Is Ebola under control in Kenya after nine cases confirmed?

Is Ebola under control in Kenya after nine cases confirmed?

Nearly 5,000 healthcare workers have been trained to deal with Ebola

Kenya is facing its first-ever Ebola outbreak, unlike neighbouring countries such as Uganda and the Democratic Republic of Congo, which are accustomed to managing the disease.

Nine cases have now been confirmed, including the first patient, who had travelled from DR Congo and died two weeks ago.

Four relatives of the first victim, three health workers and a hospital cleaner have since tested positive, showing that all of them are connected to him.

Still, fears are growing that the virus may spread further, even though the government has tried to reassure the public.

The US has warned its citizens not to travel to Kenya, while nearby countries including Uganda, Ethiopia and Somalia are also on alert.

More than 4,000 people have died since Ebola was confirmed in DR Congo in May, making it the second deadliest outbreak of the disease.

With more than 9,500 cases in DR Congo, Kenya faces a constant risk of new infections crossing its borders, according to the International Rescue Committee, which has been working with both governments to help contain the spread.

The current outbreak is being caused by the Bundibugyo strain, which is relatively uncommon and has no approved vaccine or treatment, although trials are under way.

Kenyans have questioned from the beginning how the first patient was able to spend time in the area worst hit by Ebola, then travel to two more countries before his illness was detected.

He died days after arriving in Kenya.

As a regional transport hub, the possibility of the outbreak spreading is a major concern.

Kenya’s doctors’ union has raised concerns about “lapses” at several border points, including those with Uganda and Tanzania, as well as at the country’s main airport.

Dennis Miskellah, the union representative, told the BBC that border and port facilities were severely understaffed.

However, Health Director-General Patrick Amoth said on Tuesday evening that the eight patients were all improving and responding well to treatment.

When the first case was announced, authorities urged people not to panic and said surveillance had been stepped up at airports and border crossings.

Kenya has since introduced enhanced screening for travellers arriving from 10 countries it considers high risk: DR Congo, Uganda, Tanzania, Rwanda, Burundi, Angola, Zambia, Ethiopia, South Sudan and the Central African Republic.

Travellers from those countries must complete a digital surveillance form before boarding and show a QR code to port health officials on arrival.

Kenya has also ordered stronger public health screening of aircraft arriving from those countries as authorities try to stop more imported cases.

Inside the country, the government has been issuing public messages to raise awareness about Ebola, including urging people to report suspected cases quickly and seek treatment at a hospital.

It has also stressed hygiene and safety measures, such as handwashing and avoiding close contact with sick people.

The government has also set up treatment and isolation facilities across the country, and health workers have been trained to handle the disease.

Amoth also said a dedicated laboratory had been established at the Kenyatta National Hospital Infectious Disease Unit to process Ebola tests, so the hospital’s laboratory would not be contaminated.

In Kenya, 134 out of 135 people identified as contacts of the first patient remain in quarantine. That means about 99% of contacts have been traced and isolated to stop Ebola spreading to the wider population.

The fact that all those infected so far are linked to the first victim suggests Kenya’s early response is working, according to the International Rescue Committee.

The government is also working with international partners, including Africa CDC and the World Health Organization (WHO), to support its response through surveillance, communication and community engagement.

A toll-free emergency hotline, 719, has been made available to the public to report suspected symptoms.

Amoth said none of the contacts of the first patients had shown symptoms before entering quarantine “and therefore the potential to spread to another person is very minimal, literally non-existent”.

The incubation period for Ebola is two to 21 days, meaning people exposed to the virus may not fall ill for several weeks. Ebola spreads through contact with infected bodily fluids such as blood or vomit.

Even so, Kenya’s health ministry says nearly 5,000 healthcare workers have been trained to deal with Ebola at national and local levels, in addition to the facilities designated to manage the virus.

The ministry has urged people to stay calm and alert. It has also asked Kenyans not to stigmatise people identified as contacts of Ebola cases.

The ministry and the WHO have produced posters to help people understand Ebola and support efforts to contain it. One message says: “Stop stigma, choose support. Stigma can discourage people from reporting symptoms or cooperating with response teams.”

The government has also bought protective equipment supplies.

With three health workers and a hospital cleaner among those infected, questions have been raised about whether the government could do more to protect workers.

Health workers and carers face a greater risk of Ebola infection because caring for infected patients can expose them to blood and other bodily fluids.

Dennis Miskellah, the KMPDU deputy secretary general, told the BBC that protective equipment must be supplied to hospitals so they are fully protected, especially if patients with symptoms fail to say they have been in Ebola-affected areas.

He said the government should carry out proper health education to reduce stigma, so people do not try to hide their symptoms.

The International Rescue Committee has also called for continued funding for contact tracing, border screening and training frontline health workers in Kenya.

Kenya remains open, with no restrictions on travel, trade or public gatherings.

Despite confirming the eight cases, authorities have clearly ruled out a national lockdown or a general travel ban for Kenyans.

On Monday, the US issued an advisory urging citizens to reconsider travelling to the country because of Ebola concerns. Other countries have also issued health alerts, including the UK, which warned citizens they may face enhanced health screening, and Canada, which has asked citizens to monitor their health for 21 days.

No country has imposed a complete ban on its nationals visiting Kenya, and Kenyans have not been blocked from entering other countries because of Ebola fears.

Analysts have warned about the possible effect of public health fears on international travel and tourism, but there is no evidence that this has happened yet.

However, the situation could change if the outbreak spreads into the wider population.

The exact number of Kenyans living in DR Congo is unclear.

A report published last year by the Centre for Strategic and International Studies (CSIS) think-tank estimated that about 2,500 Kenyans live in eastern DR Congo, including around 50 investors. It also said there were about four times as many Congolese living in the Kenyan capital, Nairobi, alone.

The Kenyan embassy in the Congolese capital, Kinshasa, which represents Kenya’s interests in four countries - DR Congo, Central African Republic, Congo-Brazzaville and Gabon - has previously urged Kenyans living in the region to register formally so it can serve them better.

Several countries in the region have announced tighter surveillance measures and stronger screening for visitors.

One man who had contact with the man who died in Kenya is under quarantine in Somalia, and samples have been sent to Kenya for testing.

Somalia has also said it is taking precautionary steps, including strengthening surveillance at border points “given the evolving regional situation and the movement of people between countries”.

The suspected case in Somalia had travelled through Ethiopia, which has also said it has tightened surveillance to prevent an outbreak.

In Tanzania, visitors are expected to undergo daily health monitoring for 21 days through an automated tracking system, announced after Kenya confirmed multiple Ebola cases.

Uganda said after Kenya’s first Ebola case that it was continuing to “maintain strong surveillance measures to protect public health”.

The Kenyan businessman had travelled through Uganda on his way home from DR Congo.

Uganda had reported two Ebola deaths shortly after the outbreak was reported in DR Congo, but the WHO has since declared it free of the disease.