Ebola Outbreak Expands in Eastern DRC as Kenya Confirms Imported Case

Beni, DR Congo – The Ebola outbreak in the Democratic Republic of Congo (DRC) has spread to another health zone in the east, while a fatal imported case in Kenya has highlighted the risk of cross-border transmission.

According to the World Health Organization's (WHO) October 8 update, the Alimbongo health zone in North Kivu province has recorded cases for the first time. As of October 6, the area had four confirmed cases, including two deaths.

The outbreak is caused by the Bundibugyo virus, a species within the Ebola virus family. According to the WHO, cases have been reported in 64 health zones across seven provinces of the DRC. Ituri remains the most affected province in terms of cumulative cases, while North Kivu is accounting for a growing share of newly confirmed infections.

As of October 6, the WHO recorded 8,728 confirmed cases and 4,205 confirmed deaths in the DRC. A further 2,269 people have recovered, and the crude fatality rate stands at 48.2 percent.

Kenya confirms imported case

According to the WHO, Kenya confirmed its first imported case of Bundibugyo virus disease on October 6. The patient was a Kenyan national who had been living in the DRC, contracted the disease there, and was treated at multiple health facilities before travelling to Kenya via Uganda.

The patient travelled by road to Kampala, Uganda, then flew to Nairobi, landing on October 3. The person was isolated at a hospital and tested positive for the virus. Despite supportive treatment, the patient died on October 5, according to the WHO.

Kenyan officials have identified 28 contacts, including family members and health workers. The WHO also said it is working to trace passengers and crew members on the flight to Nairobi.

Public health measures have been activated in Kenya and Uganda, including contact tracing and enhanced surveillance.

On October 8, preliminary test results for a suspected Ebola case in Kenya's Wajir County came back negative, according to the county governor. The result helped ease concerns about a possible second case, although monitoring continues.

The imported case illustrates the importance of surveillance and coordination among neighbouring countries. Identifying people who have been exposed and monitoring their symptoms is central to detecting cases early and stopping chains of transmission.

Treatment capacity under pressure

In the DRC, the response is under mounting pressure due to limited treatment capacity, insecurity and difficulties in securing cooperation from some communities.

Daniel Makasi Levergénois, founder of Watoto Radio, said insecurity and misinformation are undermining efforts to contain the outbreak. According to him, in Beni and Butembo, both in North Kivu, rumours and misunderstandings about Ebola are making some residents reluctant to cooperate with response teams.

In its October 5 update, medical organisation Doctors Without Borders (MSF) said North Kivu accounts for nearly 40 percent of newly confirmed cases nationwide, up from 24 percent at the end of August.

MSF also reported that as of September 28, 34 percent of confirmed Ebola patients were being treated at non-specialised health facilities. Dedicated treatment centres are short of beds, while delayed diagnosis means some patients are treated outside facilities equipped to handle Ebola.

The organisation warned that many of these facilities lack the resources and expertise needed to manage the disease, increasing the risk of transmission between patients and health workers.

"For weeks, treatment capacity has been stretched to its limit," said Stephanie Hoffmann, MSF's Ebola treatment centre coordinator in Butembo.

"Because there are not enough beds, we sometimes have to transfer confirmed Ebola patients elsewhere, despite the significant risk to the wider community. In addition, the standard of care at some satellite facilities does not always meet the requirements for Ebola treatment. This is extremely worrying."

Erosion of trust threatens containment

Alberto Lusenge, a community leader in Beni, said the failure to stop transmission early in Ituri province, combined with new cases and attacks on response workers in Beni and Butembo, has heightened public concern.

Lusenge warned that a lack of trust could lead residents to not report symptoms or to refuse to cooperate with health workers. He said North Kivu could become the epicentre of the outbreak if authorities fail to secure stronger cooperation from local communities.

The WHO said that as of October 4, response teams were monitoring 23,741 of 29,535 identified contacts, or 80.4 percent – below the target of at least 85 percent.

Contact tracing allows health authorities to identify people who may have been exposed, monitor their symptoms and detect cases early. Gaps in monitoring can make it harder to identify and stop chains of transmission.

The Africa Centres for Disease Control and Prevention (Africa CDC) has called for a community-centred response, including active case-finding, systematic contact tracing, daily monitoring of people who have been exposed and sustained engagement with local communities.

History of deadly outbreaks

The 2018–2020 Ebola outbreak in the DRC, caused by a different virus species, killed nearly 2,300 people. The current outbreak poses distinct challenges: according to the WHO, there is no approved vaccine or specific treatment for Bundibugyo virus disease.

Early detection, supportive care and infection prevention therefore remain the focus of the response. But as infection spreads to more health zones and treatment facilities struggle to admit patients, health agencies face a dual challenge: containing transmission while maintaining public trust.

Jean Kaseya, director-general of Africa CDC, stressed the importance of rapidly identifying and monitoring people exposed to the virus.

"To contain this outbreak, we need to know where all contacts are, monitor them and quickly identify anyone with symptoms before they pass the virus on to family, communities or across borders. We can only contain this outbreak when the last chain of transmission is broken," Kaseya said in a statement seen by Al Jazeera.