Is Ebola under control in Kenya after nine cases confirmed?

Image source, Anadolu via Getty ImagesImage caption, Nearly 5,000 healthcare workers have been trained to deal with EbolaByBasillioh RukangaReporting fromNairobiKenya is grappling with its first ever outbreak of Ebola, a disease which neighbouring countries, such as Uganda and Democratic Republic of Congo, are used to dealing with.Nine cases have now been confirmed including its first patient, who travelled from DR Congo and died two weeks ago.Four relatives of the first victim, three health workers and a hospital cleaner have now tested positive, meaning they are all linked to him.But concerns are rising that the virus could start spreading further, even as the government has sought to assure citizens.The US has warned it citizens against travelling to Kenya, while neighbouring countries such as Uganda, Ethiopia and Somalia are also on alert.Should Kenyans be concerned?Kenyans have been expressing their concerns that the disease could spread more widely.More than 4,000 people have died since Ebola was confirmed in DR Congo in May, making it the second most deadly outbreak of the disease.With more than 9,500 cases in DR Congo, Kenya faces a steady risk of new cases arriving across borders, according to the International Rescue Committee, which has been working alongside both governments to contain the spread.The latest outbreak has been caused by the Bundibugyo species, which is relatively rare, with no approved vaccine or treatment - though trials are under way. Kenyans raised questions from the outset, about how the first patient was able to spend time in the region worst-affected by Ebola, then travel to two more countries before his illness was identified. He died days after his arrival in Kenya. As a regional transport hub, the risk of the outbreak spreading is a big concern.The doctors' union in Kenya has expressed concerns at "lapses" at various border points, including with neighbouring Uganda and Tanzania, as well as at Kenya's main airport. Dennis Miskellah, the union representative, told the BBC that border and port facilities were grossly understaffed.However, Health Director-General Patrick Amoth on Tuesday evening sought to reassure people, saying that the eight patients were all improving and responding well to treatment.What is being done to stop it spreading?When the first case was announced, the authorities urged people not to panic, assuring them of heightened surveillance at airports and border crossings.Kenya has since introduced enhanced screening for travellers arriving from 10 countries it considers to be at high risk: DR Congo, Uganda, Tanzania, Rwanda, Burundi, Angola, Zambia, Ethiopia, South Sudan and the Central African Republic.Travellers arriving from those countries are required to complete a digital surveillance form before boarding their flights, and to present a QR code to port health officials on arrival.Kenya also ordered enhanced public health screening of aircraft arriving from those countries, as authorities seek to prevent further imported cases.Within the country, the government has been sharing public messages to create awareness about Ebola, including encouraging people to promptly report any suspected cases and seek care at a hospital. It has also focused on hygiene and safety measures, such as washing hands and avoiding close contact with sick people.The government has additionally designated treatment and isolation facilities across the country, and health workers have been trained to deal with the disease.Amoth also said that a dedicated laboratory had been set up at the Kenyatta National Hospital Infectious Disease Unit to handle Ebola tests, to ensure that the hospital's laboratory was not contaminated.Image source, AFP via Getty ImagesImage caption, Kenya has increased screening at border pointsIn Kenya, 134 out of 135 people listed as contacts of the first patient remain in quarantine. That means about 99% of the contacts have been traced and isolated, in order to prevent Ebola from spreading to the wider population.That all of those infected so far had links to the first victim shows Kenya's early response is working, according to the International Rescue Committee.The government is also working with international partners, including Africa CDC and the World Health Organization (WHO), to support its response, including surveillance, communication and community engagement.A toll-free emergency hotline, 719, has been provided to the public to report suspected symptoms.Is Kenya prepared in case it starts spreading further?Amoth said that none of the contacts of the first patients had showed symptoms before going into quarantine "and therefore the potential to spread to another person is very minimal, literally non-existent".The incubation period for Ebola ranges from two to 21 days, meaning those exposed to the virus