(task) Nigeria Free Of New Ebola Cases, Final Surveillance Contacts Released

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PHARMA & HEALTHCARE 9/23/2014 @ 8:19AM 46,649 views
Nigeria Free Of New Ebola Cases, Final Surveillance Contacts Released
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Update, 25 September: A point of clarification that Nigeria is not necessarily “Ebola-free”, by epidemiological definition, this even after President Goodluck Jonathan told the UN General Assembly yesterday that Nigeria is Ebola-free.

In an Agence France-Presse article, Faisal Shuaib, head of the Emergency Operation Centre for Ebola in Lagos, said via email that, “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.”

AFP then added, “Nigeria has not reported any new cases since September 8, the WHO said. If there are no further cases, Nigeria could be declared Ebola-free on October 20.”

The title of this post has been updated from, “Nigeria Free Of Ebola, Final Surveillance Contacts Released,” to, “Nigeria Free Of New Ebola Cases, Final Surveillance Contacts Released.”

The original article posted on 23 September begins here:

As the WHO Ebola Response Team published dire predictions of the West African outbreak in the New England Journal of Medicine, overnight – including an updated 70.8% fatality rate – the Health Minister of Nigeria reports that his country is completely free of active Ebola cases and have today released the final victim contacts from surveillance.

In a telephone interview last night where he was preparing for a United Nations General Assembly meeting in New York, Minister of Health Onyebuchi Chukwu, MD, said, “Presently, there is no single case of Ebola virus disease in Nigeria – none.”

Dr. Chukwu provided further details, saying, “No cases are under treatment, no suspected cases. There are no contacts in Lagos that are still under surveillance, having completed a minimum of 21 days of observation.”

In the process of tracing contacts of individuals infected with Ebola, anyone showing no symptoms after three weeks of last known contact with a victim is considered free of any potential for the disease.

Rivers State, whose capital city is Port Harcourt, had been home to over 400 contacts under medical surveillance. As of last night, only 25 contacts remained.

“None of them are showing any symptoms. Tonight [Mon 22 Sept] will mark the end of their 21 days of observation and the plan is to get them discharged from surveillance tomorrow [Tues 23 Sept].”

“Nigeria will be as clean as any other country as far as Ebola virus disease is concerned.”

Achievement in perspective

PBS TV reporter Fred de Sam Lazaro wrote yesterday from Port Harcourt, “The story of Ebola in Nigeria is an unusual and frankly rare one about things going right somewhere in Africa.”

“Nigeria’s achievement truly hits home for a television crew working “in the trenches” of a country the U.S. Central Intelligence Agency describes as “hobbled by … insecurity and pervasive corruption,” added Lazaro, who can be found on Twitter @newshourfred.

His team’s outstanding 8-minute report aired last night on PBS Newshour.

Prof. C. O. Onyebuchi Chukwu, Honourable Minister of Health, Federal Republic of Nigeria. Credit: Dan Nwomeh, Federal Ministry of Health.

Indeed, the disease has now been contained in Lagos, a city of 21 million people, and Port Harcourt, population 1.4 million.

Nigeria is the most populous country on the African continent, with 177 million people, yet only suffered 21 Ebola cases and eight deaths. In contrast, Liberia has just 4.3 million people yet has experienced 2,710 reported cases, with 1,459 deaths (as of 18 September).

Ebola virus was brought to Nigeria when naturalized American and Liberian Ministry of Finance official, Patrick Sawyer, traveled to Lagos for a meeting of the Economic Commission of West African States (ECOWAS) in Calabar on July 23.

Sawyer had symptoms of the disease before leaving Liberia and became very ill on the flight, infecting others from ECOWAS who greeted him and at the hospital where he was treated and died two days later.

A contact under quarantine in Lagos for some reason took flight to Port Harcourt, about a seven-hour drive. There, he was treated in secret by Dr. Ikechukwu Enemuo. Both Dr. Enemuo later died.

[Update, 24 Sept: A Twitter follower and another reader have contacted me to stay that the diplomat treated by Dr. Enemuo, Olu-Ibukun Koye, survived and has returned to work at ECOWAS. We are attempting to confirm this independently.]

Enemuo infected others, including his wife and sister. Both were successfully treated and recovered. But authorities had to track 477 contacts in the Port Harcourt area.

The need for cautious communication

Dr. Chukwu told me, and has said publicly elsewhere, that one challenge in Nigeria has been preventing stigmatization of anyone under surveillance as well as Ebola survivors.

“Three terms became part of our lexicon: surveillance, quarantine, and isolation.” But these need to be clearly explained, said Dr. Chukwu.

“Surveillance is sort of like house arrest. You don’t criminalize them. The person is actually a victim, not a criminal. We monitor their movements, the rest of the family are counseled about what contact can and can’t be done. We have contact with them everyday. You can imagine what this effort must’ve been like when we had 300 in Lagos and over 400 in Port Harcourt.”

