily fluids of a person who is already symptomatic, or through contaminated materials.
Kenya’s response after the diagnosis
Bundibugyo, one species of Ebola, was found in samples analysed by the National Virology Reference Laboratory and also by the Kenya Medical Research Institute. The body was buried under safe burial protocols. President William Ruto then ordered the National Security Council Committee to assess the situation and recommend measures.
- As of 6 October, eight family members and 21 healthcare workers were in quarantine.
- Tracing was extended to people on the same flight, with 27 passengers identified, according to the president’s office.
- The government has since put the number of possible contacts at 66, a figure the WHO expects to grow as tracing continues in Uganda and DR Congo.
The case arrived despite months of preparation. Since May, Kenya’s figures show:
“Kenya is prepared to deal with this public health emergency. The government will continue to strengthen surveillance, contact tracing, testing and treatment capacity as necessary,”
William Ruto, Kenyan President
Earlier coverage set out how Kenya began tracing contacts and flight travellers in the first days after the confirmation.
A regional outbreak with no approved vaccine
DR Congo has lost more than 4,000 people to Ebola this year, making it the second deadliest outbreak on record. Uganda was declared free of the disease in August. Kenya is the fourth country to log a case linked to the eastern Congo outbreak, according to the WHO, as reported by yahoo.com. WHO Director-General Tedros Adhanom Ghebreyesus said the agency is backing the governments of DR Congo, Kenya and Uganda and advises against travel restrictions.
Medical tools are limited: no vaccine or treatment currently exists for Bundibugyo virus, although candidate products are being tested in clinical trials. That puts weight on early reporting, and the WHO has warned that stigma may deter people from coming forward with symptoms. Mankoula framed it as a matter of self-interest too.
“When you reveal any Ebola-related symptoms early, you’re not only preventing the virus spreading to other countries but you’re also protecting yourself first,”
Dr Wessam Mankoula, emergency director, Africa CDC
Duale’s advice to the Kenyan public was practical: “The public is urged to continue with frequent hand washing or use alcoholic hand rubs and avoid close contact with sick people coming from countries reporting active transmission of Ebola disease,” the Health Minister said.
Featured image. Source: Pexels. Credit: Laura James. License: Pexels License.
