Kenya’s First Ebola Case Raises Questions About Border Screening

Kenya is tracing dozens of people after recording its first Ebola case, a man who traveled for weeks through three countries before the virus was detected in Nairobi, prompting regional health officials to ask how screening along the route missed him.

The patient, a Kenyan citizen who had been living in the Democratic Republic of Congo for several years, fell ill there about a month ago and received treatment, according to Kenyan Health Minister Aden Duale, as reported by Al Jazeera and the Associated Press. He then traveled by road into Uganda and flew from Uganda to Nairobi, arriving on Saturday. Relatives took him to Nairobi Hospital, where he was isolated and tested positive. He died on Monday.

Duale said Wednesday that the number of contacts being followed had risen to 57, with 10 in quarantine, the AP reported. They include fellow passengers and crew from his flight, the workers who cleaned the plane, and the immigration and customs officers who processed him at the airport.

Jean Kaseya, director-general of Africa CDC, told the AP that everyone involved should ask how one patient could drive and fly to so many places without being noticed, and said entry points need strong surveillance. He also noted that the man had not appeared on existing contact lists in Congo, a sign that the outbreak there may not be fully mapped.

Uganda, which was declared free of Ebola in July, rejected suggestions of blame. A government spokesman, Alan Kasujja, wrote on social media that Uganda should be left out of the conversation because it has no Ebola. Uganda’s Health Ministry said the man had a normal temperature when screened at Entebbe airport, and Kenyan officials have suggested he may have taken medication that masked his symptoms when he landed, Al Jazeera reported.

The case is tied to a large outbreak caused by the Bundibugyo strain, for which there is no approved vaccine. The outbreak was declared in Congo in May and has since spread to several provinces in the country’s north and east, with thousands of reported deaths. Doctors Without Borders warned this week of an alarming surge of cases in North Kivu, near the Ugandan border.

Kenya has stepped up checks at border crossings, set up an Ebola hotline, designated five health facilities with 241 isolation beds and assigned a dedicated airport gate for travelers from countries near the outbreak’s center. The World Health Organization said it is helping Kenya trace contacts and has delivered test kits.

There is a reassuring side to the episode. Wolfgang Preiser, a virologist at Stellenbosch University, told Al Jazeera that Kenya’s tracking system seemed to be working as Uganda’s had. The harder lesson, he said, is that the speed at which the virus spreads can overwhelm many health systems.