- Associated Press - Wednesday, June 12, 2019

BENI, Congo (AP) — A 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, as two more people in Uganda tested positive for the highly contagious disease that has killed more than 1,400 in Congo.

The boy, part of a Congolese family who crossed into Uganda earlier in the week, died overnight, the World Health Organization said. The two new cases are believed to be among his family members, who have been isolated at a hospital near the Congo border. Uganda now has three confirmed Ebola cases.

Authorities are trying to determine how the family, exposed to the virus in Congo, managed to cross a border where for months health officials have been screening millions of travelers.

This has become the second-deadliest Ebola outbreak in history since the first cases were declared in August.

Congo’s health ministry said a dozen members of the boy’s family had showed symptoms of Ebola and were put in isolation. But six managed to leave while awaiting transfer to an Ebola treatment center. They crossed into Uganda, where the boy received treatment and relatives were isolated. Two developed symptoms and were being tested.

Experts have long feared Ebola could spread to neighboring countries because of rebel attacks and community resistance hampering virus containment work in eastern Congo, one of the world’s most turbulent regions. The virus can spread quickly via close contact with bodily fluids of those infected and can be fatal in up to 90% of cases.

Ugandan health teams “are not panicking,” Henry Mwebesa, a physician and the national director of health services, told The Associated Press. He cited the country’s experience battling previous outbreaks of Ebola and other hemorrhagic fevers.

“We have all the contingencies to contain this case,” Mwebesa said. “It is not going to go beyond” the patient’s family.

The Congolese family likely did not pass through official border points, where health workers screen all travelers for a high temperature and isolate those who show signs of illness.

The child’s mother, who is married to a Ugandan, “knows where to pass. She does not have to go through the official border points,” Mwebesa said from Kasese, a district near the Congo border where the family is being treated.

Uganda is more stable than eastern Congo, and for the first time an experimental but effective Ebola vaccine is being widely used, with more than 130,000 doses distributed. Uganda has vaccinated nearly 4,700 health workers so far.

But Ebola has been especially feared in Uganda, where multiple outbreaks have occurred over the years. An outbreak in the north in 2000 infected 425 people and killed more than half of them.

The announcement of the first cross-border case puts new pressure on WHO to declare the Ebola outbreak a global health emergency. A WHO expert committee has twice decided that the outbreak, while of “deep concern,” is not yet a global health emergency .

But international spread is one of the major criteria the United Nations agency considers before such a declaration. Millions have travelers along Congo’s border with Uganda and Rwanda have been screened for Ebola since the outbreak began. WHO has advised against travel restrictions.

The news of a first cross-border case is “tragic but unfortunately not surprising,” said Dr. Jeremy Farrar with the Wellcome Trust, which is funding vaccine research in this outbreak. While Uganda is well-prepared with established surveillance, “we can expect and should plan for more cases in (Congo) and neighboring countries. This epidemic is in a truly frightening phase and shows no sign of stopping anytime soon.”

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Muhumuza reported from Kampala, Uganda.

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