Ebola's deadly journey: From 1976 outbreaks to Kenya's first case

Health CS Aden Duale with Public Health PS Mary Muthoni toured Nairobi Hospital on October 7, 2026. [Benard Orwongo, Standard]

On June 27, 1976, a cotton factory worker, Nzara, in a town located in present-day South Sudan, developed severe fever, headaches, and chest pains. Unable to go to work, his brother attended to him from home – a rural village with distinctive grass-thatched mud houses that defined many an African village in those years.

After three days at home and his situation growing worse, he was taken to nearby Nzara hospital; a facility that could have as well been a dispensary in modern times.

By day 5, the patient started to bleed from the mouth and nose. He developed bloody diarrhoea. On the ninth day since symptoms began, he died.

There is no peer-reviewed historical record that publicly names this first-to-be-recorded patient zero. So, let’s call him P1.

On July 12 – six days after P1 died – a colleague with whom he served in storekeeping fell ill with eerily similar symptoms. He succumbed to the disease on July 14. Let’s call him P2.

The same week he died, the caregiving brother of P1 fell ill with the same symptoms. Unlike P1 and P2, he survived. On July 19, P2’s wife died, again, from the same disease.

Later on in July, another factory worker got ill. Let’s call him P3. An outgoing and social person, P3 had many visitors coming to check on him. Among those documented to have been by his bedside were his two brothers and two women who cared for him. Three days later, P3 died.

One of his brothers developed symptoms and was accompanied by the other brother to another hospital located 128Km away from Nzara. He succumbed on August 17. Not long after, the surviving brother got sick and died too. That month, the two women who attended to P3, another factory worker, and a nurse in Nzara hospital had died from the now familiar symptoms.

By year-end, the final count in Nzara came to 284 cases. Just over half of them, 53 per cent, succumbed.

Health workers in PPE conduct safety checks during an MSF Ebola response training in Ongata Rongai, Kajiado County on July 10, 2026. [AFP]

Hundreds of kilometres south-west of Sudan, in Zaire (now Congo DRC), at Yambuku Catholic Mission – founded by Belgian missionaries in 1935 – between 6,000 and 12,000 patients received healthcare services every month.

On August 26, a 44-year-old male teacher at the nearby mission school received treatment for malaria. On September 5, he was admitted to the mission hospital with severe symptoms, among them, gastrointestinal bleeding. He died not long after.

A few weeks later, on October 3, the hospital was closed after 13 of 17 staff members had gotten sick, and 11 were dead – from the disease that seemed to be spreading through close contact.

By then, the World Health Organisation (WHO) had been notified of these strange, overlapping, but similar, epidemics – approximately 800 kilometres apart. Blood samples from Zaire and Sudan were shipped to WHO’s virus unit in Geneva, then onwards to the Centres for Disease Control (CDC) in the USA.

An internationally coordinated investigation of both Zaire and Sudan got underway. New clinical protocols – such as protective suits for everyone who was handling a patient – were instituted, which for the first time yielded results in dealing with the outbreaks.

By New Year the numbers for Zaire showed more than 300 people had been infected: nearly nine out of every 10 dead. In Zaire, it seemed, the disease was considerably more lethal than in Sudan.

Nzara and Yambuku would be the first ever recorded history of Ebola Disease – aptly named after the Ebola, a waterway that snaked through the affected villages in DRC.

The Nzara and Yambuku viruses were different strains of the same agent: identified as belonging to the filovirus family.

It turns out, the two viral strains were distinct – especially in the manner patients fared. The Nzara virus was more infectious, while the Yambuku virus was more lethal. Even though both geography and time suggested the same origin, the two epidemics appear to have been exclusive events.

A lot of scientific work has gone into understanding Ebola since 1976. According to WHO, Ebola Disease is caused by viruses that belong to the Orthoebolavirus genus of the filoviridae family. So far, six species of Orthoebolaviruses have been identified. Of the six, three cause disease.

Ebola virus causes Ebola virus disease (EVD). The Sudan virus causes Sudan virus disease (SVD). And the last one, Bundibugyo virus, causes Bundibugyo virus disease (BVD).

