The World Health Organization says the Ebola outbreak that began in the Democratic Republic of Congo is becoming harder to contain, with the Bundibugyo strain now detected in countries in both East and West Africa. The assessment came at an online briefing on Thursday, the same week Nigeria confirmed its first case of the strain. According to Al Jazeera, Mohamed Janabi, the WHO's regional director for Africa, described the situation as "a more complex outbreak landscape."
The outbreak was declared in the DRC in mid-May. Congolese health authorities say it is the deadliest in the country's history, with more than 4,000 deaths among over 9,000 confirmed cases. The Africa CDC has said the case fatality rate in the DRC is approaching 50 percent and has called the situation an extremely serious threat.
Why it matters
The Bundibugyo strain has now appeared in the DRC, Kenya and Nigeria, while Uganda recorded cases earlier in the year before being declared Ebola-free in August. Nigeria is the most populous country affected so far, and its first case has raised difficult questions about how the virus is moving between countries.
The spread across two regions of the continent complicates contact tracing and makes it harder to establish chains of transmission. Health officials are still trying to determine where Nigeria's first patient became infected, and whether she crossed paths with Kenya's first patient at an airport in Uganda.
Dispute over the Nigerian patient's travel history
The Nigerian case involves the Ugandan-born wife of a Swiss diplomat stationed in Abuja. She was confirmed positive on Tuesday. Uganda's authorities said she had travelled to eastern DRC before passing through Uganda, but the WHO and the Africa CDC said on Thursday they had not received confirmed information that she visited the DRC.
A statement from the Swiss government to Reuters said the patient is believed to have caught the disease while travelling in Uganda. Wessam Mankoula, who leads emergency preparedness and response at the Africa CDC, said both the Nigerian patient and Kenya's first case left Entebbe on October 3, and that investigators are examining whether the two may have encountered each other. Jean Kaseya, the Africa CDC's director general, also said there was no validated information that the woman had been in the DRC.
Pavel Ursu, the WHO's representative in Nigeria, said the information provided to the organisation contained no record of travel beyond Uganda. Patrick Otim, a WHO emergency response manager, said the origin of her infection remains unknown while authorities reconstruct her movements. Investigators are also checking which health facilities in Abuja she attended between the onset of symptoms and her hospitalisation two days later.
Uganda's government rejected any suggestion that the infection occurred on its soil. Government spokesman Alan Kasujja told AFP it was "preposterous" to connect Uganda to the case merely because the woman had spent a holiday there.
Kenya's cluster and contact tracing
Kenya's Ministry of Health confirmed its first case earlier this month and has reported eight more since. Patrick Amoth, the ministry's director-general, said officials have traced all 135 contacts of the first patient.
Nigeria is currently following 44 contacts. Mankoula said additional contacts have since been identified but did not provide an updated figure.
Uganda recorded 20 confirmed cases before it was declared free of the virus in August, including 15 that were imported from the DRC, along with two deaths.
What to watch
The WHO and the Africa CDC are expected to continue tracing the Nigerian patient's movements and investigating the possible Entebbe connection, while Nigeria expands its contact list. Any confirmed link between the two cases would give investigators a clearer picture of how the strain is crossing borders.
