Experts say Nigeria not yet free from Ebola outbreak

Following the death of Patrick Sawyer, a US citizen of Liberian origin, who is the first person to be diagnosed with Ebola virus disease (EVD) on Nigerian soil, public health experts say it is too early to say Nigeria is free from the deadly hemorrhagic disease.

The experts say this is because it is not always possible to identify patients with EBV early, as initial symptoms may be non-specific.
While the potential risk of cross-border and international spread constitute a grave public health concern, the quarantining of 59 persons who came in contact with Sawyer on Friday last week is yet to be certained, BusinessDay investigations reveal.

When BusinessDay contacted the special assistant to the minister of health on media, Dan Nwomeh via the phone, he said he would ascertain from the minister outbreakof health and respond back. However, patients are contagious only once the disease has progressed to the point they show symptoms, according to the World Health Organisation (WHO) with the most vulnerable been health care workers and relatives who come in much closer contact with the sick.

Oyewale Tomori, regional virologist with the World Health Organisation (WHO) and president, Nigerian Academy of Science, said that Nigeria is not free from EVD until monitoring to ascertain all who came into close contact with Patrick Sawyer are free from infection.

“We must trace all passengers on the plane (ASky Airline) that brought him to Nigeria, to those in contact with him at the Lagos airport, and all those who attended to him in the hospital where he was treated. Every such person must be monitored for the duration of the incubation period of Ebola virus infection that is up to 21 days from point of contact.

“We must get in touch with them on a daily basis to find out if they fall sick, showing the signs and exhibiting the symptoms of viral hemorrhagic fever. This must be carried out thoroughly, efficiently and rapidly,” Tomori explained.

David Heymann, professor of infectious diseases at the London School of Hygiene and Tropical Medicine said “Still, detecting Ebola in departing passengers might be tricky, since its initial symptoms are similar to many other diseases, including malaria and typhoid fever.

“ It will be very difficult now to contain this outbreak because it has spread. The chance to stop it quickly was months ago before it crossed borders … But this can still be stopped if there is good hospital infection control, contact tracing and collaboration between countries.”

Adebayo Onajole, professor of community medicine and public health, College of Medicine, University of Lagos, said Nigeria needs to strengthen its disease surveillance system in a bid to monitor, control, and prevent any occurrence of the disease.

As countries place on red alert passengers travelling from parts of West Africa, including Liberia, Sierra Leone and Guinea, considered as high risk countries, across all ports of entry and health specialists deployed, Onajole called for increased community awareness on the mode of transmission of EVD, as well as inter-state collaboration on preventive measures and early detection of the deadly disease.

Experts believe that detecting Ebola virus in passengers on board ASKY Airlines that came from Liberia to Nigeria might be tricky, since symptoms of EVD such as fever, headache, weakness, joint and muscle pain, nausea etc. are similar with ailments such as malaria, and various viral hemorrhagic fevers like Lassa fever and yellow fever.