The patient who died in Kenya last week, identified as a 40-year-old businessman, was ostensibly killed by BVD: laboratory tests have thus far confirmed.

The death is directly linked to an ongoing outbreak in DRC, first declared on May 15, 2026 by WHO. Ebola is a Public Health Emergency of International Concern (PHEIC).

Within weeks, Uganda confirmed its first case – linked to a traveller from DRC. And now, in the same fashion, Kenya has.

According to the Ministry of Health (MOH), the patient fell ill about a month ago and received treatment at several hospitals in the DRC. It has not been said whether that incident was as a result of Ebola.

He travelled by road to Kampala, then to Nairobi by flight, on Jambo Jet flight number 8523, arriving morning on Saturday, 3 October, at 1:10 pm.

Based on MOH’s chronology of the case, he must have landed at JKIA already sick. He was taken to Nairobi Hospital and, due to his travel history, was put under isolation. He exhibited typical symptoms such as fever, chills, fatigue, muscle pain, pain while swallowing, sore throat and bleeding at injection sites. Despite treatment interventions, he died on October 5.

Ebola’s incubation period – from the time one is infected to the time they show symptoms – is 21 days. As such, symptoms might show after five, 11 or 17 days but not beyond 21 days.

What makes Ebola perplexingly deadly?

Speaking to American news organisation NPR during the 2014 West Africa outbreak, virologist Christopher Baisler explained: “The normal job of the immune system is to eliminate infections. But when it's activated at extreme levels, what we call a cytokine storm, it hurts both the virus and the patient.”

A cytokine storm causes the immune system to put into use its entire defence mechanisms all at once. Ebola virus is one of the best pathogens known to cause cytokine storms.

This ‘last-ditch’ retaliation is targeted at the virus. However, because of its overwhelming power, it also attacks tissues and organs in the patient. Often, blood vessels absorb the bulk of the damage. “The cytokine storm makes the blood vessel walls more permeable,” Basler says.

The storm also causes heavy release of nitric oxide, which prevents blood from clotting easily. Arteries, veins and capillaries start to leak blood.

Ebola’s deadly history offers a stark warning as Kenya steps up efforts to contain its first confirmed Bundibugyo case. [Courtesy]

Speaking to the same organisation, immunologist Thomas Geisbert noted: “At the end stage of the disease, you have small leaks in blood vessels. You end up with essentially no blood pressure. Your body temperature drops. So, you don't die of blood loss, but from something similar to severe septic shock.”

Scientists are still studying how the Ebola cytokine storm happens. Even so, the description offered now is that the virus goes berserk upon infection. It replicates fast and attacks every cell. Sometimes one cell is attacked by several viruses. To understand why this is unusual, HIV, the virus that caused AIDS, employs a one-virus-one-cell approach as it attacks the body. This out-of-control attack provokes the body to bring out all its defences in one go.

This outbreak is the second worst in history – having claimed at least 4,000 lives so far. The 2014-2016 outbreak in West Africa, by the EVD type, is number one in mortality, having claimed 11,310 lives.

CS Aden Duale, in charge of MOH, says that the government has put in place measures to effectively respond to the threat of Ebola in Kenya, among them, heightened screening at all border points.

As of October 7, over 652,000 travellers had been screened and 267 samples tested in Kenyan virology Reference laboratories. On October 8, 66 people suspected to have come into contact with the deceased Kenyan have been accounted for and are being quarantined.

“We are mobilising infection prevention commodities and Personal Protective Equipment (PPE). We appreciate support from partners,” Duale said, noting that the ministry has received over 7,000 sets of PPE.

Duale has urged Kenyans to remain vigilant, noting that success against the disease will be determined by early detection, rapid diagnosis, timely isolation, appropriate treatment and contact tracing.

Presently, there is only one pre-qualified vaccine against Ebola virus. Known as Ervebo, the vaccine is only effective against EVD. For BVD, research as well as trials are ongoing.

This is the first ever time a Kenyan has been diagnosed with Ebola Disease in the country. As for DRC/Zaire, this is the 17th Ebola outbreak; the first having been in 1976. It is also the country’s worst outbreak.

MOH’s toll-free line, 719, for information on Ebola, remains active. It is available for use by all Kenyans, including those abroad.