Fears of a pan-African Ebola crisis growing as fourth country reports first case

As Nigeria reports its first case of Ebola, fears are growing that the epidemic that started in the Democratic Republic of Congo in May could be on the verge of becoming a bigger regional crisis. 

The epidemic is expanding faster than any previous Ebola outbreak, according to health officials, and has already become the deadliest in Congo’s history, with more than 9,500 cases and 4,600 deaths reported as of Sunday. 

Nigeria is the fourth African country to detect Ebola since the outbreak began, and is one of three countries with active cases. 

“My concern, now that this has spread from East Africa to West Africa, is that we now have a pan-African event, as opposed to a few at-risk countries,” said Ayoade Alakija, a Nigerian physician who co-chairs a G7 committee for investment in global health, Reuters reported Wednesday. 

The Nigerian case concerns a Ugandan woman who arrived in Nigeria’s capital Abuja on Oct. 5, authorities said Wednesday. She had previously travelled in Congo and Uganda, according to Ugandan authorities. 

Alakija noted that it had taken 12 days since the woman fell sick for her to be tested for Ebola, potentially exposing many other people to the infection.

“Abuja is one of Africa’s main cities … with air and road connections daily, multiple, across the world. It’s a very different prospect — and that’s what worries me — the amount of time it took.”

WATCH | Children bearing the brunt in Congo’s Ebola outbreak:

Children bear brunt of DRC’s Ebola outbreak

Death rates for children much higher than for adults, WHO estimates, while others orphaned.

So far, authorities have identified 44 contacts, most of them health-care workers. Health authorities have stated the woman is in isolation. 

“This is serious. The virus is spreading across borders and now affects three regions of our continent,” Jean Kaseya, director general of Africa Centres for Disease Control and Prevention (Africa CDC), said on X on Wednesday.

He linked to a statement by Nigeria’s health minister, Muhammad Ali Pate, in which Pate noted that Nigeria had successfully contained Ebola in 2014, and said they were confident they could do it again. 

Members of an Ebola mitigation team disinfect a wooden coffin before loading the body of an unidentified man, who according to his family, died of Ebola, in Bunia, Democratic Republic of Congo, on July 10. (Gradel Muyisa Mumbere/Reuters)

“Africa has faced Ebola before, and Africa will defeat it again,” Kaseya wrote. 

Africa CDC announced Wednesday it will be convening a virtual crisis summit between African health ministers next week to discuss cross-border management of the increasing threat. 

Where else has the virus spread?

Earlier this month, Kenya reported its first Ebola case, involving a traveller who arrived from Congo via Uganda. The country has since reported nine cases, all linked to the same patient, who later died of the virus. Authorities have tightened health surveillance at the border in the wake of the cases.

Uganda reported 20 cases in May and June, mostly imported from Congo, but the World Health Organization declared the country Ebola-free in August. Two people died during their outbreak. 

Members of the Kenya Red Cross response team direct travellers at the Malaba crossing-point between Kenya and Uganda on Oct. 8 after a man who had been living in the Democratic Republic of Congo travelled and died of Ebola in Kenya. (Jackson Adika/Reuters)

One case was reported in France in June after a medical doctor returned from the Congo, but no cases have been reported there since. 

Nigeria is the most populous country in Africa. With over 240 million people, the West African nation has more than double the amount of people in D.R.C. 

The United Nations announced last week that they were scaling up Ebola readiness in 22 countries to be prepared for a greater outbreak. 

What makes this strain so transmissible? 

This current epidemic is caused by the Bundibugyo virus, a rare strain that causes Ebola.

There has been two previous outbreaks of Bundibugyo virus in 2007 and 2012, with fatality rates ranging from around 30-50 per cent, but both outbreaks ended with under 100 deaths.

Although its fatality rate isn’t generally as high as the Zaire strain of Ebola, which was behind the most widespread Ebola epidemic in history in 2014 in West Africa, causing more than 11,000 deaths, the Bundibugyo virus is so new, and its previous outbreaks so small, that it has no approved treatment or vaccine. 

The first cases of the Zaire strain of Ebola were identified in 1976, and it’s been the focus of decades of study, with two FDA-approved monoclonal antibody treatments and a vaccine designed to treat it. 

Africa CDC is deploying that vaccine to frontline health-care workers while separately studying if it provides some protection against the Bundibugyo virus. Clinical trials are also underway for treatment aimed at Bundibugyo virus, but in the meantime, the lack of treatment is allowing for greater spread. 

Health workers and humanitarian responders on the front lines of the Ebola response gather to receive a vaccination in the North Kivu province of the Democratic Republic of Congo, Oct. 16. (Gradel Muyisa Mumbere/Reuters)

As the virus is transmitted through contact with the bodily fluids of those who are infected, WHO warns that direct handling of the bodies of those who died of the virus carries a strong risk of transmission. 

Health experts have flagged that many in the Congo are avoiding hospitals out of fears that they could catch the virus there, leading to more patients dying in their own homes and then being buried by family members who might not know how to limit their own risks of transmission in the process.