Ebola: Africa CDC warns Nigeria over cross-border threat

The Africa Centres for Disease Control and Prevention (Africa CDC) has raised concern over the risk of cross-border transmission of Ebola following Nigeria’s confirmation of an imported case, as health authorities investigate the source of the infection and trace people who may have been exposed.

Africa CDC epidemiologist, Dr Wessam Mankoula, speaking during a virtual press conference, said the case involved a woman in her 40s who reportedly arrived in Abuja from Uganda on October 3 and developed symptoms four days later.

The woman visited several health facilities before being admitted to hospital on October 11, where she was initially treated for malaria. Ebola was suspected on October 19, and the diagnosis was confirmed by Nigeria’s National Reference Laboratory on October 20. Her condition was reported to be stable.

Mankoula said Nigerian authorities had initially identified 44 high-risk contacts and were continuing investigations to identify additional people who might have been exposed, including healthcare workers.

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He said Nigeria and Uganda were working together to establish the source of the infection, with investigators examining the woman’s travel history and possible exposure before her arrival in Nigeria.

The Africa CDC official also disclosed that investigators were examining a possible link between the Nigerian case and cases reported in Kenya, as both patients reportedly departed from Entebbe, Uganda, on October 3. He cautioned, however, that no connection had been confirmed.

In Kenya, Mankoula reported nine confirmed Ebola cases, including one death, while eight other patients were in isolation and receiving treatment. Authorities had identified 135 contacts, of whom 118 were quarantined. Eight additional cases were traced to people already on the contact list.

He said nine contacts had travelled abroad, prompting notifications to destination countries through the International Health Regulations system.

The Democratic Republic of the Congo (DRC) remained the worst-affected country, with 9,704 confirmed cases and 4,687 deaths recorded as of October 20, according to figures presented during the briefing. More than 2,500 people had recovered.

Mankoula said the outbreak, declared in May, had spread to 67 health zones, with Ituri and North Kivu accounting for 94 per cent of reported cases.

He identified gaps in contact tracing as a major challenge, saying more than 80 per cent of cases in the DRC were being reported among people who had not been identified on existing contact lists. More than 60 per cent of cases were also being detected in communities.

According to Mankoula, the average interval between symptom onset and notification of health authorities was about four days, against a target of fewer than two days. In some cases, the delay reached nine to 11 days.

He warned that the decline in reported cases from epidemiological week 37 should be interpreted cautiously, as reporting delays, insecurity, community resistance and operational difficulties could affect the figures.

On treatment and vaccination, Mankoula said 762 participants had been recruited for therapeutic trials in the DRC, against a target of between 1,500 and 2,500. A separate study examining remdesivir for post-exposure use had enrolled 577 participants out of a planned 1,000.

He said the DRC had received 70,000 vaccine doses, with 50,000 allocated for compassionate use and 20,000 planned for a Phase 3 Solidarity trial. The briefing reported that 13,531 frontline and healthcare workers had been vaccinated under the compassionate-use programme.

Mankoula also raised concerns over funding for the response, noting that pledges of approximately $3 billion had been reported, alongside discrepancies between donor-reported disbursements and the amounts accounted for by implementing organisations.

Figures presented during the briefing indicated that donors had reported disbursing more than $900 million to implementing organisations, while reports from those organisations accounted for about $200 million. The resulting difference of roughly $700 million required clarification and was not established as missing money.

He said improved financial tracking was necessary as response teams continued to require resources for protective equipment, treatment centres, testing and personnel.

Mankoula also highlighted preparedness efforts involving South Sudan, Rwanda, Burundi and the Central African Republic. According to the briefing, South Sudan had reported no confirmed cases since the beginning of the outbreak.

He stressed the importance of surveillance, prompt reporting, contact tracing, community engagement and cross-border coordination as affected countries work to contain the outbreak and reduce the risk of further transmission.

The developments have placed renewed attention on Nigeria’s capacity to detect suspected infections promptly, trace contacts and coordinate with neighbouring and affected countries as investigations into the imported case continue.