KAMPALA – Ugandan authorities on Wednesday ordered the closure of the border with Congo “with immediate effect” as suspected cases surge near 1,000 in its neighbor of a rare type of Ebola and as others emerge at home.
The measure, which goes against World Health Organization guidance, underscored growing fears of contagion in this East African country that, like Congo, has experience responding to Ebola outbreaks but is faced with a type this time, Bundibugyo, with no approved medicines or vaccines.
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A local Ebola task force made the decision to close the border after a rise in Ugandan health workers exposed to the virus by Congolese patients who crossed before the outbreak was declared on May 15.
Travel across the Congo 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 Congo under emergency circumstances will be taken into mandatory self-isolation for 21 days.
Congo says over 100 cases have been confirmed
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 healthcare workers and family members caring for patients face the highest risk.
The number of suspected cases in eastern Congo is nearing 1,000, with at least 220 suspected deaths. Congo’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 U.N. agency said.
The border between Uganda and Congo is several hundred miles 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.
Health authorities in Congo are struggling to contain the outbreak that the WHO has said is outpacing them, after the rare 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 Congo, 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 Congo 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.
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 case load 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, the health official, said of health workers.
She also said she was dismayed to see some Ugandans forming crowds to celebrate Arsenal as British Premier League champions. The team has a large following in Uganda.
“I don't understand,” Atwine said, urging people to be vigilant, avoid shaking hands and use sanitizer.
Congo has had 17 Ebola outbreaks. Health experts say aid cuts last year by the United States and other rich nations are devastating for eastern Congo 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.