NO EBOLA
IN KENYA

BUT AUTHORITIES ISSUE HIGH ALERT

The Ministry of Health on Monday confirmed that there was no Ebola in the country. Laboratory results from the blood samples of a 36-year-old patient who was taken into isolation on Sunday were negative for Ebola. Her husband and two other contacts had also been quarantined.

This is an inflammation of the stomach and intestines, typically caused by a bacterial or viral infection and causing vomiting and diarrhoea. Health workers in the south-western town of Kericho said they acted out of caution in isolating the patient.

She had a fever, headache, sore throat and was vomiting – symptoms that would indicate the presence of a number of infections, including Ebola. The news sent the town into panic and most businesses and offices closed early as people left the town out of fear.

Kericho Governor Paul Chepkwony, who made the announcement in Kericho town, said she would be moved from isolation to the general ward for continued treatment. The Kenyan woman had travelled to Uganda and is known to have been in contact with three people, including her husband. She then checked into Siloam Hospital on Sunday night with headaches, fever, and vomiting.

She was transferred to Kericho County Referral Hospital yesterday and isolated. "The sample tested negative for Ebola," Chepkwony said. The sample was also tested against Rift Valley Fever, Yellow Fever, Crimean–Congo hemorrhagic fever and Malaria, all turning negative.

"The two other patients who had contact with her and were isolated have also been released because they are not sick," Chepkwony said. Kericho Health CEC Shadrack Mutai said the woman would be discharged in two or three days. "Once the patient recovers, in two or three days, she will be let go home," he said. "We will also inform the village where she comes from that she has no Ebola and is free to mingle."

Earlier in Nairobi, the Ministry of Health had already ruled out Ebola saying the symptoms did not match Ebola symptoms at all. Health Cabinet Secretary Sicily Kariuki said: "The rapid surveillance and response team has examined the patient who is in stable condition and has confirmed that she does not meet the case definition for Ebola." She spoke at the Jomo Kenyatta International Airport where health workers are screening arriving passengers through thermal cameras.

Cabinet Secretary Ministry Health Cecily Kariuki at Jomo Kenyatta International Airport to oversee the Ebola screening on 17.June.2019/EZEKIEL AMING'A

Cabinet Secretary Ministry Health Cecily Kariuki at Jomo Kenyatta International Airport to oversee the Ebola screening on 17.June.2019/EZEKIEL AMING'A

Separately, health officials indicated Kenyans would wait longer to access an Ebola vaccine. The World Health Organisation said the existing anti-Ebola vaccine, which is 97 per cent effective, is only being doled out to frontline health workers and most at-risk people in the Democratic Republic of Congo and Uganda. The WHO said there is only one investigational vaccine called rVSV-ZEBOV, which has shown to be safe and protective against the Zaire strain of the virus. WHO said the vaccine has not been commercially licensed. "The vaccine is, therefore, being used on a compassionate basis, to protect persons at highest risk of the Ebola outbreak," the organisation said in a statement.

The VSV has been genetically engineered to contain a protein from the Zaire Ebola virus so that it can provoke an immune response to the Ebola virus. It was tested in Kenya, Europe, the US, and other African countries but has not yet undergone a complete clinical trial. Separately, US Centre for Disease Control director Robert Redfield said there is currently a global stockpile of about 145,000 doses of the vaccine, while roughly 130,000 people in DRC have been vaccinated so far. This represents only about 20 per cent of the number of people that responders would like to be able to reach.

Ebola vaccination / REUTERS

Ebola vaccination / REUTERS

Ebola vaccination / REUTERS

Ebola vaccination / REUTERS

Redfield said the pharmaceutical company manufacturing the vaccine is yet to produce more. "Unfortunately, there’s going to be a six to 12-month lag before there’s adequate vaccine supply," he said. The vaccine, produced by drugs company Merck, has shown an efficacy rate of about 97 per cent. Yesterday, the WHO commenced vaccination in the Ugandan village where the virus killed three people. “We are going to the communities where the confirmed cases were identified and vaccinating those families in what we are calling ring vaccination,” said Benjamin Sensasi, WHO health promotions and communications officer in Uganda.

Those being given priority in Uganda are health workers and people who had contact with the two patients who died. The vaccination is being done at Kagando, Bwera, and Mpondwe in Kasese district in western Uganda, bordering the Democratic Republic of Congo.

In Kenya, the Ministry of Health said it has established Ebola Rapid Response Teams comprising medical specialists in disease control and laboratory scientists who are trained in investigation and testing for Ebola virus. "The ministry has a total workforce of 229 staff deployed at various ports of entry and in addition 21 Ebola champions have been deployed to support the team," Kariuki said.

She said Kenyans who experience fever, chills, headaches and have a history of recent travel to affected countries should present themselves to the nearest health facility. "They can also contact the Ministry of Health’s emergency operations centre through hotlines 0732353535 and 0729471414," she said. 

At the Busia Kenya Port Health Desk, all arriving travellers including truck drivers now have to undergo Ebola screening. Busia chief officer for health and sanitation Dr Isaac Omeri said a surveillance team is assessing the border situation and will make recommendations. He said there is an isolation ward at the Busia County Referral Hospital and at Malaba dispensary where any suspected Ebola cases are quarantined, awaiting medication.

The virus usually spreads easily from person to person, potentially affecting a large number of people. It spread through direct contact with blood or body fluids (urine, saliva, sweat, faeces, vomit, breast milk, and semen) of a person who is sick with or has died of Ebola. Others are objects (such as needles and syringes) contaminated with body fluids from a sick person. When someone gets infected with Ebola, they will not show signs or symptoms of illness right away. 

