Ebola alert as Health Ministry 'shuts down' tracking system

A real-time surveillance system used by the Ministry of Health to track Ebola and other infectious diseases has been disabled.

This has raised concerns about contact tracing, monitoring of suspected cases and the country's ability to contain the outbreak.

The All Disease Outbreak Module (ADaM), which allows health officials to monitor cases, laboratory results and contacts, was disabled on Friday, according to insiders familiar with the system.

It remains unclear why the Ministry of Health disabled the tool at a time when the government is stepping up surveillance following confirmation of an imported case of Ebola Bundibugyo virus disease.

Health officials who previously accessed the system say its suspension has left them unable to establish the latest position on contacts, people in quarantine and pending laboratory results.

“At the moment, we are in the dark about contacts, cases, those in quarantine and the status of test results,” said one source.

The source said disabling the system had complicated efforts to coordinate the response, adding that health officials could no longer easily establish where contact tracing was taking place or what action was being taken.

“We are not sure why the tool was disabled. We suspect the move is aimed at controlling the narrative,” the source said.

Efforts by The Standard to get clarity from Director General Patrick Amoth remained unsuccessful.

Dr Amoth is the highest technical adviser in the ministry.

Also, the claims could not be independently verified, and it was not immediately clear whether the system had been shut down entirely or access restricted to selected officials.

ADaM is a real-time data platform developed by the Ministry of Health to support surveillance and reporting of notifiable diseases, including Ebola and Mpox.

The system allows trained health workers to enter details of suspected cases, symptoms, treatment, laboratory tests and results.

The information is then available to authorised officials, including those coordinating the response at the national level.

According to insiders, the platform has been central to tracking suspected cases and guiding decisions on testing, isolation and contact tracing.

The system reportedly flagged a suspected Ebola case in Wajir involving a person who had travelled from the Democratic Republic of Congo (DRC), where the outbreak was reported.

Insiders also said information about the fatal imported Ebola case at Nairobi Hospital appeared on the system before the government publicly announced the case.

However, officials handling the response are required to follow established international reporting protocols, including notifying the World Health Organisation (WHO) before a public announcement.

“We knew about the case, but we cannot break protocol. The system is expected to help in better handling without creating panic, while consolidating all contacts and putting actions in place,” the source said.

The source said the platform was designed to ensure that information entered by a health worker could trigger action by response teams without waiting for separate phone calls or reports.

“The moment I put a case in the system, even before I make a phone call, they are already responding to what is required and looking for contacts,” said the source.

The source added that trained health workers across the country had been able to report cases through the platform, allowing national officials to monitor developments in different counties.

“For instance, if a provider is in Garissa, they can see what is happening and where contact tracing is being conducted. For now, we do not know. This was the essence of the system, to ensure smooth coordination and action to prevent further transmission,” added the source.

The disruption is also said to affect reporting of other infectious diseases listed on the platform.

The system was established during the Covid-19 pandemic to support surveillance and monitoring of outbreaks.

A case reported in Nakuru, for example, could be entered into the platform and viewed by authorised personnel at the national operations centre.

Only a few health professionals trained in June on Ebola have rights to access the system.

The professionals expressed concern that without timely access to updated information, health workers could struggle to establish the status of cases and determine what action was required.

“If they freeze the system, it becomes hard to monitor. We are the implementers,” said a source.

The source warned that restricting access to surveillance information could undermine coordination, particularly when health workers need to know whether contacts have been identified, tested or placed under monitoring.

Meanwhile, questions are emerging over the follow-up of people who came into contact with the patient who died of Ebola.

The Ministry of Health has said at least 66 contacts were identified, including healthcare workers, transport providers, flight personnel, family members and friends.

“Currently, we are in the dark. The system should have indicated finer details on contacts, including tests,” he said.

Kenya Medical Practitioners and Dentists Union (KMPDU) said that though the government has good reason for disabling the tool, there should be clear communication.

KMPDU Deputy Secretary General Dr Dennis Miskellah said the moment the government start operating in secrecy, it loses trust among health workers and Kenyans at large.

“Transparency is key in an emergency. When we start hiding information, we start having rumours that spread like bushfires, which are likely to harm us if not taken with much care,” said Miskellah.

“Having an active tool or system does not necessarily mean sharing information with the public, but a measure to handle a pandemic so as not to be caught barefoot,” he added.

Miskellah maintained that transparency should be key, with clear communication factored in, not only in Ebola, but other infections.

A section of contacts to a fatal Ebola case have reportedly been released from quarantine after testing negative using polymerase chain reaction (PCR) tests.

However, insiders raised concerns about the classification of direct and indirect contacts, as well as the limited information available on test results and secondary contacts.

They said people released from quarantine still require close monitoring for 21 days, the period used to monitor contacts for symptoms of Ebola.

Those under follow-up are expected to report symptoms such as fever or a runny nose to health teams. Their condition is recorded on monitoring forms that help maintain communication between contacts and the facilities or teams overseeing their follow-up.

A negative test result does not remove the need for continued monitoring where required under public health protocols.

“The forms maintain information between a contact and the centre where they were quarantined,” explained the source.

Concerns have also been raised over reports that some people linked to the fatal case had their mobile phones confiscated.

According to sources, this was aimed at preventing them from sharing information about the patient's admission and treatment, including any details on Ebola response.

Dr Miskellah said he raised the issue with the hospital management, which promised to handle the concern and take immediate action.

Nevertheless, Miskellah raised concerns about how communication on Ebola preparedness and contact tracing, and the announcement of tests, is done.

According to him, there is a need to have a single channel of communication, for clarity, like it was during the COVID-19 pandemic.

“It is annoying that anyone wakes up and feels like talking about Ebola. We have PSs talking, Governors, the police, the CS. This is wrong because it brings confusion,” said Miskellah.

His concern was witnessed over the weekend, when the Department of Public Health gave a contradictory statement about a ban on meetings for ministry staff.

The statement was immediately withdrawn and clarified that it would only affect staff working under public health.

Wajir Governor Abdul Abdullahi also announced the results of a case of a 20-year-old man who had been taken for Ebola tests.

“The ministry should have strictures. We need a single trusted source where we can get information. There is confusion all over that is not good in handling an emergency,” he said.