The first confirmed Ebola patient in Nigeria began showing symptoms on 7 October and was admitted to a private hospital in Abuja on 11 October. The woman is the Ugandan-born wife of a Swiss diplomat based in Abuja, and tested positive after returning from Uganda.
Nigeria reported the case on Tuesday, 20 October, its first of the outbreak and the fourth African country affected. Patrick Otim, the World Health Organization emergency response manager, said on Thursday that officials still did not know where she had been infected.
The case belongs to an outbreak of the Bundibugyo strain of Ebola, declared in the Democratic Republic of the Congo on 15 May after the virus had gone undetected for months. The World Health Organization classified the outbreak as a public health emergency of international concern by 17 May.
Bundibugyo is a rare Ebola variant with no approved vaccine, drug or cure.
Ituri province, in the north east of the Democratic Republic of the Congo and bordering Uganda and South Sudan, is the centre of the outbreak. Cases have been recorded in eight provinces of the country.
Uganda recorded 20 confirmed cases, including 15 imported from the DRC, and two deaths before it was declared Ebola-free in August.
Kenya confirmed its first case earlier in October after a man travelling from Congo through Uganda carried the virus across the border. The country has recorded nine cases, including one death, and more than 120 people are in quarantine.
Both the first Kenyan patient and the woman in Nigeria left Entebbe Airport on 3 October. Ugandan authorities said the Nigerian patient had travelled to eastern DRC before transiting through Uganda.
Nigeria’s health minister, Muhammad Pate, said authorities had begun tracing 44 people identified as contacts of the patient.
France recorded the only reported case outside Africa when a doctor travelling back from Congo was confirmed infected in June. The person recovered and was discharged on 4 July.
More than 70% of new cases in the DRC involved people who had not been identified as known contacts. At least 60% of deaths there had occurred outside treatment centres as of early October.
Insecurity, displacement and restricted humanitarian access have made surveillance, contact tracing and disease control harder in the DRC. Population movements, violence, mistrust and poor conditions for frontline health workers have also accelerated transmission.
Mohamed Yakub Janabi, the WHO Regional Director for Africa, said at an online briefing: “Ebola does not wait. It follows movement, exploits gaps, and tests the strength of our health systems. Today, the test is no longer confined to one place. It is a regional concern that demands regional vigilance and collective resolve.”
Jean Kaseya, director general of the Africa Centres for Disease Control and Prevention, said: “This Bundibugyo Ebola outbreak has already become the most geographically extensive in history, affecting several countries spread across three regions of Africa.” He added on Wednesday: “Ebola is crossing borders. Our response must move faster, with stronger coordination, greater solidarity and decisive political leadership.”
The Africa CDC says the outbreak has the widest geographic scope in Ebola history, affecting Central Africa, East Africa and West Africa. It has called an extraordinary virtual meeting of African health ministers for 28 October.
Kenya’s director-general for health, Patrick Amoth, said the country had requested 10,000 vaccine doses from the WHO and the Africa Centers for Disease Control and Prevention.
The epidemic is the largest and deadliest Ebola outbreak recorded in the DRC, and the second-largest globally after the 2014–2016 West Africa epidemic, which killed 11,000 people.
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