Contact tracing: Brace for the worst Ebola scenario

Health workers practise safe PPE removal during Ebola response training in Ongata Rongai, Kajiado County, on July 10, 2026. [AFP]

The country could be staring at increased Ebola infection rates, bordering on catastrophic levels, as contact tracing falters and suspected persons fail to turn up at quarantine centres.

It is emerging that the laxity noted in tracing and putting in quarantine centres the persons who were in contact with the first case points to a major challenge that could spur infections if more cases are confirmed.

Scientists are now warning of a worst-case scenario of infections if testing and monitoring of contacts linked to the single confirmed case leads to the identification of more infections and further spread of the disease.

By last evening, sources at the Ministry of Health indicated that some results were at the verification stage and were due for release.

KMPDU Deputy Secretary General Dr Dennis Miskellah poked holes in the contact tracing that has been done so far, terming it a joke.

“We are a joking country. This individual case interacted with too many people, and this infection might get out of hand if we are not keen enough,” he added.

He said the war on Ebola could be won or lost at contact tracing. Dr Miskellah said Kenya should have identified all individuals from the immigration office at the port, taxi drivers and those he provided transport with and officials who served him at the Jomo Kenyatta International Airport (JKIA) where he landed.

Other individuals he said include clerks, security personnel and a hospital receptionist.

“Do we have flight operators who served him food, who exchanged flight material with him? Are we having cleaners both at the airport, on the flight and at the hospital? Posed Miskellah.

According to Miskellah, the Migration department should announce the number of individuals who served the patient and ensure everyone is quarantined.

Among individuals, he said, are those who stamped his passport and those at port health.

A section of primary contacts, he said, might have interacted in social spaces, risking transmission of the virus.

Even though Prof Omu Anzala, a virologist, said the country should not panic over the single confirmed case, he warned that additional cases could be reported in the coming days or weeks.

Having a high number of infections, he warned, could make it difficult to contain the spread of the disease.

“Let us prepare for the best, and work on the worst scenario. We should take nothing for granted,” warned Prof Anzala.

He warned that although Kenya has confirmed only one case of Ebola Bundibugyo virus disease, there is a likelihood that more cases could be reported.

“We need to ensure we have all systems in place, as fast as possible. This time round, we should not show any laxity. Ebola is still spreading, and we have learnt Ebola can get to Kenya through the borders,” he said.

As long as individuals continue travelling from the Democratic Republic of Congo (DRC), a highly affected area, Kenya remains at risk of importing more cases, potentially putting pressure on the country’s health system.

“At the borders, are people still travelling? Are Ugandan flights coming here? Are trucks moving from DRC to Uganda to Kenya?” posed Anzala. “Yes, we are not looking at this single case- no,” he added.

Another concerning case on free movement at Kenya's border points is that of a 20-year-old man in Wajir suspected of hemorrhagic fever.

A nurse in personal protective equipment at an Ebola isolation facility at Nairobi Hospital on October 7, 2026. [Luis Tato/AFP]

The Kenyan is reported to have also presented with a cough and headache, and was found to be severely anaemic in a private hospital.

The patient is said to have travelled from DRC, through Uganda to Kenya by road. A journey of not less than 2,000 kilometres.

Along the way, he interacted with hundreds of people, stopping in Isiolo before getting to Wajir, raising risks of infectious disease.

Questions have arisen on why the case was not identified during checks at the borders.

Speaking on Thursday, Health Cabinet Secretary Aden Duale said 66 contacts linked to the case have been identified, but only 10 have been quarantined.

"How can we only have 66 contacts when these people landed at the airport, were received by family, picked up by a taxi driver and interacted with lots of people at the hospital? The number of primary contacts could be more than 100," Dr Miskellah said.

He added: "We need everyone, including cleaners at the airport, hospital and even those who handled his passport, to be moped up to avoid any time bomb we are subjecting the country to."

In a brief to Ambassadors, Duale, however, said individuals already accounted for are under appropriate monitoring and quarantine.

The contacts, according to the ministry, include all potential contacts from airports, airlines, hospitals, friends and family.

“Our teams are working continuously to trace the remaining contacts and ensure that anyone who develops symptoms is rapidly identified, isolated, tested and managed,” said Duale.

But according to Kenya Medical Practitioners and Dentists Union (KMPDU), the number of individuals who came in contact might be more.

Prof Wallace Bulimo, a molecular virologist and lead, pandemic and emergency at KEMRI, said of the 57 cases, at least 21 were contacts at the Nairobi Hospital.

Asked whether 57 contacts represent a total of individuals who got in contact with the deceased, Bulimo said it is easy to get to know the exact number.

