The United Republic of Tanzania has been unforthcoming about several reports of suspected Ebola cases in the country, and the reports have been trickling in since September 10, the World Health Organization said in an unusual statement Saturday.
To date, the WHO said its disease surveillance programs have picked up unofficial reports of at least four cases of suspected Ebola virus disease in Tanzania, including one death, as well as an unidentified number of contacts being quarantined in “various sites in the country.
The official word from Tanzanian authorities is that there have been no cases of Ebola in the country and that it does not “have any suspected case admitted anywhere.” However, the WHO says Tanzanian officials have been cagey about sharing information about the cases and have not said what the people involved were sickened with if it was not Ebola.
“[T]o date, clinical data, results of the investigations, possible contacts and potential laboratory tests performed for differential diagnosis of those patients have not been communicated to WHO. This information is required for WHO to be able to fully assess of the potential risk posed by this event,” the organization said in its statement.
The WHO first got word of the situation on September 10, when reports came in that someone suspected of having Ebola virus disease had died in Dar es Salaam, the largest city in Tanzania. According to the Associated Press, which saw internal WHO documents, that patient was a 34-year-old doctor who died on September 8 after returning from Uganda, where she had visited health facilities on a research mission. Initial reports to the WHO also suggested that an unidentified number of people who had contact with the doctor were being held in quarantine in various unspecified places in Tanzania.
Uganda, which borders Tanzania and the Democratic Republic of the Congo, does not have an outbreak of Ebola. However, the DRC is experiencing an outbreak, and a small number of cases have spilled over to Uganda from the DRC’s affected northeastern provinces. The outbreak there began in August of 2018 and has sickened over 3,000, killing more than 2,000. It is the second largest Ebola outbreak on record.
The WHO immediately requested information about the doctor’s death in Tanzania. The next day, September 11, the organization got an unofficial report through its monitoring system that the doctor had tested positive for Ebola and that there was another suspected Ebola case in Mwanza, a northern port city on Lake Victoria.
Unofficial reports to the WHO suggested that the case in Mwanza ended up testing negative for Ebola, but additional reports came in of another suspected case in a 27-year-old in Dar es Salaam on September 12.
Dearth of details
All the while, Tanzanian officials did not provide the WHO with any information on any of the cases. On September 16, Tanzanian health authorities officially told the WHO that they would not do further testing at WHO-sanctioned laboratories to confirm the absence of Ebola, despite strong recommendations from WHO experts that they do such tests. On the 18th, the country officially announced that it was Ebola free.
The very next day, September 19, the WHO picked up yet another unofficial report that a contact of the initial case—the 34-year-old doctor who died—had fallen ill and was hospitalized. Still, Tanzanian officials deny the presence of Ebola and even suspected cases.
“The limited available official information from Tanzanian authorities represents a challenge for assessing the risk posed by this event,” the WHO said in its statement.
The organization noted that Tanzania does have an Ebola preparedness program and response plan. However, in recent outbreak simulations, experts identified “areas for improvement.”
Given the public health risk, the WHO conducted a risk assessment, reporting the results as follows:
Due to uncertainties around the event, the absence of any official information, and considering that if confirmed this would have been the first EVD outbreak reported in this country, and that the presumptive case travelled extensively within the United Republic of Tanzania, the risk was assessed as very high at national level. The risk at regional level was considered as high due to potential cross-border travels and significant population movements as well as potential unknown transmission chains. The risk at the global level was considered low.
Without out more information, the WHO is currently recommending against any travel or trade restrictions.
Tourism is a significant and expanding chunk of Tanzania’s economy. The country is home to a rich array of wildlife, numerous parks and conserved areas, several UNESCO World Heritage Sites, as well as Mount Kilamanjaro, the tallest mountain in Africa.