Health workers with infected child, North Kivu / REUTERS

Health workers with infected child, North Kivu / REUTERS

The current outbreak of Ebola in DR Congo is the second-worst in history. Only the West African epidemic of 2014, which killed more than 11,000 people in Guinea, Liberia and Sierra Leone, claimed more lives. In Congo, some 1,400 people have died since August, two-thirds of the roughly 2,000 who contracted the disease. 

Once an outbreak is contained, it takes 42 days for a country to be declared free of Ebola transmission. WHO doubles the 21-day incubation period of the virus to ensure no new infections are happening.

Q & A WITH
EBOLA DOCTOR

By Lyndsay Nyawira

The government has moved to calm fears that Ebola has spread into the country. Earlier, a woman was isolated after exhibiting Ebola-like symptoms. She was cleared and Health CS Sicily Kariuki said there are no cases of Ebola in Kenya. The Star spoke to Public Health Specialist Dr Elvis Ogweno.

What is Ebola?

Ebola virus disease formerly known as Ebola haemorrhagic fever is a rare and deadly disease most commonly affecting people and non-human primates (monkeys, gorillas, and chimpanzees).

How is the virus transmitted to humans?

You can get infected through direct contact (such as through broken skin or mucous membranes in the eyes, nose, or mouth with the infected animals, eating Ebola-infected monkeys.

How is the virus spread among human beings?

Through direct contact with infected blood, vomit, faeces or bodily fluids of someone with Ebola. The virus can also be present in urine and semen and can survive on surfaces for some hours.

How long is the incubation period?

It can take up anything from two to 21 days for humans with the virus to show symptoms.

What are the first symptoms to show after the incubation period?

Initial symptoms can include a sudden fever, intense weakness, muscle pain and a sore throat. Subsequent stages can bring vomiting, diarrhoea and - in some cases - both internal and external bleeding. Patients tend to die from dehydration and multiple organ failure.

Is the disease commonly misdiagnosed?

Many common illnesses can have these same symptoms, including influenza (flu) or malaria.

What measures are taken after the diagnosis?

If a patient shows early signs of EVD and has had a possible exposure, he or she should be isolated immediately. He is treated in seclusion, his blood samples are collected and tested to confirm infection.

Why is it so hard to contain it in DR Congo?

There is a mistrust not only that targets outsiders, but also extends to anyone affiliated with the government, including locals who may be assisting in vaccination and containment efforts. Some people in this region still do not believe that the Ebola virus is real. Others do not believe in the safety of the vaccine in general. Some people have avoided vaccination because they believe the vaccine is a poison or something to make them sick. It is also very hard to track the person who had it first and spread it because of the congestion. Poor infrastructure and insecurity in Kivu hinder access so we can't camp there.

Is there a cure? 

Vaccines and curative treatments are still on the trial and are being used to treat Ebola victims in DR Congo. There is a 93 per cent success on vaccines used on the victims.

MYTHS ABOUT EBOLA

Myth #1: Ebola is universally fatal.

Ebola can certainly be fatal, but not universally so. The case fatality ratio for Ebola and its close cousin, the Marburg virus, varies greatly depending on the setting.

Myth #2: Ebola isn’t treatable.

There are actually several effective treatments for Ebola that can help support individuals through the worst phases of the disease and increase their chance of survival. These treatments include early and careful resuscitation with IV fluids; blood products such as packed red blood cells (PRBCs), platelets, concentrations of clotting factors to prevent bleeding; antibiotics to treat common bacterial coinfections, respiratory support with oxygen (in severe cases, via a ventilator), and powerful vasoactive medications to counter the effects of shock.

Myth #3: Ebola is the most contagious

Ebola is the most contagious disease and will spread rapidly across the US if it enters the country. Ebola isn’t the most contagious disease known. It’s not airborne and it’s not spread by aerosols (small droplets that float through the air). This makes it less contagious than a host of other diseases, such as measles, chicken pox, tuberculosis, or even the seasonal flu. To the best of our knowledge, Ebola is spread only by close physical contact, especially with bodily fluids. So, unless someone on the subway vomits, defaecates, or bleeds on you, they aren’t going to be passing Ebola onto you.

Myth #4: We need to give experimental

Ebola drugs to as many Africans as possible to help stem the outbreak. Any human being given an experimental treatment that hasn’t yet been proven safe and effective in humans is, by definition, being experimented upon. Experimenting on humans, even those in poor countries, isn’t necessarily a bad thing. Conducting research in resource-limited settings is part of what I do for Partners in Health. However, every person enrolled in a medical research study, whether they are American or African, is entitled to the same basic international ethical protections—and people in poor countries actually deserve special protections.

Myth #5: Nothing can be done to help

Africa—it’s just too poor. The true tragedy of the Ebola outbreak is that most Africans lack access to the very same medications, equipment, and skilled physicians and nurses that have been available in the US and Europe for several decades. Access to these things could have prevented the current epidemic from raging out of control. These very same measures could also be used to reduce mortality from the variety of other diseases, aside from Ebola, currently killing Africans each day.

A health worker wearing Ebola protection gear, at the ALIMA Ebola treatment centre in Beni / REUTERS

A health worker wearing Ebola protection gear, at the ALIMA Ebola treatment centre in Beni / REUTERS

Medical stuff and an Ebola survivor treat an Ebola patient in a medical centre in Beni, Democratic Republic of Congo / REUTERS

Medical stuff and an Ebola survivor treat an Ebola patient in a medical centre in Beni, Democratic Republic of Congo / REUTERS

A priest and family members watch as health workers prepare the body of an Ebola patient for burial in Butembo / REUTERS

A priest and family members watch as health workers prepare the body of an Ebola patient for burial in Butembo / REUTERS

Suspected Ebola patients at an Ebola treatment centre in Butembo / REUTERS

Suspected Ebola patients at an Ebola treatment centre in Butembo / REUTERS