“There is no way we can absolutely tell,” said the researcher. “We don’t know everybody”

Bulimo said KEMRI and the ministry, in support of other entities, are on high alert, finding out if there are additional contacts.

The researcher maintained that scientists are doing all they can to avoid having more cases in the country.

This is through revamping screening and surveillance at the border of entry points.

“Ebola is real. One imported case can bring a disaster; this is why we are on high alert,” he said.

Bulimo added that KEMRI, in collaboration with the ministry, has enhanced screening at the border points, especially the Busia border, which reports a high volume of travellers, including truck drivers.

Asked why then the patient escaped being identified at JKIA, he said that remains a puzzle.

“I am not sure what happened at the airport, whether he was picked up or not. I do not think they checked his temperatures.” Painkillers are taken to lower temperatures. Immediately, he was picked up by two relatives at the hospital, based on how the patient

Bulimu admitted that the case was missed at the airport; Bulimu agreed that travel history of the patient remained questionable.

He pointed to the likelihood of him having left traces of Ebola during his travel. This was via road and by flight.

“Reality on contact tracing for this particular patient was funny, from the airport to the hospital,” said an insider who is part of the contact tracing.

Because of being on drugs, symptoms could have been missed, but internal organs might be deteriorating until the haemorrhagic phase.

“The patient came from Uganda, and underwent normal screening,” said Bulimo.

Moses Masika, a virologist, said the government seem to know who was in proximity to the Ebola patient, who died.

“Jambojet should have a list, the hospital should have a list and the relatives and friend driver from the airport should be easy to find,” he said.

Data tool developed by the Ministry for continuous surveillance of all notified diseases dubbed ADaM (All Disease Outbreak Module) shows at least 49 contacts are in quarantine.

Of the 49 cases, at least 21 are healthcare workers who interacted with the patient, while 28 others.

Insiders hinted that the healthcare workers are likely to be released at any time, with the release of their results.

Results for the cases are expected to be communicated from the Public Health Emergency Operations Centre (PHEOC), the highest organ of KPHI.

Whereas Anzala observed that the current contact tracing is ongoing, he maintained the need for enhancement by involving the community.

To succeed in contact tracing, under the current situation, he said there is a need for it to be done through community education.

This will ease fears and stigma.

“We must get in touch with any suspected case. If you are home, and your relative came into contact with the person, you can imagine the anxiety that goes around the country,” he said.

Reports that healthcare workers quarantined at the Nairobi Hospital have been denied communication also complicate the plea for voluntary isolation.

The Standard established that immediately after they were identified as primary contacts, they had their phones confiscated.

This, according to a source, also limits contact tracing. For instance, the individuals cannot communicate with their families, and they cannot reach out to those they may have interacted with for screening.

"The government seems to be very determined to control the narrative. This, they say, is a national security issue," said the source.

Contact tracing, he maintained, is not an issue of just picking someone and taking them to quarantine.

Instead, it is an issue of ensuring the community and family at large are aware of the situation, what to do and what is expected in the long run.

“Contact tracing is not a rush. It is a continuous process. We need information and education to complete all cases,” observed the researcher.

“Contact tracing is a continuous process, because we need to know where the next infection came from. For contact tracing, we need to prepare ourselves for a long run,” he added.

Additionally, Dr Robert Rono, an epidemiologist, emphasised the need to watch symptoms to avoid transmission of the disease.

The symptoms include fever, muscle pain, fatigue and weakness, chills, and bleeding in advanced stages, among others.

“If someone has symptoms and is travelling, they should isolate and notify authorities. This is the only way to cut the chain of transmission,” said Rono.

Dr Paul Olale, public health in emergencies technical lead at the Kenya Red Cross Society, explained that contact tracing is following up potential people who might have interacted with a case

Contacts, he said, are also individuals who might have interacted with surfaces where an active case has been.

In this scenario of death, individuals who might have touched surfaces on the flight, in toilets, or at the port where the disease was.

From the contact, case identification is done.

Those who are found to have had contact are then screened to find out if they can be identified as cases.

Here, an individual is examined to find out whether he or she meets minimum requirements, for example, exhibits symptoms, and has a history of travel from an endemic zone.

Those exhibiting symptoms are then moved to isolation for treatment of the disease.

Contact tracing and identification are a joint operation being done by Kenya Red Cross Society, the Ministry of Health, and partners.

“It is key, because this is what helps a country to contain the virus, by wrapping up anyone who might have interacted with a case,” said Olale.

Anzala stressed that anyone who came into contact with an active case must be treated as a potential contact.

“You do not take chances when you come into 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.”