Uganda orders ‘immediate’ closure of border with Congo as rare Ebola cases surge

Ugandan authorities on Wednesday ordered the closure of the border with Democratic Republic of Congo (D.R.C.) “with immediate effect.” Suspected cases of a rare type of Ebola surged to close to 1,000 in D.R.C. as the number of people exposed to the virus in Uganda ticked up, according to health authorities.

The border closure, which goes against World Health Organization (WHO) guidance, underscored growing fears of contagion in this East African country that, like Democratic Republic of Congo, has experience responding to Ebola outbreaks but is this time faced with a type, Bundibugyo, with no approved medicines or vaccines.

A local Ebola task force led by Vice-President Jesca Alupo made the decision after a rise in Ugandan health workers exposed to the virus by Congolese patients who crossed the border before the outbreak was declared on May 15.

Travel across the D.R.C. border will be authorized only in emergency cases, including for the outbreak response, cargo or security reasons, Dr. Diana Atwine, permanent secretary of the Ministry of Health, told journalists. Any people entering from D.R.C. under emergency circumstances will be taken into mandatory self-isolation for 21 days.

Tracing and isolating Ebola contacts is seen as key to stopping the spread of the disease, which usually manifests as hemorrhagic fever. The virus is spread through close contact with sick or deceased patients’ bodily fluids. Experts say health-care workers and family members caring for patients face the highest risk.

The number of suspected cases in eastern D.R.C. is nearing 1,000, with at least 220 suspected deaths. D.R.C.’s Health Ministry on Tuesday said 101 cases have been confirmed, and they are looking into over 3,000 possible contacts.

The WHO, while declaring this outbreak a public health emergency of international concern, discouraged border closures while acknowledging that neighboring countries are at high risk of contagion.

Closures “push the movement of people and goods to informal border crossings that are not monitored, thus increasing the chances of the spread of disease,” the United Nations agency said.

The border between Uganda and Congo is several hundred kilometres long and crossed by numerous footpaths beyond formal border posts. Many people come and go in the course of a day to visit families or to trade.

Struggling to contain outbreak

Health authorities in D.R.C. are struggling to contain the outbreak the WHO has said is outpacing them. The rare Bundibugyo type of Ebola was confirmed weeks late, as tests were carried out for a more common type.

Challenges include the threat from armed groups in eastern D.R.C., a large number of displaced people and poor infrastructure.

WHO director-general Tedros Adhanom Ghebreyesus on Wednesday called for a ceasefire in the region to allow safe access for responders and others, saying on social media that “attacks on health facilities make tracking cases and their contacts nearly impossible.”

Responders in D.R.C. have said they are underprepared and underprotected for this outbreak, while conflict-traumatized residents long wary of outsiders have attacked a number of clinics and hurled stones and abuse at volunteers trying to make people aware of the virus and its risks.

The WHO has said infected people or those have been in contact should not undertake international travel unless it’s a medical evacuation. On Wednesday, the Trump administration said it is planning to send Americans who are exposed to Ebola to a new facility in Kenya instead of flying them to the United States.

Canada on Tuesday announced it was clamping down on travel and immigration from multiple countries in central Africa. 

In a Tuesday briefing, federal public health and immigration officials said that as of Wednesday at 11:59 p.m. ET, immigration documents from citizens of the D.R.C., Uganda and South Sudan will be suspended.

Uganda is concerned about exposed health workers

Uganda has reported seven cases of Ebola, including the first case of a 59-year-old man who died in Kampala, the capital, on May 14.

While the Ebola caseload in Uganda is not spiking, the number of locals exposed to infection via health workers has been rising.

“They have families, and so the number has been increasing,” Atwine said of health workers.

She said she was dismayed to see some Ugandans forming crowds to celebrate Arsenal winning the English Premier League title. The London-based team has a large following in Uganda.

“I don’t understand,” Atwine said, urging Ugandans to be vigilant, avoid shaking hands and use sanitizer.

D.R.C. has had 17 Ebola outbreaks. Health experts say aid cuts last year by the United States and other rich countries are devastating for eastern D.R.C. because of the region’s unique problems.

Aid groups fighting this outbreak say they don’t have the equipment they need such as face shields and suits to protect health workers from infection, testing kits and body bags needed to safely bury victims.