Uganda on Tuesday confirmed a child there has been diagnosed with Ebola, the first cross-border case from the Democratic Republic of the Congo, where a large outbreak has raged for the last 10 months.
Five family members traveling with the child, a 5-year-old, are also ill and have been tested for Ebola, Ugandan Health Minister Dr. Jane Ruth Aceng said. Those test results are pending.
The news will likely increase pressure on the World Health Organization to declare the outbreak a public health emergency of international concern. The agency’s director-general, Tedros Adhanom Ghebreyesus, told STAT he will convene an advisory body — called an emergency committee — as quickly as possible to review the situation and decide whether the outbreak now poses a global health threat.
Dr. Mike Ryan, who heads the WHO’s emergencies program, said the meeting will likely occur within the next day or two, after the agency consults with the governments of Uganda and DRC.
Ryan said Uganda and partners have been working for months to protect the border area against just this type of event. “It’s never good news to have Ebola,” he said, but suggested the preparatory work should help contain the threat.
The infected child crossed into Uganda with his family in Bwera, near the Congolese city of Butembo. The Congolese Health Ministry said the family was traveling from Mabalako. Both Mabalako and Butembo have experienced intense Ebola transmission of late.
The boy’s mother is Congolese but his father is Ugandan; they live in Uganda, near the border. The family had traveled to DRC to see the woman’s father. He died from Ebola in late May.
A group of 14 family members set off to return to Uganda, arriving at a village called Kasindi near the border on June 10. Of the group, seven are children, ranging in age from 7 months to 12 years of age.
When they arrived at Kasindi, 12 members of the group were experiencing symptoms, and they stopped there at a health facility. They were directed to an isolation center, but then six members of the family fled the facility, crossing into Uganda, said the Congolese Health Ministry, which alerted Ugandan authorities of the family’s movements. The group that crossed the border included the boy, his mother, and four others.
The WHO’s country office for Uganda said that after crossing the border, the group sought care at a hospital in Kagando, where health workers recognized the boy was likely infected with Ebola.
The boy was transferred to an Ebola treatment center at Bwera, one of the facilities Uganda has set up in anticipation of the possibility of seeing cases imported from DRC. He was tested for the virus there.
For months, DRC’s neighbors have been preparing for the possibility that a case arising from the outbreak in DRC could spill into their territories, with Uganda, South Sudan, and Rwanda vaccinating health workers in health facilities near their borders with DRC. Vaccination of health workers in parts of Burundi is also planned.
Uganda has vaccinated nearly 5,000 health workers at 165 health facilities, including both the one where the boy is being treated, and the one at Kagando where his family first stopped for care.
The WHO said Uganda’s health ministry has dispatched rapid response teams to the area in a bid to ensure the virus is contained. Tedros told STAT the WHO is also sending supplies of vaccine to Uganda in case it’s needed. Ryan said eight potential contacts of this group on the Ugandan side of the border have been identified so far.
The outbreak in northeastern DRC is the second largest on record. To date, there have been 2,071 cases and 1,396 deaths. The outbreak is believed to have started in late April 2018 but was only recognized as Ebola at the end of July.
Twice so far Tedros, as the WHO director general is known, has convened an emergency committee to advise him on whether the outbreak constitutes a global health threat. Both times they concluded it did not, pointing specifically to the lack of international spread.
The emergency committee has also warned that declaring a public health emergency might actually complicate the job of stopping the outbreak, which is occurring in a conflict zone.