Uganda's Ministry of Health on Saturday confirmed three new Ebola infections, bringing the country's case count to five, as health authorities stepped up contact tracing to contain a cross-border outbreak centered in the Democratic Republic of Congo. The new patients include a driver who transported Uganda's first confirmed case and a health worker exposed while caring for that patient.
The update came a day after World Health Organization Director-General Tedros Adhanom Ghebreyesus raised the agency's risk assessment for the Bundibugyo strain to "very high at the national level" in Congo. The outbreak has no approved vaccine, has crossed two borders and prompted the United States to bar entry to noncitizens who have been in Congo, Uganda or South Sudan in the previous 21 days.
What shifted
The third Ugandan case is a woman from Congo who entered with mild abdominal symptoms and traveled from Arua, near the border, to Entebbe before seeking care at a private hospital in Kampala. She initially improved and returned to Congo, but tested positive after a follow-up prompted by a tip from a pilot who had transported her, the ministry said.
In Congo, the WHO has logged 82 confirmed cases and seven confirmed deaths, with almost 750 suspected cases and 177 suspected deaths. "The Ebola outbreak in the Democratic Republic of the Congo is spreading rapidly," Tedros told reporters Friday. "We are now revising our risk assessment to very high at the national level."
On the ground
Authorities in northeastern Congo on Friday banned funeral wakes and gatherings of more than 50 people, and required journalists to obtain a permit to report on the outbreak. The order followed an arson attack Thursday in Rwampara, where local youths set fire to an Ebola treatment center after being stopped from retrieving the body of a friend who had died of the virus. Aid workers fled in vehicles.
Neighboring Rwanda has shut its border crossings with Congo. A Berlin hospital treating an American Ebola patient said the man is not critically ill and that his wife and four children have tested negative.
The supply gap
First responders in Congo say they lack basic supplies, which some have attributed to foreign aid cuts by major international donors, particularly the United States, Al Jazeera reported. Jean Kaseya, director-general of the Africa Centers for Disease Control and Prevention, said surveillance is still ramping up. "I expect the number of cases to increase as surveillance becomes more and more rigorous," Kaseya said. One expert said this week that a Bundibugyo vaccine is at least six to nine months away.
The counterpoint
The WHO has kept the global risk rating low, and the situation in Uganda remains "stable," Tedros said, with patients identified through known contact lists rather than community transmission. Trump administration health officials had not publicly responded to donor-cut critiques or defended the U.S. travel restrictions by press time.
What's next
India and the African Union on Thursday postponed next week's India-Africa Forum Summit in New Delhi, citing the "evolving health situation in parts of Africa." Congo's national soccer team has canceled its World Cup preparation camp. Tedros said the WHO is working with the Africa CDC and partners in Congo and Uganda to contain the outbreak in what he called "this critical moment."