Kenya urged to sustain Ebola safeguards as contact tracing continues

Kenya’s healthcare professionals have been praised for their skills and training in handling health emergencies as the Ministry of Health steps up preparedness for Ebola.

Researchers, doctors, clinical officers and nurses have been at the forefront of the response since the country confirmed its first imported case of the disease.

Nine days after the case was confirmed, no additional infections had been reported among healthcare workers or the wider population.

The Kenya National Union of Nurses and Midwives says healthcare workers can contain the imported virus with adequate support.

“I have no doubt that health workers in Kenya are properly trained to handle any serious or emerging infectious diseases,” said the union’s Secretary-General, Seth Panyako.

Panyako said the fact that no healthcare worker had been reported to have contracted the virus, including those who handled the fatal case, was encouraging.

“No single healthcare worker has acquired the virus, even despite interacting with a fatal case. I am proud of our health professionals. This is encouraging because it means that by protecting ourselves, we are able to keep the public safe,” he said.

In 2014, Kenya deployed 170 health professionals, including clinical officers, nurses, doctors and public health officers, to support the fight against Ebola during an outbreak in West Africa.

The healthcare workers returned safely and were honoured by then President Uhuru Kenyatta.

However, hundreds of healthcare workers from other countries died while responding to Ebola outbreaks in West Africa.

“Kenya’s healthcare system is top in Africa and leads as an example. Kenyans successfully fought Ebola in Liberia and Sierra Leone because of their skills and training. I am proud of Kenya’s healthcare system,” Panyako said.

But virologist Dr Moses Masika cautioned that although the absence of additional cases was encouraging, the virus’s incubation period was longer.

The incubation period for Ebola ranges from two to 21 days.

“It is a welcome sign but we need to keep in mind that incubation period can be as long as three weeks. We need double that time (42 days) to be sure we are in the all clear,” Masika said.

Kenya confirmed its first imported case of Ebola Bundibugyo virus disease on October 6.

The Ministry of Health has listed 122 contacts, of whom 108 have been placed in quarantine.

Masika commended the government’s contact-tracing efforts, saying they were key to preventing further transmission from the fatal case.

“I think the government has done well to trace and quarantine contacts. That is the main thing,” he said.

The patient was a 40-year-old man who had travelled from the Democratic Republic of Congo (DRC), which is experiencing an outbreak of the virus. He entered Kenya through Uganda on October 3 and died on October 5.

Panyako said authorities at Entebbe International Airport and Jomo Kenyatta International Airport (JKIA) had failed to prevent the case from entering the country, raising concerns about surveillance at regional entry points.

“The case got into Kenya because there was a problem in Uganda. The Ugandan authorities should have put him in quarantine because the ports of entry were Entebbe and JKIA in Nairobi. The two airports messed up East Africa. The Ugandan authorities failed, and the Kenyan airport failed,” he said.

Despite the measures in place, Panyako warned against relaxing surveillance and other preventive measures, saying this could allow more cases to enter the country and expose additional contacts.

“We should never forget how this virus ravaged people in West Africa. This is why we should not relax any measures. Proper checks should be done, and individuals presenting with the disease quarantined,” he said.

He added that despite the skills and knowledge of Kenyan healthcare professionals, the government must provide adequate support to contain the imported case and prevent further transmission.

This includes supplying quality personal protective equipment (PPE) and ensuring that isolation and quarantine facilities meet the required standards.

“In terms of preparedness, I think the country is well prepared because of the last experience of 2019. Prevention and management of Ebola is on top gear,” Panyako added.

“Protective equipment and the handling of Covid-19 are almost the same. The Ministry should ensure there are strict checks at the points of entry. So long as outbreaks are in neighbouring countries, measures should not be relaxed.”

University of Nairobi virologist Prof Omu Anzala said hospitals and isolation centres must meet the required standards and be equipped with appropriate PPE to protect healthcare workers from infection.

The protective equipment includes fluid-resistant coveralls or impermeable full-body gowns, double-layered gloves, N95 respirators, full-face shields to protect the eyes and other mucous membranes, and head and neck coverings.

Healthcare workers should also have waterproof footwear and boot covers.

Aprons should be worn over coveralls when treating patients experiencing vomiting or diarrhoea.

“Kenya must demonstrate readiness in critical areas, including isolation infrastructure, laboratory diagnostics and providing quality PPEs,” Anzala said.

The researcher explained that quarantine facilities were crucial in separating suspected cases from the general population while they awaited test results.

Confirmed patients should then be transferred to specialised treatment or isolation centres.

“The real test is preventing the virus from spreading to other people,” he said.

Rapid quarantine, contact tracing and surveillance remain central to Ebola containment, he added.

“Quarantine and contact tracing are the entire essence of controlling an outbreak. This is where our emphasis should be,” Anzala said.

Ebola diagnosis relies on polymerase chain reaction (PCR) testing, the same technology used during the Covid-19 pandemic.

“The technology exists. The question is whether we have adequate reagents and supplies to sustain testing in case the disease gets out of hand,” he added.

Anzala stressed that frontline healthcare workers must receive regular training on handling suspected Ebola patients, collecting samples safely and protecting themselves from infection.

Healthcare workers are at the forefront of the response and face a heightened risk of exposure when caring for infected patients. In the DRC, healthcare workers have been among those infected during Ebola outbreaks.

Anzala said healthcare workers needed continuous training on operating isolation units, collecting blood samples safely and managing patients without exposing themselves to the virus.

“Training is critical because health workers are involved in procedures such as drawing blood. They must know how to do this safely, wear the correct protective gear and avoid contact with patient secretions,” he said.

Ebola spreads through direct contact with the blood or other bodily fluids of an infected person, or with contaminated materials. This places healthcare workers at particular risk when infection prevention measures are not properly followed.

Beyond ensuring the availability of PPE, Anzala said healthcare workers must know how to remove contaminated equipment safely and decontaminate themselves before leaving isolation areas.

“Healthcare workers must dress in a manner that protects them from exposure. A patient may vomit or release infectious fluids, which can easily come into contact with the eyes, face or skin if proper precautions are not observed,” he said.

Anzala also called on the government to engage the public and other stakeholders, address their concerns and fears, and build consensus on the measures needed to contain the outbreak.