5-year-old dies of Ebola as outbreak crosses Congo border

AP

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  • People crossing the border have their temperature taken to check for symptoms of Ebola, at the border crossing near Kasindi, eastern Congo Wednesday, June 12, 2019, just across from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 1

    This photo released by the International Rescue Committee (IRC) shows the treatment unit where the confirmed and suspected cases of Ebola are being treated Wednesday, June 12, 2019 at Bwera hospital, Kasese District, in western Uganda near the border with Congo. A 5-year-old boy vomiting blood has become the first cross-border case of Ebola in the current deadly outbreak and now authorities are trying to determine how his family, exposed to the virus, managed to cross from Congo into neighboring Uganda. (Ben Wise/International Rescue Committee via AP)

  • 2

    A woman carrying belongings on her head wades across the shallow Lubiriha River, an area that is popular with those who want to cross into Uganda without passing through the official border crossing, in Kasindi, eastern Congo Wednesday, June 12, 2019, just across the border from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 3

    Police operate a checkpoint at the border crossing near Kasindi, eastern Congo Wednesday, June 12, 2019, just across from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 4

    People walk along the street on the Ugandan side of the border crossing near Kasindi, eastern Congo Wednesday, June 12, 2019, just across from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 5

    This photo taken Monday, June 10, 2019 and released by the International Rescue Committee (IRC), shows an Ebola screening checkpoint where people crossing from Congo go through foot and hand washing with a chlorine solution and have their temperature taken, at the Bunagana border crossing with Congo, in western Uganda. Uganda's health ministry said late Tuesday, June 11, 2019 that a child in Uganda has tested positive for Ebola in the first cross-border case of the deadly virus since an outbreak started in neighboring Congo last year. (Ben Wise/International Rescue Committee via AP)

  • 6

    People crossing the border have their temperature taken to check for symptoms of Ebola, at the border crossing near Kasindi, eastern Congo Wednesday, June 12, 2019, just across from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 7

    This photo taken Thursday, May 9, 2019 and released by the World Health Organization (WHO), shows an Ebola screening checkpoint for people crossing from Congo at the Mpondwe border crossing, between the towns of Kasindi in Congo and Bwera in Uganda. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, June 12, 2019 while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (Matthew Taylor/World Health Organization via AP)

  • 8

    Local residents wash clothes in the shallow Lubiriha River, an area that is popular with those who want to cross into Uganda without passing through the official border crossing, in Kasindi, eastern Congo Wednesday, June 12, 2019, just across the border from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 9

    Local residents wash clothes and wade in the shallow Lubiriha River, an area that is popular with those who want to cross into Uganda without passing through the official border crossing, in Kasindi, eastern Congo Wednesday, June 12, 2019, just across the border from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 10

    Local residents wash clothes and wade in the shallow Lubiriha River, an area that is popular with those who want to cross into Uganda without passing through the official border crossing, in Kasindi, eastern Congo Wednesday, June 12, 2019, just across the border from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 11

    This photo taken Thursday, April 18, 2019 and released by the International Rescue Committee (IRC), shows the shores of Lake Albert near the border with Congo, at Kabakanga in Kagadi district, western Uganda. Uganda's health ministry said late Tuesday, June 11, 2019 that a child in Uganda has tested positive for Ebola in the first cross-border case of the deadly virus since an outbreak started in neighboring Congo last year. (Ben Wise/International Rescue Committee via AP)

  • 12

    This photo taken Thursday, April 18, 2019 and released by the International Rescue Committee (IRC), shows an Ebola-prevention information sign at the Ndaiga Health Centre II, near the shores of Lake Albert and the border with Congo, in Kagadi district, western Uganda. Uganda's health ministry said late Tuesday, June 11, 2019 that a child in Uganda has tested positive for Ebola in the first cross-border case of the deadly virus since an outbreak started in neighboring Congo last year. (Ben Wise/International Rescue Committee via AP)

