There is no established evidence that the deceased patient or his family knew he had Ebola. An imported case does not mean the family knowingly brought an Ebola patient into Kenya. First and foremost, WHO reports that he had been unwell for about a month and had received treatment at several hospitals in DRC. His reported care included facilities in Bondo and Kisangani before he travelled to Kenya via Uganda. Whether those hospitals tested him for Ebola is not publicly established. Had he tested positive, isolation would have been expected. Crucially, WHO considers it likely that his original illness was something else and that he acquired Ebola later while seeking care. Being sick for a month does not mean he had Ebola for a month. The family bringing him to Kenya was consistent with seeking further treatment for an illness that had persisted despite medical care. According to reporting of Africa CDC’s briefing, he travelled through Beni and crossed into Uganda through Kasindi on 1 October, before flying from Entebbe to Nairobi on 3 October. Uganda reported a normal temperature at Entebbe, and he also passed screening in Nairobi. A relative took him directly to Nairobi Hospital, where he was isolated. He tested positive on 5 October and died that night. Passing screening does not rule out infection. The subsequent infections among relatives and healthcare workers show that transmission occurred, but cannot establish exactly when he acquired Ebola or whether he was at peak infectiousness on arrival. At this point, the focus should be on how an unwell traveller from an outbreak-affected country passed successive screening points, and how healthcare workers became infected despite reported isolation. What precautions were taken from the outset, and where did they fall short? Those questions demand answers. Publicly vilifying a bereaved family, some of whose members are now battling the same disease, does nothing to answer them or protect the public. #Ebola #EbolaKE @daktari1 @SokoAnalyst @MOH_Kenya @WHOKenya @WHO

This is the 𝐭𝐡𝐢𝐫𝐝 𝐄𝐛𝐨𝐥𝐚 𝐜𝐚𝐬𝐞 𝐢𝐧 𝐊𝐞𝐧𝐲𝐚, 𝐚𝐧𝐝 𝐭𝐡𝐞 𝐬𝐞𝐜𝐨𝐧𝐝 𝐥𝐨𝐜𝐚𝐥 𝐭𝐫𝐚𝐧𝐬𝐦𝐢𝐬𝐬𝐢𝐨𝐧 linked to the first imported case as confirmed by @MOH_Kenya. Is it concerning? Yes … but the reassuring detail is that both secondary cases were detected while already under quarantine and daily monitoring. This means the contact-tracing and quarantine system working as intended. The latest patient is reported to be a 65-year-old woman, who is a close family contact of the index case, and had been under quarantine since 6 October. When she developed symptoms, she was promptly isolated, tested and started on supportive care. Quarantine cannot undo an infection acquired earlier. Its purpose is to identify illness promptly, facilitate early treatment and prevent further spread. Ebola transmission begins after symptoms develop, so contact with someone before they became symptomatic does not, by itself, constitute an Ebola exposure. Detecting these cases within quarantine therefore substantially limits opportunities for onward transmission. The lingering concern remains any untraced contacts of the original patient, and anyone who may have had unprotected exposure to either secondary case after symptoms began, including quarantine staff and health workers involved in care or transfer. These possible exposures need careful assessment before we can be confident that the transmission chain has been contained. There is reason for cautious reassurance. Two secondary cases within a known contact group do not, on their own, establish wider community spread. But every contact must be accounted for and monitored for the full 21 days from their last possible exposure. Clear, regular public updates remain essential. We hope and pray for the full recovery of both patients now under isolation and treatment, and for the protection of their families and the healthcare and quarantine teams supporting them. #Ebola #EbolaKE