Mohamed Janabi, regional director for WHO in Africa, said at an online media briefing on Thursday that the outbreak landscape had grown more complex. Nigeria's first case, confirmed on Tuesday, joins active or recent infections in the Democratic Republic of Congo and Kenya. Uganda recorded cases earlier this year but has since been declared Ebola-free.
The Nigerian patient is married to a Swiss diplomat based in Abuja. Authorities in Uganda said she had travelled to eastern DRC before transiting through Uganda, but the WHO and the Africa Centres for Disease Control and Prevention said on Thursday they had not received confirmed information that she visited the DRC. A Swiss government statement said the patient is believed to have contracted the disease while travelling in Uganda.
Ugandan government spokesman Alan Kasujja rejected that suggestion as "preposterous," arguing it was unfair to link Uganda to the case simply because she had holidayed there. Wessam Mankoula, head of Emergency Preparedness and Response at Africa CDC, noted that both the first Nigerian case and the first Kenyan case had left Entebbe airport on October 3, and that a possible encounter between them was under investigation.
Pavel Ursu, the WHO representative in Nigeria, said the information provided to the organisation included no travel outside Uganda. Patrick Otim, a WHO emergency response manager, said the source of her infection remained unknown as investigators pieced together her travel history. He added that authorities were looking at which Abuja health facilities she visited between the onset of symptoms and her hospitalisation 48 hours later.
Kenya's Ministry of Health confirmed its first case earlier this month and has since reported eight more. Patrick Amoth, the ministry's director-general, said officials had traced all 135 contacts of the first case. Nigeria is tracing 44 contacts, with more identified since.
The outbreak is the deadliest in DRC's history, with more than 4,000 deaths from over 9,000 confirmed cases since May. Uganda recorded 20 confirmed cases, including 15 imported from the DRC, and two deaths before being declared Ebola-free in August. Africa CDC has warned of an "extremely serious threat," with the fatality rate in DRC approaching 50 percent.