  • 13

    This photo taken Monday, June 10, 2019 and released by the International Rescue Committee (IRC), shows an Ebola screening checkpoint where people crossing from Congo go through foot and hand washing with a chlorine solution and have their temperature taken, at the Bunagana border crossing with Congo, in western Uganda. Uganda's health ministry said late Tuesday, June 11, 2019 that a child in Uganda has tested positive for Ebola in the first cross-border case of the deadly virus since an outbreak started in neighboring Congo last year. (Ben Wise/International Rescue Committee via AP)

  • 14

    This photo taken Tuesday, June 11, 2019 and released by the International Rescue Committee (IRC), shows the Matanda Transit Center for newly arrived asylum seekers where arrivals, like all people crossing from Congo, go through foot and hand washing with a chlorine solution and have their temperature taken, in western Uganda near the border with Congo. Uganda's health ministry said late Tuesday, June 11, 2019 that a child in Uganda has tested positive for Ebola in the first cross-border case of the deadly virus since an outbreak started in neighboring Congo last year. (Ben Wise/International Rescue Committee via AP)

  • 15

    This photo released by the International Rescue Committee (IRC) shows the treatment unit where the confirmed and suspected cases of Ebola are being treated Wednesday, June 12, 2019 at Bwera hospital, Kasese District, in western Uganda near the border with Congo. A 5-year-old boy vomiting blood has become the first cross-border case of Ebola in the current deadly outbreak and now authorities are trying to determine how his family, exposed to the virus, managed to cross from Congo into neighboring Uganda. (Ben Wise/International Rescue Committee via AP)

  • 16

    This photo released by the International Rescue Committee (IRC) shows hospital staff and others being briefed on how to keep themselves safe, at Bwera hospital where the confirmed and suspected cases of Ebola are being treated Wednesday, June 12, 2019 in Kasese District, western Uganda, near the border with Congo. A 5-year-old boy vomiting blood has become the first cross-border case of Ebola in the current deadly outbreak and now authorities are trying to determine how his family, exposed to the virus, managed to cross from Congo into neighboring Uganda. (Ben Wise/International Rescue Committee via AP)

  • 17

    This photo released by the International Rescue Committee (IRC) shows hospital staff and others being briefed on how to keep themselves safe, at Bwera hospital where the confirmed and suspected cases of Ebola are being treated Wednesday, June 12, 2019 in Kasese District, western Uganda, near the border with Congo. A 5-year-old boy vomiting blood has become the first cross-border case of Ebola in the current deadly outbreak and now authorities are trying to determine how his family, exposed to the virus, managed to cross from Congo into neighboring Uganda. (Ben Wise/International Rescue Committee via AP)

  • 18

    In this photo taken Tuesday, June 11, 2019 and released by the International Rescue Committee (IRC), a sign is attached to a window of a new Ebola treatment unit currently under construction at the Kihihi Health Centre IV in Kanungu district, western Uganda, near the border with Congo. Uganda's health ministry said late Tuesday, June 11, 2019 that a child in Uganda has tested positive for Ebola in the first cross-border case of the deadly virus since an outbreak started in neighboring Congo last year. (Ben Wise/International Rescue Committee via AP)

  • 19

    FILE - This Tuesday, April, 16, 2019 file photo taken in Congo shows an Ebola health worker at a treatment center in Beni, Eastern Congo. Uganda's health ministry said late Tuesday, June 11, 2019 that a 5-year-old Congolese boy who crossed into Uganda has tested positive for Ebola in what is the first cross-border case of the deadly virus since an outbreak started in neighboring Congo last year. (AP Photo/Al-hadji Kudra Maliro, File)

  • People crossing the border have their temperature taken to check for symptoms of Ebola, at the border crossing near Kasindi, eastern Congo Wednesday, June 12, 2019, just across from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 1

