Ebola case exposes gaps in Kenya's preparedness

Health workers in PPE conduct safety checks during an MSF Ebola response training in Ongata Rongai, Kajiado County, on July 10, 2026. [AFP]

The battle to contain the Ebola virus in the country has begun in earnest, with the challenge harder than previously anticipated. Patient one, who died in Nairobi Hospital, could have made contact with more people than was announced by the Ministry of Health Cabinet Secretary, Aden Duale. Having been processed as an ordinary traveller, the patient, who arrived at the JKIA on Saturday at 1.10pm from Entebbe, Uganda, could have made contact with other travellers and airport workers.  The driver who took him to hospital has been identified as a contact and is to be placed in isolation. After being dropped off at the hospital, the patient went through the normal protocols until a doctor recommended he be isolated. It has also emerged that test results confirming the Ebola Bundibugyo virus came out after the patient had died.

From the JKIA to his interactions with the driver and medical service providers at the Nairobi Hospital, the number of Kenyans exposed to the virus could be higher.

Also, while at the facility and queuing to be attended to at the Nairobi Hospital, the patient could have exposed several other patients to the virus, including hospital staff.

These factors, in addition to the revelation that test results were out after the patient's death, also raise questions over Kenya’s preparedness in handling Ebola.

It took about 48 hours for Kenyan authorities to announce the case after the patient arrived in the country.

And now, concern is growing over whether enough contact tracing has been done to establish the extent of the exposure to the virus during those many hours.

Insiders told The Standard that the patient was received at Nairobi Hospital on Saturday, October 3.

Initially, he was taken through the normal outpatient area before being moved to the clinical observation area, where he was examined by a doctor.

During the examination, the doctor raised the alarm after the patient presented with symptoms consistent with Ebola.

He was then moved to an isolation area within the hospital and samples were collected for testing.

However, his condition deteriorated rapidly. He was wheeled to the facility’s Intensive Care Unit (ICU) for specialised care.

The patient died on Monday night, with his test results arriving after his death. “Results for Ebola came in when the patient was already dead, and that is when the Ebola protocols were fully initiated”, said a source.

The patient died in the ICU after being resuscitated twice. “The patient was very sick in the ICU,” added the source.

The delayed confirmation has raised questions about the extent of the patient’s interactions with health workers, hospital staff, relatives and other members of the public before he was isolated.

Experts warn that such interactions could increase the risk of infection, particularly among healthcare workers and other close contacts.

“Though a doctor flagged the case as a suspected Ebola case, results came out after death,” said an insider.

According to a healthcare provider who was among the Kenyans who fought Ebola during the 2014 outbreak in Liberia, results should ordinarily be available within about eight hours.

The health professional said a faster turnaround time is critical for contact tracing and immediate management of suspected cases.

“Having results after death means maybe there was a delay in collection of samples or in testing. This is discouraged because interaction continues, risking spread,” warned the expert.

“Turnaround time for Ebola results should be about eight hours. This enhances contact tracing and management of a patient to contain spread.”

The delay has also raised concerns within the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU).

KMPDU questioned how the case was handled from the time the patient landed at Jomo Kenyatta International Airport (JKIA) to the time he was admitted to Nairobi Hospital.

Questions are also swirling about how such a case was not detected at JKIA through screening and whether such precautionary services exist at the critical port of entry.

KMPDU Deputy Secretary General Dr Dennis Miskellah said the handling of the case exposed gaps in Kenya’s preparedness to deal with Ebola.

“If a patient landed at JKIA on Saturday at 1.10 pm, why did it take us three days to announce the results?” asked Miskellah.

“With the delay, how many people might have gotten in contact with the patient?”

Miskellah said all individuals who interacted with the patient, including hospital cleaners and airport staff, should be identified and assessed for possible exposure.

He specifically called for those working at immigration to be considered during contact tracing.

“Taking more than 24 hours before a diagnosis means it is hard to trace everyone who was in contact with this patient. Tracing is crazy,” said Miskellah.

According to Health Cabinet Secretary Aden Duale, the patient landed at JKIA on Saturday at 1.10pm before being driven to Nairobi Hospital.

Duale said the patient was quickly isolated in a separate room at the Accident and Emergency department before being transferred to the East Wing Isolation facility.

“...he was quickly isolated in a separate room at the Accident and Emergency in the hospital and later transferred to the East Wing Isolation facility,” said Duale.

