Nigeria Confirms First Ebola Case in a Decade as Nations Clash Over Infection Route

Health officials across four African countries are disagreeing over how Nigeria recorded its first Ebola infection in more than a decade. The patient is a Ugandan-born woman married to a Swiss diplomat serving in Abuja, according to the Swiss foreign ministry. That account conflicts with reports from Uganda, which said she traveled to eastern DR Congo. The dispute matters because authorities are trying to determine where the woman caught the virus before arriving in Nigeria.

The outbreak began in DR Congo in mid-May and has since moved through Uganda and Kenya to Nigeria. More than 9,500 people have been infected. Nearly half of those cases have been fatal. The cause is the Bundibugyo virus, a rare strain for which there is no approved vaccine or treatment. The Swiss ministry said Friday that the patient did not travel to DR Congo and is believed to have contracted the illness while moving through Uganda with her husband. Uganda reported its own cases in May and June and was declared free of the virus in August. A Ugandan spokesperson said Thursday the country has no active cases.

The Africa Centres for Disease Control and Prevention is examining whether the patient crossed paths with a case in Kenya. Dr Wessam Mankoula, who leads the group's emergency preparedness and response work, said both individuals passed through Uganda's Entebbe airport on October 3. Catherine Smallwood, an Ebola incident manager with the World Health Organization based in DR Congo, said her staff has no record showing the Nigerian patient entered that country. WHO investigations into the source remain open.

Marion Koopmans, a Dutch virologist who sits on the WHO's Ebola emergency committee, questioned the airport theory. She called the idea "very speculative unless there is evidence of sharing the same space in a manner that could explain that" and said that appearing at a large airport is "not a supported epidemiological link by any standard of what we currently know." Smallwood said a connection to the Kenyan case is possible, but the timing of symptom onset in Nigeria would have to be compared with the Kenyan patient's timeline to judge where the infection likely occurred.

Nigeria's health minister, Muhammad Ali Pate, said contact tracing is underway in the country. "We are trying to contain it so it doesn't go out to the communities," he said. Melaku Yirga, vice-president for Africa at Prosper Global, formerly Mercy Corps, said the appearance of cases in both Kenya and Nigeria requires countries to share information across borders without delay and to equip frontline health workers and local organizations to respond.

The Bundibugyo outbreak was first announced on May 15. It stands as the largest and deadliest episode in DR Congo's history and the second largest recorded anywhere, behind the 2014 to 2016 west Africa epidemic, which sickened more than 28,600 people and killed more than 11,000.