    This photo released by the International Rescue Committee (IRC) shows the treatment unit where the confirmed and suspected cases of Ebola are being treated Wednesday, June 12, 2019 at Bwera hospital, Kasese District, in western Uganda near the border with Congo. A 5-year-old boy vomiting blood has become the first cross-border case of Ebola in the current deadly outbreak and now authorities are trying to determine how his family, exposed to the virus, managed to cross from Congo into neighboring Uganda. (Ben Wise/International Rescue Committee via AP)

  • 2

    A woman carrying belongings on her head wades across the shallow Lubiriha River, an area that is popular with those who want to cross into Uganda without passing through the official border crossing, in Kasindi, eastern Congo Wednesday, June 12, 2019, just across the border from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 3

    Police operate a checkpoint at the border crossing near Kasindi, eastern Congo Wednesday, June 12, 2019, just across from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 4

    People walk along the street on the Ugandan side of the border crossing near Kasindi, eastern Congo Wednesday, June 12, 2019, just across from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 5

    This photo taken Monday, June 10, 2019 and released by the International Rescue Committee (IRC), shows an Ebola screening checkpoint where people crossing from Congo go through foot and hand washing with a chlorine solution and have their temperature taken, at the Bunagana border crossing with Congo, in western Uganda. Uganda's health ministry said late Tuesday, June 11, 2019 that a child in Uganda has tested positive for Ebola in the first cross-border case of the deadly virus since an outbreak started in neighboring Congo last year. (Ben Wise/International Rescue Committee via AP)

  • 6

    People crossing the border have their temperature taken to check for symptoms of Ebola, at the border crossing near Kasindi, eastern Congo Wednesday, June 12, 2019, just across from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 7

    This photo taken Thursday, May 9, 2019 and released by the World Health Organization (WHO), shows an Ebola screening checkpoint for people crossing from Congo at the Mpondwe border crossing, between the towns of Kasindi in Congo and Bwera in Uganda. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, June 12, 2019 while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (Matthew Taylor/World Health Organization via AP)

  • 8

    Local residents wash clothes in the shallow Lubiriha River, an area that is popular with those who want to cross into Uganda without passing through the official border crossing, in Kasindi, eastern Congo Wednesday, June 12, 2019, just across the border from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 9

    Local residents wash clothes and wade in the shallow Lubiriha River, an area that is popular with those who want to cross into Uganda without passing through the official border crossing, in Kasindi, eastern Congo Wednesday, June 12, 2019, just across the border from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 10

    Local residents wash clothes and wade in the shallow Lubiriha River, an area that is popular with those who want to cross into Uganda without passing through the official border crossing, in Kasindi, eastern Congo Wednesday, June 12, 2019, just across the border from the Ugandan town of Bwera. In Uganda, a 5-year-old boy vomiting blood became the first cross-border victim of Ebola in the current outbreak on Wednesday, while two more people in Uganda tested positive for the highly contagious disease that has killed nearly 1,400 in Congo. (AP Photo/Al-hadji Kudra Maliro)

  • 11

    This photo taken Thursday, April 18, 2019 and released by the International Rescue Committee (IRC), shows the shores of Lake Albert near the border with Congo, at Kabakanga in Kagadi district, western Uganda. Uganda's health ministry said late Tuesday, June 11, 2019 that a child in Uganda has tested positive for Ebola in the first cross-border case of the deadly virus since an outbreak started in neighboring Congo last year. (Ben Wise/International Rescue Committee via AP)

  • 12

    This photo taken Thursday, April 18, 2019 and released by the International Rescue Committee (IRC), shows an Ebola-prevention information sign at the Ndaiga Health Centre II, near the shores of Lake Albert and the border with Congo, in Kagadi district, western Uganda. Uganda's health ministry said late Tuesday, June 11, 2019 that a child in Uganda has tested positive for Ebola in the first cross-border case of the deadly virus since an outbreak started in neighboring Congo last year. (Ben Wise/International Rescue Committee via AP)