Contrary to the ministry’s statement on where the patient was received, the Nairobi Hospital said the patient was placed in an isolation facility that is physically separate from the main hospital.

The facility remained fully operational throughout. Miskellah said the differing accounts need to be clarified.

“Hospital and Ministry of Health statements are contradicting. We need clear information, so that the single case does not cause us a disaster,” said the official.

“Hospital says the patient was taken to isolation directly, yet the Ministry says he was in an isolated room in the hospital,” added Miskellah.

He also questioned why it took so long for the results to be released after doctors had already suspected Ebola.

“The delay causes trouble for us. I am sure the patient may have gone to washrooms and was visited by relatives based on our culture. These relatives also went back home to meet their families,” said Miskellah.

Duale, however, said the 48-hour period was necessary because the samples had to be tested in several laboratories before the case could be confirmed.

While thorough testing was crucial to ascertain the virus, the delay in the process has raised concern as the patient could have potentially exposed many others.

The process, he said, began after doctors at the private facility identified symptoms associated with Ebola.

The patient presented with fever, chills, intense fatigue and weakness, muscle pain, painful swallowing, sore throat and bleeding under the skin at an injection site.

Duale said the patient’s history of travel to the Democratic Republic of Congo (DRC), combined with his symptoms, led the doctor to suspect viral haemorrhagic fever.

Samples were collected and tested at both the National Virology Reference Laboratory and the Kenya Medical Research Institute (KEMRI), with both laboratories confirming Ebola Bundibugyo virus disease.

“The patient was given supportive treatment but regrettably passed on last night,” Duale said on Tuesday during a media briefing.

According to virologist Prof Omu Anzala, director of the Kenya AIDS Vaccine Initiative (KAVI) at the University of Nairobi, anyone who came into contact with an active case must be treated as a potential contact.

And this is what complicates contact tracing, as the patients potentially exposed to the virus could have gone home and while some may have travelled to other parts of the country through public transport.

“You do not take chances when you come in contact with an active case. This places us at a high risk,” said Anzala, noting that healthcare workers are particularly vulnerable.

“The critical thing is getting all contacts and strengthening all control measures.”

Miskellah, however, questioned whether the suspicion should have started much earlier, particularly at the country’s main point of entry.

“What was seen at Nairobi Hospital should have been detected at Port Health,” he said.

He alleged that the Port Health unit at JKIA is understaffed and that some of those manning it are not adequately trained health professionals.

“How many times have you gone through serious checks at JKIA, apart from someone checking your temperature as a by-the-way?” he asked.

“For us, KMPDU has said we are ill-prepared. To have somebody come from Uganda on a plane, a very sick patient, arrive at the airport with all these symptoms and die within 24 hours means they were very sick.”

Miskellah said KMPDU had previously raised concerns about a shortage of healthcare providers at the Port Health unit with the Public Service Commission but was yet to receive a response.

The union has also called for investigations, arrest and prosecution of anyone who allegedly ‘sneaked’ the patient into Kenya.

Miskellah said the circumstances posed a serious security and public health risk that should not be condoned.

He said individuals who travelled with the patient, including members of his family, should have reported his condition to the authorities.

“Failure to report the patient amounted to criminal negligence and exposed millions of Kenyans to the risk of Ebola infection,” he said.

“The most patriotic and humane thing to do would have been to notify the authorities and the government.”

Miskellah questioned why the patient, who had reportedly been ill for about a month, was not declared at the border despite travelling to Kenya to seek treatment.

He alleged that the patient and his companions deliberately avoided official routes because they feared being stopped at checkpoints, instead travelling by road from the DRC through Uganda.

“It is very unfair to sacrifice your own people and country. Kenyans should be able to call out such traitors,” said Miskellah.

The union has also raised concerns over preparedness in the counties to handle suspected Ebola cases.

According to Miskellah, while counties are responsible for managing the health docket, many facilities remain ill-equipped to handle highly infectious diseases.

He said most isolation units that were established during the Covid-19 pandemic have since been converted into maternity or general treatment wards.

“Ebola protocols stipulate that a patient should be treated where they are, to break the chain of transmission. What happens if a patient is confirmed in the counties?” posed Miskellah.

He said counties should establish dedicated isolation wards and equip them with adequate and quality Personal Protective Equipment (PPE).

“We must do better, otherwise we are going to end up with a tragedy,” warned Miskellah.