Karonga District Health Office received a report of 8 year old male Congolese, who presented with vomiting at the border on 21/11/19. The patient had history of fever that started on 18/11/19 and vomiting since 19/11/19. There was also complaint of general body weakness.

*Action by border staff*

Upon getting reports of the case from one traveller, immigration officials informed Port Health Officers who isolated the case.

Port Health Officers conducted screening and found that the patient had a body temperature of 37.4 degrees celcius but with history of being on paracetamol treatment since 18/11/19. Port Health Officers reported the issue to District Health Office due to Ebola like symptoms (vomiting, body weakness & history of fever) and Epidemilogical linkage i.e. originating from country where there is active transimission of Ebola.

*Action by District Health Office*

A Rapid Response Team was immediately deployed to conduct investigations.

*Findings by Rapid Response Team*

The patient originated from Tulonge area (South Kivu) in Democratic Republic of Congo. He left South Kivu early November in company of 7 other family members, passing through Burundi and Tanzania. Upon arrival at Songwe Border, they joined a group of about 80 other allegedly asylum seekers and spent nights along the banks of Songwe river.

On 20/11/19, the family tried to find their way into Malawi without clearance by immigration officials. They were intercepted at Iponga Road Block by security officials and sent back to Songwe Border.

On examination, the patient was weak with body temperature of 36.6 degrees celcius. It was also reported that the patient had vomited 6 times during the day and sought treatment at Lughano Private Clinic at the border, where the following drugs were prescribed: LA, Paracetamol and Promethazine.

Rapid Response Team had the impression that it could be a case of Malaria with Ebola as a differential.

Sample for Malaria Rapid Diagnostic Test was taken and came positive. Ebola sample was taken and will be sent to National Reference Laboratory in Lilongwe.

The Rapid Response Team made the following recommendations:
– Case be transferred to Karonga Ebola Treatment Unit for further management with all standard operating procedures activated
– All contacts be listed and put on followup
– Relevant authorities to make sure asylum seekers gathered at Songwe Border be relocated immediately because of lack of sanitary facilities and related health problems that may arise from poor sanitation and exposure to malaria vectors.

The case has been transferred to Karonga Ebola Treatment Unit and is being managed accordingly.

The patient is in stable condition.

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