The surveillance Kenya needs to prevent Ebola

The Ebola Virus Disease (EVD), one of the deadliest viral diseases, was discovered in 1976. The first outbreak occurred in the Democratic Republic of Congo (DRC) near the Ebola River, which gave the virus its name. Viral and epidemiologic data suggest that Ebola virus has existed long before this period.

Population growth and forest encroachment have contributed to the spread of the virus. African fruit bats are likely involved in the spread of Ebola virus and may even be the source animal for this deadly virus.

Close contact with infected blood, reuse of contaminated needles, and improper nursing techniques were the source for much of the human-to-human transmission during early Ebola outbreaks.

By the 1994 Cote d’Ivoire outbreak, scientists and public health officials had a better understanding of how Ebola virus spreads and progress was made to reduce transmission through the use of facemasks, gloves and gowns for healthcare personnel.

During the worst outbreak in West Africa in 2014-2016, which claimed more than 11,000 lives, the majority of transmission events were between family members (74percet). Direct contact with the bodies of those who died from the virus proved to be one of the most dangerous – and effective – methods of transmission. Changes in behaviors related to mourning and burial, along with the adoption of safe burial practices, were critical in controlling that particular epidemic.

About 2,000 cases and 1,300 deaths caused by Ebola have been recorded in DRC since last August. The disease has spread to Uganda, which shares a border with Kenya, with two deaths reported.

In Kenya, we had an Ebola scare in Kerich, but the Health Ministry said results from the Kenya Medical Research Institute were negative.

Most people cross formal borders but many evade the main ports of entry manage to cross over informally.

People cross for all sorts of reasons. One of them is funeral rites. The response teams from both the DRC and Uganda must be commended for preventing the mass cross-border export of Ebola cases given the complex nature of the current outbreak.

When people fall ill, they will do what anyone would: seek support from their relatives and friends, some of whom are in border towns. All of this means that health authorities’ interventions must be strategic. They cannot physically monitor all of the informal porous borders between these countries.

What they need to do now is to mobilise towns and villages that share border points with the regions that are at high risk for the export of Ebola. Get the local chiefs to keep a visitor log. The visitors can then be tracked back to their village of origin to investigate any linkage to a cluster of cases.

Kenya is strategically located as a gateway to East and Central Africa, with trade between most of the countries. Jomo Kenyatta International Airport (JKIA) with its connections, functions as an effective air hub between Africa, Europe, Asia and USA.

With this in mind, the Ministry of Health has to be super vigilant in monitoring people that enter the country.

Kenya being the health care hub in the region has many patients from DRC and Uganda seeking medical treatment in the country, the authorities need to ensure that if a patient with Ebola ever entered the borders the response to containment, isolation and treatment are adhered to the letter.

The Ministry should also ensure that proper personal protective equipment.

Importantly, tap into the experts and educate local communities on how the disease spreads; the hospitals properly staffed and stocked with equipment; and healthcare personnel trained in disease reporting, patient case identification, and methods for reducing transmission in the healthcare setting.

The writer is Consultant Physician and Infectious Diseases Specialist, Department of Medicine, Aga Khan University, Medical College, East Africa.