Ebola cases rise in DRC border with Uganda as Kenya tracks contacts

Ebola quarantine facility/HANDOUT

The ebola epidemic in the Democratic Republic of Congo is continuing to grow in provinces bordering Uganda.

This has raised concern about further cross-border infections even as transmission shows signs of slowing in some other parts of the country.

The World Health Organization (WHO) on Friday said Ituri and North Kivu, which are on the border with Uganda, accounted for all the new cases reported in the most recent 24-hour period covered by its October 8 update.

 Ituri recorded 33 cases while North Kivu had 30, highlighting the continued concentration of infections in eastern DRC.

The latest figures came days after Kenya confirmed its first imported case of Bundibugyo ebola, involving a Kenyan man who had travelled from DRC through Uganda before arriving in Nairobi. The man was isolated and treated in hospital but died on October 5.

Kenya has accounted for 66 people who may have come into contact with its first confirmed imported Ebola patient, who has since died. The contacts have been quarantined at the National Police Service Hospital in Nairobi as the government intensifies efforts to prevent further transmission.

The Ministry of Health said efforts to trace and follow up with the remaining contacts were continuing.

The imported case has heightened concern over the risk of the virus spreading across borders as health authorities in the region work to contain the outbreak.

According to the WHO report, DRC had recorded 8,728 confirmed cases and 4,205 deaths by October 6, representing a crude case fatality ratio of 48.2 per cent.

The country had also recorded 2,269 recoveries. The cases had spread across 64 health zones in seven provinces, including Ituri, North Kivu, South Kivu, Haut-Uélé, Bas-Uélé, Tshopo and Sud-Ubangi.

Since the previous WHO situation report on September 25, the country had recorded an additional 775 confirmed cases and 379 deaths.

Ituri remained the worst-affected province, with 6,480 confirmed cases and 2,989 deaths.

North Kivu had recorded 1,755 cases and 1,013 deaths, with a reported case fatality ratio of 57.7 per cent.

The outbreak also expanded into Alimbongo health zone in North Kivu, which reported four confirmed cases, including two deaths.

This brought the epidemic into an additional health zone since the previous report.

The WHO said transmission remained intense nationally, but the situation varied considerably between locations.

“At the national level, transmission remains intense, although the burden is unevenly distributed. In some areas, there are clear signs the epidemic is slowing down, although in others it continues to grow,” it said.

The number of new cases reported nationally over the three most recent completed epidemiological weeks rose by 2.5 per cent, from 475 to 487.

Deaths reported weekly remained broadly stable, increasing from 222 to 224.

The figures suggest that while the overall outbreak continues to expand, its trajectory is not the same everywhere.

The increase in cases in Ituri and North Kivu remains a particular concern because of the continued movement of people across the region.

The WHO said tracking people who may have been exposed to the virus remained a major challenge in DRC, with follow-up falling short of the target in recent weeks.

As of October 4, health teams had reached 23,741 of the 29,535 contacts being monitored, representing 80.4 per cent coverage against a target of 85 per cent.

This means thousands of people identified as contacts had not been reached during the reporting period.

The organisation also raised concern about the number of people dying outside treatment centres, which could indicate delays in detecting the disease and accessing medical care.

“Since the last Disease Outbreak News, 264 of the 372 reported deaths occurred in communities and 108 in treatment centres," the WHO said.

"The persistently high mortality, together with the large number of deaths occurring outside treatment centres, continues to point to delays in identifying illness and reaching appropriate care.” 

The outbreak has also affected healthcare workers.

On October 1, the Netherlands reported the medical evacuation of a health worker who had tested positive for Bundibugyo virus while working in DRC.

The patient was receiving treatment in the Netherlands, according to the WHO.

Kenya has intensified surveillance following the imported case, including efforts to identify people who had contact with the patient and passengers who travelled on the same flight.

The Health ministry said more than 652,000 travellers had been screened since the outbreak began, while 267 samples had been tested through the national laboratory network by October 7.

The government has also identified facilities equipped to isolate and manage suspected and confirmed cases.

The WHO said the risk remained particularly high for countries sharing land borders with DRC, while the risk to the rest of Africa and the world was assessed as low.

It advised against travel or trade restrictions against affected countries.

Bundibugyo virus disease is a severe form of Ebola spread through direct contact with the blood or other body fluids of infected people, or contaminated materials.

There is currently no approved vaccine or specific treatment for this strain, making early detection, isolation, supportive care and contact tracing central to controlling the outbreak.

Instant analysis

Surging Bundibugyo Ebola cases along the DRC-Uganda border, coupled with low contact-tracing coverage, underscore severe cross-border transmission risks. Kenya’s isolation of 66 contacts following an imported fatality reflects high regional vulnerability. With a 48 per cent fatality rate and no strain-specific vaccine, strict border surveillance and rapid contact tracing remain paramount.