Ebola next door: 20 deaths in Uganda as laxity stalks Kenya

ebola screening

Travellers from Uganda check in at the Busia One Stop Border Point on September 21.

Photo credit: Tonny Omondi I Nation Media Group

More than five days since the declaration of Ebola in Uganda, there is no serious health surveillance on the Kenyan side of the common border despite the Health ministry’s call for more vigilance.

 According to the Uganda Health ministry, there were 31 confirmed and suspected cases as of Saturday, a sharp spike from the seven cases registered on Tuesday, when the outbreak was first confirmed. The total confirmed and suspected Ebola deaths have also increased exponentially from one to 20.

 In Busia, Kenyan and Ugandan residents walk across the border with minimal screening for the virus. This even after confirmed and suspected cases have been reported in Kampala, hundreds of kilometres from the initial Mubende epicentre. Cases have also been reported in Kisoro, Kakumiro, and Kyegegwa districts of Uganda as the disease spreads, information from the response team indicates.

 Dr Henry Kyobe, Uganda’s Ebola incident commander, said the majority of the cases are in Mubende, the latest Ebola “ground zero” or epicentre.

The sub-counties of Madudu, Kiruuma, and Kasambya have reported one or more confirmed and/or suspected cases of Ebola.

 In Kyegegwa, at least six suspected cases, one suspected Ebola death, and 20 contacts of victims have been listed and are being followed up.

 Dr Kyobe, who is also the deputy director of the Uganda National Institute of Public Health in the Health ministry, and Dr Issa Makumbi, the director of the Public Health Emergency Operations Centre, warned that cases may continue to rise if communities do not cooperate with health workers.

 At the Kenyan Malaba border point, a tent has been pitched to facilitate screening. However, the Nation has learnt that the there is no systematic monitoring, with officials randomly taking the temperature readings of truck drivers.

 The Health ministry, in a statement released on Thursday last week, asked county officials to screen at-risk population such as travellers, truck drivers, bush meat handlers, and healthcare workers. However, walk-in and walk-out residents were left out of the list.

 Health Cabinet Secretary Mutahi Kagwe said counties that share borders with Uganda have been advised to sensitise their residents and healthcare workers to enable them to identify Ebola cases, institute preventive measures, and gain proficiency in case and sample management.

 The Interim Chief Officer of Health in Busia county, Dr Melsa Lutomia, yesterday told the Nation that about 3,000 truck drivers have been screened at the Busia border and another 2,000 truck drivers at the Malaba border.

 “We’ve tried to be vigilant as we use a thermal scanner to check the temperature of truck drivers when they enter the country from Uganda as well as take their details through a surveillance form that we give them. We try to find out where they [come] from in Uganda and their destination while in the country,” she said.

 Dr Lutomia agreed that the porous borders in the region pose a challenge. She asked for reinforcements from the Ministry of Interior.

 “We’ve not managed to screen all incoming residents, especially those not using buses or personal vehicles. The people are many and it becomes uncontrollable.

“As we weigh the situation, the biggest challenge has been the porous borders, but we will try to ensure there is security through officials from the Ministry of Interior,” Dr Lutomia said.

 Busia Deputy Governor Arthur Odera, while inspecting operations at the Malaba border post, said the county government is working closely with the national government to prevent the disease from spreading into the country.

 “We’re at risk of being infected because of our proximity to the border, but we’re working closely with the national government to [ensure] all porous routes are being closely monitored by security officials to prevent the possibility of infected persons getting into the country illegally,” he said.

 Dr Ahmed Kalebi, a consultant pathologist, explained that in as much as Kenya has had threats before, there is a bigger risk this time round compared to previous outbreak cycles.

 “The Ebola outbreak in the central region of Uganda poses the biggest threat to Kenya unlike any other we’ve ever faced in the past. This is because the strain called the Sudan Ebola virus is new and unconnected to any other outbreak. It seems to be from a forest in Uganda,” he said

 Dr Kalebi explained that the virus’ new nature is that it spreads insidiously before revealing itself. At the moment, there is no effective vaccine against the Ebola-Sudan strain as well as treatment. The virus also has a higher death rate compared to the coronavirus.

 “Case fatality rate for Sudan Ebola species is, on average, 40 per cent to 60 per cent and ranges from 25 per cent to 90 per cent. The case fatality rate for Covid-19 was below 1 per cent in Kenya. The central region of Uganda is densely populated and the area affected is on a transport corridor, meaning that it can easily and rapidly spread within and outside Uganda,” Dr Kalebi said.

  He advised the country’s health officials to urgently and seriously institute screening measures for all travellers from Uganda, whether on foot, road transport, or by air. 

“The standard temperature screening is important for Ebola and intense massive public awareness is needed, especially at the border so that people can be vigilant. Also, bear in mind that Ebola can’t be tested like other common viruses as it needs a highly specialised laboratory with stringent biosafety facilities.

“Ebola patients can’t be managed in normal hospitals as it needs highly specialised infection management units to protect the health workers,” he pointed out.

 “The other very important thing in the Ebola public health response at the border is to have robust records of all those who are travelling, where they are coming from, where they have been, where they are going, and their physical address plus contact details. This will help in contact tracing in case a case is detected,” he added.

 According to the World Health Organisation, human transmission of the Ebola virus is through body fluids and objects that have come into contact with such fluids.

The symptoms of Ebola virus infection include fever, vomiting, bleeding and diarrhoea, fatigue, muscle pain, headache, and sore throat.

Additional reporting by Daily Monitor