Beyond containment of active Ebola cases
While the United Nations General Assembly, were meeting in New York to among other things discuss on ways to arrest the spread of the deadly Ebola Virus Disease (EVD) ravaging three West African countries – Guinea, Liberia and Sierra Leone, Nigeria’s minister of health, Onyebuchi Chukwu, revealed that Nigeria is completely free of active Ebola cases. According to the minister, presently, there are no cases under treatment, no suspected cases, and no contact is still under surveillance in Lagos, while only 25 of the 400 contacts under medical surveillance in Port Harcourt remained.
On the contrary, Faisal Shuaib, head of the Emergency Operation Centre for Ebola in Lagos, and an article in Agence France-Presse (AFP), elucidated that Nigeria is not necessarily “Ebola-free”, by epidemiological definition. The outbreak in Nigeria can be declared officially over only if there are no more cases after 42 days, or two incubation periods from the last confirmed case. According to the AFP Nigeria has not reported any new cases since September 8, hence, the country could only be declared Ebola-free on October 20.
Nonetheless, worthy of commendation is the fact that Nigeria was able to successfully contain the virus within the shortest possible time, even though eight deaths were recorded amongst the 21 Ebola cases that the country suffered. But, the paramount issue now should be where do we go from here given our lack of maintenance culture and tendencies towards reacting to events instead of being proactive?
It was obvious that because Nigeria has never seen a single case of Ebola virus before, our medical professionals, scientists and the ministry of health were just not prepared for it; even when the first Ebola outbreaks were identified in 1976 simultaneously in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo (DRC). Until this year,all previous Ebola outbreaks have occurred in Central Africa and the DRC has had seven outbreaks since 1976, when the first known Ebola outbreak occurred there (then Zaire.
Some Nigerian Scientists have expressed fears that Nigeria may soon be hit by the deadly Ebola virus again because of the porous nature of our borders which is a huge risk factor for the diseases that has killed scores in neighbouring countries.
In the developed countries Public health officials are relatively unconcerned about Ebola becoming a big problem in the developed world, because the outbreaks persist in countries with poor sanitation and a shortage of resources to contain them. For this reason, continued spread in Africa is really what public health officials are worried about. Experts opine that the prime concern is that this is going to go into adjacent areas through people travelling in the region. And in the short term, the main vector is the traveller
Although it has been reported that all countries in West Africa are already on alert, and that the national authorities in Ghana, Côte d’Ivoire, Nigeria, and Togo are working with the WHO on prevention efforts and monitoring potential cases; we cannot afford to be passive again.
We are aware that there is no laboratory in Nigeria that can effectively diagnose the Ebola virus because there is none that has the requisite infrastructure to culture and manipulate the deadly virus. The most advanced laboratories in Nigeria that can handle similar cases have a maximum Level 3 Bio safety level as against Level 4, which is the basic for Ebola Virus culturing and manipulation.
Therefore, there is a need to continue the campaign for personal hygiene; while the preventive checks must continue especially at our borders. In addition, the country should establish or equip existing laboratories in Nigeria with the requisite infrastructure to diagnose the Ebola virus; and our doctors can benefit from the expertise of doctors in Uganda and the DRC who have successfully treated Ebola patients.