  • 13

    This photo taken Monday, June 10, 2019 and released by the International Rescue Committee (IRC), shows an Ebola screening checkpoint where people crossing from Congo go through foot and hand washing with a chlorine solution and have their temperature taken, at the Bunagana border crossing with Congo, in western Uganda. Uganda's health ministry said late Tuesday, June 11, 2019 that a child in Uganda has tested positive for Ebola in the first cross-border case of the deadly virus since an outbreak started in neighboring Congo last year. (Ben Wise/International Rescue Committee via AP)

  • 14

    This photo taken Tuesday, June 11, 2019 and released by the International Rescue Committee (IRC), shows the Matanda Transit Center for newly arrived asylum seekers where arrivals, like all people crossing from Congo, go through foot and hand washing with a chlorine solution and have their temperature taken, in western Uganda near the border with Congo. Uganda's health ministry said late Tuesday, June 11, 2019 that a child in Uganda has tested positive for Ebola in the first cross-border case of the deadly virus since an outbreak started in neighboring Congo last year. (Ben Wise/International Rescue Committee via AP)

  • 15

    This photo released by the International Rescue Committee (IRC) shows the treatment unit where the confirmed and suspected cases of Ebola are being treated Wednesday, June 12, 2019 at Bwera hospital, Kasese District, in western Uganda near the border with Congo. A 5-year-old boy vomiting blood has become the first cross-border case of Ebola in the current deadly outbreak and now authorities are trying to determine how his family, exposed to the virus, managed to cross from Congo into neighboring Uganda. (Ben Wise/International Rescue Committee via AP)

  • 16

    This photo released by the International Rescue Committee (IRC) shows hospital staff and others being briefed on how to keep themselves safe, at Bwera hospital where the confirmed and suspected cases of Ebola are being treated Wednesday, June 12, 2019 in Kasese District, western Uganda, near the border with Congo. A 5-year-old boy vomiting blood has become the first cross-border case of Ebola in the current deadly outbreak and now authorities are trying to determine how his family, exposed to the virus, managed to cross from Congo into neighboring Uganda. (Ben Wise/International Rescue Committee via AP)

  • 17

    This photo released by the International Rescue Committee (IRC) shows hospital staff and others being briefed on how to keep themselves safe, at Bwera hospital where the confirmed and suspected cases of Ebola are being treated Wednesday, June 12, 2019 in Kasese District, western Uganda, near the border with Congo. A 5-year-old boy vomiting blood has become the first cross-border case of Ebola in the current deadly outbreak and now authorities are trying to determine how his family, exposed to the virus, managed to cross from Congo into neighboring Uganda. (Ben Wise/International Rescue Committee via AP)

  • 18

    In this photo taken Tuesday, June 11, 2019 and released by the International Rescue Committee (IRC), a sign is attached to a window of a new Ebola treatment unit currently under construction at the Kihihi Health Centre IV in Kanungu district, western Uganda, near the border with Congo. Uganda's health ministry said late Tuesday, June 11, 2019 that a child in Uganda has tested positive for Ebola in the first cross-border case of the deadly virus since an outbreak started in neighboring Congo last year. (Ben Wise/International Rescue Committee via AP)

  • 19

    FILE - This Tuesday, April, 16, 2019 file photo taken in Congo shows an Ebola health worker at a treatment center in Beni, Eastern Congo. Uganda's health ministry said late Tuesday, June 11, 2019 that a 5-year-old Congolese boy who crossed into Uganda has tested positive for Ebola in what is the first cross-border case of the deadly virus since an outbreak started in neighboring Congo last year. (AP Photo/Al-hadji Kudra Maliro, File)

KASINDI, Congo (AP) A 5-year-old boy vomiting blood became the first cross-border victim in the current Ebola outbreak on Wednesday, while his 3-year-old brother and grandmother tested positive for the disease that has killed nearly 1,400 people in Congo.

