Ebola outbreak spreads: Eighth case in Kenya, eighth Congo province affected

According to Kenya’s director-general of health, Dr. Patrick Amoth, the latest patient is not a medical professional. His job involved cleaning utensils and bedding, and he was apparently exposed to the virus while caring for the first patient. On Saturday, he developed a fever, headache and muscle pain. He was separated from the others in quarantine and diagnosed with Ebola the following day. “Today, 38 people were tested, and one tested positive for Ebola,” Amoth told Citizen TV.

The six other patients, including three relatives of the first patient, among them a 39-year-old man and a 65-year-old woman, and three health care workers who treated him, are in stable condition and receiving supportive care. Following the first patient’s death, about 130 people who had come into contact with him were identified, including medical personnel. Of those, 128 remain in quarantine. Anyone who develops symptoms while in quarantine is immediately tested for Ebola.

The first patient, a 40-year-old Kenyan man who lived in Congo, had traveled through three provinces affected by the outbreak. According to Kenya’s health minister, Aden Duale, the man became ill about a month before his death and received treatment in Congo. He then traveled overland to Kampala, Uganda’s capital, before boarding a flight to Nairobi. He landed on October 3, and a relative drove him to the hospital, where he died two days later. Until then, no Ebola cases had been diagnosed in Kenya.

The first case exposed gaps in Kenya’s health screening procedures at border crossings. Authorities have since stepped up screening and established a hotline for anyone who suspects they may have come into contact with an Ebola patient or developed symptoms.

At Nairobi’s main airport, a separate gate has been designated for all flights arriving from the 10 countries identified as outbreak hotspots. Neighboring Tanzania has also tightened its border screening procedures, requiring travelers from high-risk countries to complete health declarations and placing them under monitoring for 21 days.

Ebola is highly contagious, and those caring for infected patients are particularly vulnerable. The virus spreads through direct contact with bodily fluids from an infected person, such as blood and vomit, as well as through contact with contaminated objects and surfaces, including bedding and clothing. The incubation period can last up to 21 days, which is why people exposed to the virus are quarantined for that period.

Kenya also hosts a U.S.-funded quarantine facility where American citizens exposed to Ebola spend 21 days before returning to the United States. When the government announced plans earlier this year to establish an Ebola facility at Laikipia Air Base, about 200 kilometers from Nairobi, the announcement sparked public outrage. In practice, Kenya’s first patient arrived in the capital on a flight from Uganda, prompting authorities to track down the 23 passengers who had traveled on the same plane.

Kenya is the fourth country to report a case in the current outbreak. Uganda, through which Kenya’s first patient traveled, recorded 20 cases and two deaths during the early months of the outbreak and was declared free of the disease in August. In France, an intensive care physician who returned from a humanitarian mission in Congo was diagnosed in June. The doctor had previously been vaccinated against the Zaire strain of Ebola. He was treated with the antiviral drug remdesivir and made a full recovery.

In Congo itself, the virus has spread to another province. On Sunday, the National Institute for Biomedical Research confirmed two cases, one of them fatal, in North Ubangi province, which borders the Central African Republic.

It is the eighth province affected by the outbreak, joining Ituri, North Kivu, South Kivu and four others. The spread to the border region presents a new challenge for health authorities already struggling to contain the epidemic.

According to the latest situation report, Congo recorded 67 new confirmed cases and 26 deaths in the 24-hour period ending October 16. Since the outbreak began, 9,415 cases have been diagnosed in the country, with 4,536 deaths, nearly half of those infected.

Ituri province in eastern Congo, where the outbreak was first detected in mid-May, remains the main epicenter. Of the 67 new cases, 44 were recorded there.

This is the most severe outbreak in Congo’s history and the fastest-spreading Ebola outbreak ever recorded. The country’s previous major outbreak, which began in 2018, killed about 2,300 people. The World Health Organization has warned that the current epidemic could become the deadliest in the disease’s history, surpassing the 2014–2016 outbreak in West Africa that claimed more than 11,000 lives.

The current outbreak is caused by the rare Bundibugyo strain, which had been identified only twice before: first in 2007 in Uganda’s Bundibugyo district, where 149 people were infected and 37 died, and again in Congo in 2012.

Unlike the more common Zaire strain, there is no approved vaccine or treatment for Bundibugyo. Patients receive supportive care, which the WHO says can save lives when administered early.

With no vaccine specifically approved for Bundibugyo, Congo has received 70,000 doses of Ervebo, a vaccine approved against the Zaire strain. Of those, 50,000 doses have been allocated to health care workers and others on the front lines of the outbreak, while 20,000 have been designated for a Phase 3 clinical trial to determine whether the vaccine also provides protection against Bundibugyo.

According to the WHO, preliminary animal studies suggest some degree of protection, but it remains unknown whether the vaccine can prevent the disease in humans.

Meanwhile, the first vaccine developed specifically against Bundibugyo, by the University of Oxford, has entered human trials. Moderna has also begun testing an experimental mRNA vaccine against the strain in humans, using the same technology employed in the COVID-19 vaccines developed by Moderna and Pfizer-BioNTech.

When the WHO declared the outbreak a public health emergency of international concern on May 17, it warned that countries bordering Congo faced a high risk of the disease spreading across their borders.

The cases in Kenya, which does not share a border with Congo, and the arrival of the virus near the border with the Central African Republic have heightened concerns about an even wider regional spread.