American infected with Ebola in DRC, as US moves to limit entry from virus-hit region

As of Tuesday, there have been 131 deaths linked to the current outbreak, according to the DRC’s health minister, Dr. Samuel Roger Kamba.

(CNN) — An international effort is underway to contain an Ebola outbreak in the Democratic Republic of Congo (DRC) and Uganda that is believed by local authorities to have caused more than 130 deaths, with the United States triggering a public health law to limit entry from the affected region.

An American working in the DRC tested positive for Ebola, the US Centers for Disease Control and Prevention (CDC) confirmed Monday. Though the CDC did not identify the person, the international charity Serge reported that a Christian missionary physician – Dr. Peter Stafford – had “tested positive” after “presenting symptoms consistent with the virus.” His wife, Dr. Rebekah Stafford, and another physician – both of whom were treating patients when the outbreak began – are being monitored for signs of the virus but are currently asymptomatic, the charity said. The couple’s four children are also being monitored.

On Sunday, the World Health Organization (WHO) declared the Ebola epidemic a “public health emergency of international concern.” The outbreak does not yet meet the criteria of a “pandemic emergency,” but WHO warned that the high positivity rate and increasing number of cases and deaths across health zones point toward “a potentially much larger outbreak.”

As of Tuesday, there have been 131 deaths linked to the current outbreak, according to the DRC’s health minister, Dr. Samuel Roger Kamba.

The Africa CDC declared the outbreak a Public Health Emergency of Continental Security (PHECS), which allows the group to coordinate responses across the continent.

Relief officials warned that years of war and aid cuts have “deepened a humanitarian crisis of staggering scale” in the DRC, where thousands of people have been killed and many more displaced since January. Mounting hostilities have slashed access to key surveillance systems that “should have detected this outbreak weeks earlier,” according to the country director for the international NGO Oxfam.

That same day, the CDC invoked Title 42 – a public health law that restricts entry into the US during outbreaks of communicable diseases – for at least 30 days starting Monday.

Title 42 has been on the books since 1944 but has been used only twice in the modern era. The first time was from March 2020 to May 2023, during the Covid-19 pandemic. Monday’s action on Ebola marks the second.

Dr. Jeanne Marrazzo, chief executive officer of the Infectious Diseases Society of America, says that restricting immigration can stem the spread of an infection but only if measures are coupled with exit screening from affected countries and with attention to human rights.

“Singling out non-US passport holders singles out non-US citizens,” she said. “Pathogens don’t recognize passports.”

The CDC assessed the immediate risk to the US public as “low” but added that officials would track the “evolving situation” in a statement Monday.

‘A major battle’

The Congolese government said Tuesday that 513 suspected cases have so far been linked to the outbreak. US health officials are working to move seven people from the Central African country to Germany, including the American national who tested positive for the virus, according to Capt. Satish K. Pillai, a doctor and incident manager for the CDC’s Ebola response.

Germany’s Ministry of Health told CNN Tuesday that arrangements are “currently being made to admit and treat the patient in Germany.”

WHO said the outbreak is affecting the country’s remote northeastern Ituri province. In neighboring Uganda, two laboratory-confirmed cases, including one death, have been reported in the capital, Kampala, WHO reported.

The latest outbreak is being driven by the Bundibugyo strain, one of several viruses that can cause Ebola disease, WHO said. The organizaton has called the outbreak “extraordinary” as there are currently no approved treatments or vaccines specific to the Bundibugyo virus.

Ebola symptoms include fever, muscle pain, rash and sometimes bleeding. The virus is transmitted through direct contact with bodily fluids, including the handling of contaminated materials or someone who has died from the disease.

The fatality rate involving the Bundibugyo strain is estimated to be between 25% and 40%, according to Médecins Sans Frontières (MSF), also known as Doctors Without Borders.

Aid workers and health professionals in the region called on the international community to strengthen response efforts to the outbreak, with one doctor recounting a “battle against the infection.”

“We are also appealing to all people and organizations capable of supporting this battle against the infection,” Dr. Patient Mazirane, the medical director at the Universelle Clinic in the Ituri capital of Bunia, told CNN on Monday.

“This is a major battle which requires enormous resources in order to save all those who can still be saved from this illness,” he said.

Another resident in the capital warned the outbreak “seems even more deadly” than previous strains. Jean-Faustin Baraka urged health organizations to “find the most efficient means for quickly resolving this problem.”

Americans to be relocated

Starting Monday, US health officials will enforce a range of mechanisms to try to curb the Ebola outbreak, including enhancing public health screenings for people arriving from affected regions and placing restrictions on non-US passport holders if they have traveled to Uganda, the DRC or South Sudan in the past three weeks.

The sweeping measures came after the CDC announced it was supporting interagency partners with efforts to relocate “a small number of Americans who are directly affected” by the outbreak.

On Sunday, the State Department issued new advisories warning against travel to the DRC and Uganda due to the outbreak.

The CDC said it was deploying resources from the agency’s offices — who were already in the country — to help with efforts including surveillance, contact tracing and laboratory testing, and would mobilize additional support from the agency’s headquarters in Atlanta.

International coordination is being ramped up to prevent the epidemic’s spread as experts warn of “extremely concerning” conditions. Kamba said Sunday that three treatment centers were being opened in the affected region to increase capacity amid the outbreak.

About 7metric tons of emergency medical supplies, including protective equipment, tents and beds, arrived in Bunia on Sunday to “help scale up frontline response efforts,” according to WHO.

Health workers navigating a medical system depleted by hostilities in the DRC are unable to offer adequate care to patients, according to Oxfam.

“There are already deaths in the community. When people die at home, it means there are many more undetected cases,” Dr. Manenji Mangudu, the Oxfam DRC country director, said in a statement Monday.

In Uganda, the two confirmed cases in Kampala have no known connection to each other, which is “often a warning sign that the outbreak in the DRC is larger than health authorities can currently see,” Adrian Esterman, professor and chair of biostatistics at Adelaide University, said in a statement.

As a result, the US embassy in Kampala announced Monday that it had temporarily paused all visa services in light of the ongoing Ebola outbreak.

WHO said that four health workers were among the suspected deaths reported from the affected area.

Dr. Matt Mason, senior lecturer for the School of Health at the University of the Sunshine Coast in Australia, said this “raises serious concerns about gaps in infection prevention and control and the potential for amplification within health facilities, leading to the wider community.”

This is the 17th Ebola outbreak in the DRC since the virus was first identified in 1976, according to WHO. The country is particularly prone to Ebola outbreaks in part because the virus’ “natural reservoir” is the fruit bat, which are found within the DRC’s forested areas, public health expert Ahmed Ogwell, former deputy director-general of Africa CDC, told CNN. Locals in those areas are closely engaged with the forest, meaning they are very exposed to the bats and with them the virus, Ogwell said.

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