The outbreak's spread into Uganda prompted the World Health Organization to revisit whether the second-largest Ebola epidemic in history should be declared a global health emergency. A WHO expert committee meets on Friday. Such declarations almost always boost attention and donor funding.

The boy's mother had taken him and his brother from Uganda into Congo, where her father was ill. WHO said he died of Ebola, and officials believe those who mourned him became infected, too.

The family then crossed back into Uganda via an unguarded foot path, bypassing official border crossings where health workers have been screening millions of travelers since the outbreak was declared in August.

Authorities in both countries now vow to step up border security.

Experts have long feared Ebola could spread to neighboring countries because of rebel attacks and community resistance hampering containment work in eastern Congo, one of the world's most turbulent regions. The virus can spread quickly via close contact with bodily fluids of those infected and can be fatal in up to 90% of cases.

The 5-year-old boy's mother and grandmother, along with several other children, were stopped at a border post before crossing into Uganda. A dozen of them already showed symptoms of Ebola.

Congo's health ministry said those 12 were put in an isolation center, but in fact they were told to remain where they were staying until transport was found to an Ebola treatment unit, Dr. Dominique Kabongo, a local coordinator of response teams, told The Associated Press.

Instead, six family members quietly crossed into Uganda.

"Many people are evading (border) customs and using small footpaths and it is difficult for us to follow the contacts," Kabongo said.

On arrival in Uganda, where authorities had been alerted by Congolese colleagues, the boy received treatment while relatives were isolated and tested. The boy's uncle is among seven suspected cases now identified in Uganda.

On the Congo side, five family members who did not cross into Uganda have tested positive for Ebola, the health ministry said.

Health teams in Uganda "are not panicking," Henry Mwebesa, the national director of health services, told the AP. He cited the East African nation's experience battling previous outbreaks of Ebola and other hemorrhagic fevers.

This outbreak "is not going to go beyond" the boy's family in Uganda, he added.

While officials vowed to close unauthorized crossings, an AP reporter in the border area where the family crossed saw surveillance teams patrolling the Ugandan side. Some footpaths, however, remained unguarded. Some people wade across the shallow Lubiriha River.

The "stubbornness of Congolese" is a challenge in screening, a Ugandan Red Cross official, Francis Tumwine, told the AP at one border crossing last week. "They have failed to understand that Ebola is there, they think that it is witchcraft which is killing them."

A Congolese trader, Muhindo Kaongezekela, added: "We are not sure if there's Ebola in Congo. In Congo, if they find you with a headache, they take you to the hospital and later say they died of Ebola."

This is the first time this restive part of vast Congo, veteran of several Ebola outbreaks, has experienced the virus.

Resistance by residents wary of authorities has hurt containment efforts in an outbreak where an experimental but effective Ebola vaccine is being widely used for the first time. More than 130,000 people have received the vaccine.

Uganda is more stable than eastern Congo, and it has vaccinated nearly 4,700 health workers. WHO is shipping another 3,500 doses this week for health workers and contacts of those infected.

The WHO expert committee has twice decided that this outbreak, while of "deep concern," is not yet a global health emergency . But international spread is one of the major criteria the United Nations agency considers before making a declaration. WHO has advised against travel restrictions.

The first cross-border case is "tragic but unfortunately not surprising," said Dr. Jeremy Farrar with the Wellcome Trust, which funds Ebola vaccine research.

While Uganda is well-prepared, he added, "we can expect and should plan for more cases in (Congo) and neighboring countries. This epidemic is in a truly frightening phase and shows no sign of stopping anytime soon."

___

Muhumuza reported from Kampala, Uganda. Associated Press writers Maria Cheng in London; Saleh Mwanamilongo in Kinshasa, Congo; Krista Larson in Dakar, Senegal and video journalist Tina Smole in Mpondwe, Uganda contributed.

___

Follow Africa news at https://twitter.com/AP_Africa

                  

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