The Ebola virus entered Lagos on 20
July via an infected Liberian air traveller, who died 5 days later. At the
departure airport, he was visibly very ill, lying on the floor of the waiting
room while awaiting the flight.
He vomited during the flight, on
arrival and, yet again, in the private car that drove him to a private
hospital. The protocol officer who escorted him later died of Ebola.
At the hospital, he told staff that he
had malaria and denied any contact with an Ebola patient. As was learned later,
his sister was a confirmed case who had died from the disease in Liberia. The
traveller visited his sister while in hospital and attended her traditional
funeral and burial ceremony.
As malaria is not transmitted from
person to person, no staff at the hospital took protective precautions. Over
the coming days, 9 doctors and nurses became infected and 4 of them died.
The second outbreak
site: Port Harcourt
The virus entered the country’s oil
hub, Port Harcourt, on 1 August, when a close contact of the index case flew
there seeking care from a private physician. That doctor developed symptoms on
10 August and died of Ebola on 23 August. Laboratory tests confirmed the city’s
first case on 27 August.
An investigation undertaken by a team
of epidemiologists from the Nigerian Centre for Disease Control (NCDC), the
Nigeria Field Epidemiology and Laboratory Training Programme and the State
Ministry of Health, assisted by WHO, revealed an alarming number of high-risk
and very high-risk exposures for hundreds of people.
Again, all the ingredients for an
explosion of new cases were in place. Dr Rui Vaz, the head of WHO’s country
office in Nigeria, visited Rivers State (where Port Harcourt is located) to
assess the situation there. He informed the State’s Governor of the potentially
explosive situation and made his advice crystal clear: “All required resources
must be immediately mobilized to stop this outbreak.”
Again, that explosion never happened.
Fortunately, the State’s Governor heeded WHO’s advice.
Today, exactly 42 days (twice the
maximum incubation period for Ebola virus disease) after the country’s last
infectious contact with a confirmed or probable case occurred, the chains of
transmission have been broken.
The virus is gone – for now. The
outbreak in Nigeria has been defeated.
What accounts for
this great news?
To a large extent, the answer is
straightforward: the country’s strong leadership and effective coordination of
the response. The Nigerian response to the outbreak was greatly aided by the
rapid utilization of a national public institution (NCDC) and the prompt
establishment of an Emergency Operations Centre, supported by the Disease
Prevention and Control Cluster within the WHO country office.
Another key asset was the country’s
first-rate virology laboratory affiliated with the Lagos University Teaching
Hospital. That laboratory was staffed and equipped to quickly and reliably
diagnose a case of Ebola virus disease, which ensured that containment measures
could begin with the shortest possible delay.
In addition, high-quality contact
tracing by experienced epidemiologists expedited the early detection of cases
and their rapid movement to an isolation ward, thereby greatly diminishing
opportunities for further transmission.
How a highly
contagious virus was stopped dead in its tracks
Dr Rui Vaz and the WHO country team of
epidemiologists, clinicians, logisticians and administrators have identified a
number of specific lessons that may be useful for other countries facing their
first imported Ebola case or preparing for one. They have also carefully
documented a large number of “best practices” for containing an Ebola outbreak
quickly.
The most critical factor is leadership
and engagement from the head of state and the Minister of Health. Generous
allocation of government funds and their quick disbursement helped as well.
Partnership with the private sector was yet another asset that brought in
substantial resources to help scale up control measures that would eventually
stop the Ebola virus dead in its tracks.
Health and government officials fully
appreciated the importance of communication with the general public. They
rallied communities to support containment measures.
House-to-house information campaigns
and messages on local radio stations, in local dialects, were used to explain
the level of risk, effective personal preventive measures and the actions being
taken for control. On his part, the President reassured the country’s vast and
diversified population through appearances on nationally televised newscasts.
The full range of media opportunities
was exploited – from social media to televised facts about the disease
delivered by well-known “Nollywood” movie stars.
Source: http://www.who.int
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