Ebola: Africa CDC seeks full travel history of Nigeria’s patient to trace source of infection

The Director-General of the Africa Centres for Disease Control and Prevention (Africa CDC), Jean Kaseya, has called on Nigeria’s first confirmed Ebola patient to disclose her complete travel history and possible contacts during a recent visit to Uganda to help health authorities establish how she contracted the virus.

Mr Kaseya said the woman, who was born in Uganda but resides in Abuja, spent several days in her home country before her husband, a diplomat, travelled to join her. The couple subsequently returned to Nigeria on 3 October.

Speaking during an interview on Channels Television’s The Morning Brief on Thursday, Mr Kaseya said investigators were seeking additional information about the woman’s movements, including whether she travelled outside Kampala and had contact with anyone who might have been exposed to the virus.

He said the information was necessary to support investigations by Nigerian and Ugandan authorities and prevent disagreements between countries over the possible source of infection.

“What we want is collaboration from this person, the lady. She has to disclose to the authorities,” he said.

Mr Kaseya explained that the Africa CDC was working with authorities across the region to establish the circumstances surrounding the infection and determine whether the patient might have been exposed elsewhere during her trip.

He stressed that the woman needed to provide accurate information about her movements and contacts to enable public health officials to identify possible transmission links.

“I need this information, Nigeria needs this information because we need also to support Uganda,” he said.

“She needs to tell us if she flew to the DRC; if she went out of Kampala; if she was in contact with someone who came from the DRC.”

He added that obtaining the information would help strengthen cooperation between countries responding to the outbreak.

“I think these are informations we are looking for, and it will help all of us and avoid a crisis between African countries.”

Patient’s travel history

Nigeria’s first confirmed Ebola patient is the wife of a diplomat who travelled to Uganda’s capital, Kampala, for a holiday.

Mr Kaseya had earlier disclosed that the woman, originally from Uganda but resident in Abuja, developed symptoms three days after returning to Nigeria on 3 October.

Providing details of her medical history during an interview with the BBC’s Newshour programme, he said she first developed symptoms on 6 October and initially sought treatment at a private hospital, believing she had malaria.

She subsequently visited another private hospital, where she was admitted on 11 October after her condition failed to improve.

“She went to the first hospital, a private hospital, thinking that she had malaria, and then she went to the second private hospital. She was admitted on the 11th,” Mr Kaseya told the BBC.

Nigeria’s Coordinating Minister of Health and Social Welfare, Muhammad Pate, confirmed that the 42-year-old woman spent two and a half weeks in Kampala before returning to Abuja through Ethiopia, where she had a two-hour stopover in Addis Ababa.

Mr Pate said the patient, who tested positive for Ebola on Tuesday, was stable and responding to treatment.

He said health authorities had identified 44 people who came into contact with the patient and were taking measures to prevent further transmission.

“Not all of them have been in close proximity. We cast the net wide so that we contain it as broadly as possible,” he told the BBC.

Conflicting accounts of patient’s travel history

The Africa CDC chief’s latest appeal comes amid differing accounts of the patient’s movements before arriving in Nigeria.

Uganda’s Ministry of Health had earlier described the patient as a Nigerian national who travelled to eastern Democratic Republic of the Congo (DRC) for business and only passed through Uganda while returning home.

Ugandan authorities maintained that the country had no active confirmed Ebola cases and that the woman’s transit through Uganda did not establish that she contracted the virus there.

Mr Pate said Nigerian authorities were working with Uganda, Ethiopia and the Africa CDC to establish the patient’s complete travel history and determine where she might have contracted the infection.

“We respect our sister nation of Uganda,” he said. “We have very strong solidarity, we are all in it together.”

Regional outbreak

Nigeria’s case comes amid a continuing Ebola outbreak in the DRC and recent cases in other countries.

According to the European Centre for Disease Prevention and Control (ECDC), the DRC had recorded 9,552 confirmed cases and 4,602 related deaths as of 19 October, based on data available up to 18 October. The outbreak has affected eight provinces.

Kenya had also reported nine confirmed cases, including one death, as of 20 October, following an imported case involving a person who had travelled from the DRC through Uganda.

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Uganda recorded 20 confirmed cases of Ebola disease caused by the Bundibugyo virus between May and June. 15 of the cases were imported from the DRC, while five were locally acquired among contacts and health workers linked to the imported cases. In August, the World Health Organisation (WHO) declared the outbreak in Uganda over after 42 days without a new confirmed case.

WHO has also urged Nigerians to remain calm, saying that one imported case does not by itself mean Nigeria is experiencing an Ebola outbreak.

WHO Regional Director for Africa, Mohamed Janabi, said the organisation is supporting Nigeria with case investigation, contact tracing, laboratory testing, infection prevention and control, and protection of health workers and communities.