KINSHASA, Oct. 22 (Xinhua) -- Africa is facing "a more complex outbreak landscape" as Ebola spreads across borders and persistent surveillance gaps cast doubt on whether recent signs of a slowdown can be sustained.
Despite a temporary decline in transmission in some affected areas, gaps in contact tracing and delays in diagnosis have heightened concerns that undetected infections could fuel further spread, elevating the ongoing Ebola outbreak to a regional public health threat.
As the outbreak widens, the World Health Organization (WHO) and the Africa Centers for Disease Control and Prevention (Africa CDC) are calling for stronger regional coordination to contain transmission and prevent further cross-border spread.
CROSS-BORDER SPREAD RAISES ALARM
Africa CDC data shows five countries, the Democratic Republic of the Congo (DRC), Uganda, Kenya, Nigeria and France, have reported Ebola cases linked to the current outbreak since May.
"Ebola does not wait. It follows movement, exploits gaps, and tests the strength of our health systems," WHO Regional Director for Africa Mohamed Yakub Janabi said Thursday during an online press briefing.
"Today, the test is no longer confined to one place... We are facing a more complex outbreak landscape," Janabi said, calling for stronger regional vigilance and collective action.
The DRC remains the epicenter, accounting for 9,704 confirmed cases, including 4,687 deaths as of Tuesday, with a case fatality rate of 48.3 percent, according to a situation report released Wednesday by the DRC health authorities. The outbreak has affected eight of the country's 26 provinces and 66 health zones.
Beyond the DRC, Kenya has confirmed nine cases, including one death, while Nigeria reported its first imported case on Tuesday.
All eight secondary cases in Kenya had been detected among previously identified contacts who were already under quarantine, suggesting that the known transmission chains remained traceable, said Wessam Mankoula, head of the Continental Incident Management Support Team for the Ebola response at Africa CDC, at an online press briefing Thursday.
Kenya has identified 135 contacts, with 118 currently in quarantine, Mankoula said.
In Nigeria, the confirmed patient, a woman who arrived from Uganda on Oct. 3, developed symptoms four days later but was not diagnosed with Ebola until Oct. 20.
The WHO's latest regional situation report released Tuesday showed that the prolonged interval between symptom onset and confirmation raises concerns about possible undetected exposures and secondary transmission, requiring urgent retrospective investigation and intensified surveillance.
Mankoula said the source of the patient's infection remained unknown, with Nigerian and Ugandan authorities conducting joint investigations into her travel and exposure history.
On Tuesday evening, following Nigeria's confirmation of its first Ebola case, Africa CDC Director-General Jean Kaseya warned that the outbreak had become the most geographically widespread Ebola epidemic on record, with infections reported across Central, Eastern and Western Africa.
FRAGILE SLOWDOWN MASKS PERSISTENT TRANSMISSION
Despite recent signs of easing transmission in some affected areas in the DRC, health authorities warned that the outbreak remained far from under control.
The WHO's latest regional report showed that Ebola infections in the DRC have rebounded after a brief decline.
"The most recent seven-day moving average indicates a modest upward trend, suggesting renewed intensification of transmission," the WHO Regional Office for Africa said in the report, highlighting the outbreak's "widening international dimension and the growing complexity."
Beyond the fluctuating case numbers, health authorities identified persistent weaknesses in early detection, contact tracing and access to treatment as major obstacles to controlling the outbreak.
Africa CDC data showed only about 12 percent of confirmed cases in the DRC have been identified among previously known contacts, meaning that nearly nine in ten infections are being detected outside established contact-tracing networks.
"This means there are ongoing chains of transmission that we are not detecting," Mankoula warned.
Africa CDC announced Wednesday that it would convene an extraordinary virtual meeting of African health ministers on Oct. 28 to coordinate efforts against the escalating outbreak.
The epidemic was declared in the DRC on May 15 and designated a public health emergency of international concern by the WHO two days later. The Africa CDC subsequently declared it a public health emergency of continental security.
The current Ebola outbreak has become the largest and deadliest ever recorded in the DRC and the second-largest Ebola outbreak globally, after the 2014-2016 West Africa epidemic. ■
