More than forty African health ministers joined one video call on Wednesday. What came out of it was a decision about borders: keep them open, and watch them closely. Thursday, October 29th, and you're with Ebola Watch. We start with what that ministers' meeting actually agreed and Congo's newest count. Then genetic results on the Nigeria and Kenya patients.
Hassan Wekesa, writing for Dawan Africa:
By the end of the meeting, the Ministers had agreed to prepare every country for possible cases and to coordinate their response across borders.
Anything more concrete than that? One concrete line. Per the same report, the ministers resolved to keep borders open while monitoring them closely. Africa CDC's Director-General, Jean Kaseya, told them the continent is not yet winning this fight, and says partners pledged support for Africa's containment plan. The article doesn't say which partners, or how much. So no dollar figure. What numbers did he put in front of them? Across the whole outbreak, 10,172 confirmed cases and 4,932 deaths. For Congo alone, both Dawan Africa and CIDRAP give 10,141 confirmed and 4,928 deaths. That's a case fatality rate of about 48.6 percent among confirmed cases. Yesterday we had 10,060 and 4,887, ministry data through Sunday the 25th. All confirmed, nothing suspected mixed in. Is it slowing at all? Not on what WHO officials told CIDRAP. They still record 50 to 80 new cases a day across eight provinces, and 80 percent come from outside known transmission chains. Africa CDC says at least 95 percent of cases should come from known contacts before officials can say the outbreak is largely under control. Eighty percent unknown against a target of ninety-five percent known. That's a long way off. It is. And Kaseya is now talking beyond Africa. CIDRAP reports that on Wednesday he warned the outbreak could reach the United Kingdom and other European countries, and said countries on every continent should raise their preparedness. Meanwhile Washington is doing the opposite of open borders. Right, and that tension is real. We covered CDC's attestation order on October 23rd. One new detail from CIDRAP: the requirement runs from November 3rd through December 18th. Anyone in Congo in the previous 21 days, U.S. citizens included, can't board a U.S.-bound flight. CDC still describes the risk to Americans as low. And Uganda's fourth treatment centre at Bulongo? We said we'd check. We haven't seen confirmation that it has opened. African ministers vote to keep the doors open, and Washington asks for a signature at the gate.
Stephanie Soucheray, reporting for CIDRAP at the University of Minnesota:
Genomic testing released today shows that recent cases in Nigeria and Kenya are from the same genetic group as current cases in DRC, but there is still no understanding of how the patient in Nigeria got infected.
We've been waiting for this sequencing for a week. So, where did she catch it? Still unknown. These results tell us more about what didn't happen. CIDRAP says samples from both index patients carry no markers of the Ugandan cases from May and June. That cuts against the idea of undetected spread inside Uganda. Both match the lineage circulating in Congo. But the two of them were in the same airport. Entebbe, on October 3rd. The Nigerian patient had been in Uganda from September 15th. The Kenyan patient travelled from Congo through Uganda between October 1st and 3rd. Uganda's health ministry said earlier that CCTV showed no physical interaction between them. A match to an outbreak of ten thousand cases is a wide net. It doesn't tell you where or from whom she was exposed. So Uganda gets some relief, and Nigeria still doesn't get an answer. That's a fair reading. And Nigeria's contact list has grown again. Nkechi Onyedika-Ugoeze reports in Nigeria's Guardian that NCDC is now monitoring 54 primary contacts, up from the 53 we've been citing. Follow-up inquiries identified an e-hailing driver. A ride-share driver. If I'm in Abuja, should that worry me? NCDC's Abiodun Ogunniyi addressed exactly that. He said Ebola is not spread by living in the same city, sharing public spaces or being near an infected person. It spreads through direct contact with the blood or body fluids of someone who has symptoms, or with contaminated materials. When can Nigeria call this over? The Federal Government has named December 7th as a provisional date. Ogunniyi says that depends on the evidence and on WHO's criteria, generally 42 days without a new confirmed case. No new patients have been identified in Nigeria, per CIDRAP. Kenya stays at nine confirmed and two deaths. The sequencing finally came back, and the biggest open question is exactly where it was last week.
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Tomorrow we'll look for a written communiqué from the ministers, any word on Bulongo, and whether Nigeria's 54 contacts stay symptom-free. That's Ebola Watch for Thursday, a Lantern Podcast. Keep your sources official and your nerves steady. Talk to you tomorrow.