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Rhea Rose Abraham
Suspected cases of a rare type of Ebola virus are being investigated in Brazil after travellers returned from visits to the Democratic Republic of Congo (DRC) and Uganda.
The virus is also being detected across a widening swath of the DRC’s conflict-hit east as health authorities struggle to trace exposed contacts and determine the true scale of the epidemic.
In Brazil, a man with a suspected case of Ebola in Sao Paulo tested positive for meningitis. Another suspected case emerged in Rio de Janeiro, where the patient tested positive for malaria, local health authorities said on Sunday (Brasilia time).
In neither case did the diagnosis rule out the possibility of Ebola, they said, adding that both cases were still under investigation.
In the Sao Paulo case, a man from the DRC presented with a fever after recently visiting the African country, while in Rio, the patient had recently travelled to Uganda, which has recorded nine cases, one of them fatal. Brazil’s Health Ministry said the man in Sao Paulo had been intubated and his condition was serious.
If confirmed, they would be the first cases outside Africa since the outbreak – caused by the rare Bundibugyo version of the virus – began in the DRC, the BBC reported.
Meanwhile, in Italy, protocols for a suspected case of Ebola were triggered in Sardinia’s capital, Cagliari, for a man who had flown back from Congo on Saturday with some symptoms, but the health ministry said on Monday that he had tested negative.
Last month, the WHO declared the outbreak in the DRC and Uganda a public health emergency of international concern, although it does not meet the criteria of a pandemic emergency.
The number of confirmed Ebola cases in the DRC has increased to 282, with 42 deaths, after 19 new positive test results were recorded, according to data from the communications ministry.
The outbreak – the 17th in the DRC and the third-largest since Ebola was discovered half a century ago – is outpacing the global response, which got off to a late start.
“The risk of regional spread is already happening,” Jean Kaseya, director-general of the Africa Centres for Disease Control and Prevention, said in a Financial Times opinion piece published on the weekend.
The outbreak’s apparent geographic footprint has expanded to 22 affected health zones across three eastern provinces in the DRC – from 13 reported just days earlier – according to government data.
Health officials are simultaneously clearing testing backlogs and reclassifying hundreds of suspected cases, making it difficult to determine how much of the increase reflects new transmission and how much of it reflects improved detection and surveillance.
The rapidly growing epidemic has become one of the most complex Ebola outbreaks in years, unfolding across areas impacted by armed conflict, mass displacement and weak health infrastructure. Mongbwalu, considered the epidemic’s point of origin, lies in Djugu territory, where multiple armed groups operate – and where frequent population movements occur towards Uganda.
But in a positive development, the World Health Organisation said four nurses who were being treated for the Bundibugyo strain had been discharged from a hospital in Bunia, in the DRC, after recovering.
A laboratory worker had also recovered earlier this week, the agency said, bringing the total number of people who have recovered from the virus to five.
More recoveries are expected, especially when people are diagnosed early and can access care, and as the response to the outbreak intensifies.
While noting that there was currently no licensed vaccine or treatment for the Bundibugyo strain, WHO director-general Tedros Adhanom Ghebreyesus said during a visit to Bunia that “it is not without hope”, as it can be survived with good medical care.
Ebola is highly contagious and can be transmitted to people from wild animals. It spreads in the human population through contact with bodily fluids such as vomit, blood or semen, and with contaminated surfaces and materials such as bedding and clothing.
The disease is rare but severe and often fatal in people. Symptoms include fever, vomiting, diarrhoea, muscle pain, and at times, internal and external bleeding.
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