The Kenyan man who died of Ebola this week travelled extensively through the Democratic Republic of Congo (DRC) and Uganda and sought medical care from mid-September – passing through several airport health screenings without detection, even two days before he died.

Dr Wessam Mankoula, head of health emergencies for Africa Centre for Disease Control and Prevention (CDC), presented a map of the man’s travels at a media briefing on Thursday, showing that he sought medical treatment at health centres in Bondo and Kasangani in the DRC from as early as 17 September.

The deceased travelled through at least eight towns and cities and took three flights while sick, his final journey being a flight from Entebbe in Uganda to Nairobi on 3 October. He was picked up at Nairobi’s Jomo Kenyatta International Airport by a family member who drove him directly to Nairobi Hospital, where he died of Ebola two days’ later.

His medical records indicate that he had been suffering from fever and skin rash, and was diagnosed with a staphylococcal skin infection. There was some suggestion that he might have erroneously been diagnosed wth Rift Valley Fever, a mosquito-borne disease.

By the time he reached Nairobi, “he was suffering from fever, sore throat, muscle pain, and also bleeding in some of the infection sites,” said Mankoula.

The World Health Organization (WHO) reported on Wednesday that the man’s temperature had been recorded as normal when he was screened on two separate occasions.

Mankoula said he was possibly taking antipyretic medication, which had masked his fever and urged travellers to be transparent about their symptoms to ensure they did not endanger others.

“Please, if you start having any symptoms related to Ebola, if you have been in touch with any confirmed cases of Ebola, report this to the health authorities in your countries,” Mankoula urged.

“If you start having fever, please don’t try to take drugs to mask those symptoms so that you can start crossing the borders. 

“When you reveal if you have any symptoms or signs related to Ebola, you are not only preventing further spread to other countries, but also you are protecting yourself first. When you seek medical care early, we see an improvement in the outcome. When you delay in seeking medical care, this is when we see worse outcomes.”

“Africa CDC is calling for vigilance, not panic,” Mankoula stressed, saying that co-operation between the three affected countries has enabled authorities to map the man’s movements and start tracing his contacts.

In response, Kenya has activated its public health emergency operations centre and a national task force led by the Ministry of Health

Mankoula also called for the strengthening of health screening measures at countries’ points of entry and points of exit. 

“We have tried, through thermal screening, through some of the questionnaires in the countries, to track the history of the travellers and also if they have any symptoms or signs. So this is helping the countries to take quick measures to identify any suspected cases quickly and deal with this.”

More than 8,700 cases have been reported in DRC with 4,205 deaths – a 48% case fatality rate. There has been a 24% decrease in Ituri in the past three weeks, and a 19% decrease in Nord-Kivu, although conflict in the province is affecting surveillance. 

Image Credits: Twitter: @MoetiTshidi.