Only when those under surveillance show symptoms – a fever, whether it ends up being Ebola, yellow fever, or malaria – they are put under quarantine.

“That is the first time we are denying that individual the comfort of his own bed. We put him in separately from the isolation ward from those who are confirmed. If malaria, we discharge them to their doctor to be treated for malaria.”

Credit to WHO-assigned physicians

The Ebola survivors in Nigeria were not treated with any experimental drugs. Contract tracing and early identification of cases were managed by isolating the patients and replacing fluids and electrolytes. In some cases, blood transfusions were necessary.

Dr. Chukwu had high praise for WHO Director General, Margaret Chan, for sending physicians to Nigeria. “We only knew about Ebola virus through our medical books. We’ve never seen a single case of Ebola virus until this year. So we needed someone with practical experience who had seen the virus to come and train our doctors what to do and the rest, and then we took over.”

“It is important that we let the world know that WHO did well in sending us doctors with practical experience, said Dr. Chukwu. “But we also worked with the CDC, UNICEF, and MSF in managing the disease.”

Controlling the outbreak in Guinea, Liberia, and Sierra Leone

Dr. Chukwu said that a major challenge is that the three countries are contiguous and in need of independent, coordinated oversight. The case in Nigeria was different because once President Goodluck Jonathan declared a health emergency, he had the authority and resources to direct the entire national effort.

In an attempt to centralize the West African response, the current chairman of ECOWAS is the president of Ghana and convening a meeting of West African health ministers together with the director of the Nigerian Center for Disease Control.

In the rest of Africa, Dr. Chukwu suggested that Guinea, Liberia, Sierra Leone (as well as Senegal) could benefit from the expertise of doctors in Uganda and the DRC who have successfully treated Ebola patients. The rest of the world can certainly provide the aid that is starting to grow: emergency mobile hospitals, supplies such as IV fluids and personal protective equipment.

But people in these countries are also voicing a loss of confidence in their own governments as their economies fail and food and clean water are in short supply.

And, particularly with the killing of aid workers in Guinea last week, the international effort must bolster security to encourage volunteers that they can work safely in what are already extremely demanding conditions.

For more health and pharmaceutical news and commentary, follow me on Twitter @DavidKroll, here at Forbes.com, or by clicking “Follow” on my Facebook.

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Shannon McKee 2 days ago
I wouldn’t bet on that just yet.

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Oviejack Iboje 2 days ago
I SWEAR WITH ANY MANS BELIEF AND GOD THAT IF NOT CORRUPTION WHICH BE-DEVILED NIGERIA? NIGERIA CAN HANDLE THE WORLD AND TAKE CARE OF ANY PREDICAMENT THAT DEVILS ANY NATION WITHOUT FEAR OR RANCOUR.WE ARE GREAT BLACK PEOPLE WHO KNOWS HOW TO CURTAIL AND DEAL WITH ANY SITUATION SPIRITUALLY AND PHYSICALLY. NIGERIA IS A BLESSED NATION WITH STRONG IDEAL MEN AND WOMEN, TRUST ME. FORGET ABOUT THE MEDIA AND STORIES.NO NATION IS BETTER THAN NIGERIA IN TERMS OF CORRUPTION.WATCH AMERICANS AND BRITONS CAREFULLY AND SEE WHAT AM SAYING.

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kunle soyinka 2 days ago
This is definitely some cheering news. I must commend the minster of health and all those that worked assiduously to curb the spread of Ebola in Nigeria. For once government valued the sanctity of human life. I say well done. replicate such effort in other spheres of human life

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Mekaino Mech 2 days ago
Nigerian Government really did a nice Job in the case of Ebola stuffs. If they should respond and attend to other national issues this way, Personally, I don’t think there will be a problem in the country. I urge the Government as a matter of urgency to let the world know that Nigeria is Ebola free.

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Uchenna Iwuchukwu 2 days ago
Glory be to God..

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TheJess 1 day ago
He is lying!!!!
Nigeria is not safe, nor free of ebola.
Their economy is hurting; therefore, he lies!!!!

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Jay Dillon 1 day ago
Nigeria should not be declared “Ebola free” until the required 42 day cooldown period has passed. This will not be completed until October 20, 2014. Why is it that the responsible officials are not aware of the full 42 day requirement?

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David Kroll, Contributor 22 hours ago
Thank you, Jay. I’ve learned that you are indeed correct, even after President Goodluck Jonathan told the UN General Assembly this morning that Nigeria is Ebola-free. In a Agence France-Presse article, Faisal Shuaib, head of the Emergency Operation Centre for Ebola in Lagos, said via email that, “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.”

AFP then added, “Nigeria has not reported any new cases since September 8, the WHO said. If there are no further cases, Nigeria could be declared Ebola-free on October 20.”

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Terence Nsai Kiwoh 1 day ago
Congratulations to the authoirities of the Federal Republic of Nigeria. This shows that africa can efficeiently manage complex health issues.

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