may not become ill for several weeks. The Ebola virus spreads through contact with infected bodily fluids such as blood or vomit.Despite that, Kenya's health ministry says nearly 5,000 healthcare workers have been trained to deal with Ebola at the national and local levels, besides the facilities that have been designated to handle the virus. The ministry has urged people to remain calm and vigilant. It has also asked Kenyans not to stigmatise people identified as contacts of Ebola cases. The ministry, along with the WHO, have produced posters to help people understand Ebola and support its containment. One message reads: "Stop stigma, choose support. Stigma can discourage people from reporting symptoms or cooperating with response teams."In addition, the government has procured supplies of protective equipment.Is enough being done to protect health workers?Not according to the Kenya Medical Practitioners and Dentists Union (KMPDU). With three health workers and a hospital cleaner among those infected, questions have been asked as to whether the government could do more to protect workers.Health workers and carers can face a higher risk of Ebola infection because caring for infected patients may bring them into contact with blood and other bodily fluids.Dennis Miskellah, the KMPDU deputy secretary general, told the BBC that protective equipment must be provided to hospitals so that they are fully protected, especially in case patients with symptoms do not declare that they have been in areas with Ebola.He suggests the government ought to conduct proper health education to destigmatise the virus, so that people do not seek to hide their symptoms.The International Rescue Committee has also called for continued funding for contact tracing, border screening and training of frontline health workers in Kenya.Will there be any restrictions, like a travel ban?Kenya remains open with no restrictions on travel, trade or public gatherings. Despite confirming the eight cases, the authorities have explicitly ruled out a national lockdown or general travel ban for Kenyans. The US on Monday issued an advisory asking citizens to reconsider travelling to the country over Ebola concerns. Other countries have issued health alerts, including the UK, which warned its citizens that they may encounter enhanced health screening, and Canada, which has asked citizens to monitor their health for 21 days.No country has issued an outright ban against their nationals visiting Kenya, nor have Kenyans been blocked from entering other countries over Ebola fears.Image source, AFP via Getty ImagesImage caption, Kenyan authorities have ruled out travel restrictionsHas business and tourism been affected?Analysts have raised concerns over the potential impact of public health fears on international travel and tourism but there is no evidence this has happened yet.But the situation could change if the outbreak were to spread into the wider population.How many Kenyans are there in DR Congo?The exact number of Kenyans living in the DR Congo is not clear.A report authored last year by the Centre for Strategic and International Studies (CSIS) think-tank put the number of Kenyans living in eastern DR Congo at about 2,500, including about 50 investors. It also noted that there were about four times as many Congolese living in the Kenyan capital, Nairobi, alone.The Kenyan embassy in the Congolese capital, Kinshasa, which represents Kenya's interests in four countries - DR Congo, Central African Republic, Congo-Brazzaville and Gabon - has in the past urged Kenyans living in the region to formally register so that it is able to serve them better.How have neighbouring countries responded?Several countries in the region have announced tightening of surveillance measures and enhanced screening for visitors.One man who came into contact with the man who died in Kenya is under quarantine in Somalia and samples have been sent to Kenya for testing.Somalia has also said it was taking precautionary measures, including enhancing surveillance measures at border points "given the evolving regional situation and the movement of people between countries".The suspected case in Somalia had travelled through Ethiopia, which has also said it had tightened surveillance to prevent an outbreakIn Tanzania, visitors are expected to undergo daily health monitoring for 21 days, through an automated tracking system, which was announced after Kenya confirmed multiple cases of Ebola infections.Uganda said after Kenya's first Ebola case that it was continuing to "maintain strong surveillance measures to protect public health". The Kenyan businessman had travelled through Uganda on his way home from DR Congo.Uganda had reported two Ebola deaths shortly after the outbreak was reported in DR Congo, but the WHO has since declared it to be free of the disease.You may also be interested in: BBC Africa podcasts