Ten people who came into contact with a man who died of Ebola in Kenya have been quarantined, health officials in the East African nation say.
They are also trying to trace 57 other contacts of the Kenyan patient after he travelled from the Democratic Republic of Congo, dying in hospital in Nairobi on Monday.
This is the East African nation’s first-ever Ebola case and there is now growing concern about the country’s screening measures.
The Africa Centres for Disease Control and Prevention chief has told the BBC that despite being sick for a month, the patient passed through multiple cities in DR Congo, driving to Uganda and eventually flying to Kenya without his sickness being detected.
“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,” Jean Kaseya told the BBC’s Focus on Africa programme.
“What are symptoms he was presenting? Why was he not detected?” he asked.
The Ebola virus spreads through contact with infected bodily fluids such as blood or vomit.
The current outbreak in DR Congo, which began in May, has been caused by the Bundibugyo species of Ebola, which is relatively rare, with no approved vaccine or treatment – though trials are under way.
Kaseya said the Africa CDC was investigating the case, alongside the Congolese authorities. A team from the organisation was also due to meet the Kenyan health authorities.
Kenya’s health ministry official Patrick Amoth said the patient might have passed screening after taking medications that masked his symptoms.
After arriving at the airport in Kenya’s capital, he was transferred by a relative to a hospital in the city where he died, and was buried on Tuesday in line with health safety guidelines.
Kenyan authorities have urged people not to panic, with the health ministry assuring of heightened surveillance at airports and border crossings.
But Dr Dennis Miskellah, a representative from Kenya’s main doctors’ union, said the Ebola case did not come as a surprise to him and most health workers.
He told the BBC’s Newsday programme that he had witnessed “lapses” at various border points, including with neighbouring Uganda and Tanzania, as well as at Kenyan’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 health ministry says it has intensified measures to contain the spread, with a joint response involving county administrations, humanitarian partners and others.
President William Ruto has said that surveillance and rapid response teams are on the ground, building on the systems that the country adopted following the outbreak in DR Congo in May.
His spokesman said Kenya had the capacity to detect, isolate and manage suspected cases, adding that so far more than 650,000 travellers had been screened and 267 samples tested.
Facilities in four main hospitals have been designated for the management of Ebola patients, including at the Nairobi Hospital, where the first Ebola patient died.
ReutersIn June, a US plan to establish an Ebola treatment facility at a military base in the central Kenyan town of Nanyuki sparked concern, with Kenyans reacting furiously about the risks of cross-border infection. The plan was halted by the courts.
On Wednesday, Health Minister Aden Duale told local television station NTV that pending the outcome of the court case, the government was considering turning the facility into the “first” infectious disease hospital in the region, to deal with outbreaks like Ebola.
More than 4,000 people have died from Ebola in DR Congo this year, in what is the second most deadly known outbreak of the disease.
Shortly after DR Congo declared an outbreak of Ebola in May, it was also reported in Uganda, where two people died.
However, the World Health Organization (WHO) declared that county free of the disease in August.
On Tuesday, Uganda’s health ministry emphasised that the country remained free of Ebola and was continuing to “maintain strong surveillance measures to protect public health”.
It said the Kenyan Ebola patient had transited through the country for less than 24 hours and screening teams had “observed he had a normal temperature at the time of departure”.
According to Africa CDC chief, his organisation was working with all the countries in the region to reinforce response mechanisms.
Kasiye said Kenya was “well prepared” and was therefore able to immediately receive the case, “but it is not the case for all other countries”.
“It means the regional approach is more important today to stop this outbreak.”
However, Kasiye said there was no quick testing available at border points and the taking of temperatures was unreliable as medication is able to stop a fever.
“I have to make it clear – we don’t have diagnostics to test for Ebola. It’s just about temperature,” he said.
Dr Miskellah, from the Kenyan doctors’ union, said he was concerned that governments were counting on the “honesty and full co-operation of the travellers to self-declare, to say the truth” about their health.
This was however undermined by a lack of proper health education to destigmatise the virus, meaning people often wanted to hide their symptoms, he said.
