The World Health Organization (WHO) says the Ebola outbreak that emerged in the Democratic Republic of Congo (DRC) is growing more “complex”, with cases now present in countries in East and West Africa.
This comes as health authorities investigate where Nigeria’s first case , which was confirmed this week, originated, raising questions about whether the patient crossed paths with Kenya’s first patient at a Ugandan airport.
“We are facing a more complex outbreak landscape,” Mohamed Janabi, regional director for WHO in Africa, told an online media briefing on Thursday.
Nigeria reported its first case of the Bundibugyo strain of Ebola on Tuesday, becoming the fourth African country and the most populous yet to be affected by an outbreak that was announced in DRC in mid-May and has since killed more than 4,000 people there.
Kenya, DRC and Nigeria all have active or recent cases of the Bundibugyo strain, while Uganda had cases earlier in the year but has since been declared Ebola-free.
The Nigeria patient is the Ugandan-born wife of a Swiss diplomat based in Abuja. Authorities in Uganda said she had travelled to eastern DRC before transiting through Uganda. But the WHO and Africa’s top health agency said on Thursday they had not received confirmed information that the woman travelled to the DRC.
A Swiss government statement to the Reuters news agency also said the patient is believed to have contracted the disease while travelling in Uganda.
Wessam Mankoula, the head of Emergency Preparedness and Response at the Africa Centres for Disease Control and Prevention (Africa CDC), said on Thursday that both the first Nigerian case and the first Kenyan case had left Entebbe on October 3, and that a possible encounter between them was under investigation.
Ugandan authorities rejected the suggestion that she was infected in the country. Government spokesman Alan Kasujja told the AFP news agency that it was “preposterous” to link Uganda to the case simply because she had holidayed there.
However, Mankoula said there was no validated information that she had been to DRC, and Jean Kaseya, the Africa CDC director general, said the same. Pavel Ursu, the WHO representative in Nigeria, said the information given to the organisation included no travel outside Uganda.
Patrick Otim, a WHO emergency response manager, said on Thursday the source of her infection was still unknown as health authorities were working to piece together her travel history.
Investigators were looking at which Abuja health facilities she visited between the onset of symptoms and her hospitalisation 48 hours later, he added.
Kenya’s Ministry of Health confirmed its first case earlier this month and had reported eight more since. Patrick Amoth, the Health Ministry’s director-general, said officials had traced all 135 contacts of the first case.
Nigeria is now tracing 44 contacts, and Mankoula said more had since been identified but did not give a new number.
The current outbreak is the deadliest in DRC’s history, according to the country’s health authorities. It has killed more than 4,000 people out of more than 9,000 confirmed cases since May.
Neighbouring Uganda recorded 20 confirmed cases, including 15 imported from the DRC, and two deaths, before it was declared Ebola-free in August.
The Africa CDC has warned of an “extremely serious threat”, with the fatality rate in DRC approaching 50 percent.
