TIME Infectious Disease

How Nigeria Is Keeping Ebola at Bay

APTOPIX Nigeria Ebola
Nigeria health officials wait to screen passengers at the arrival hall of Murtala Muhammed International Airport in Lagos, Nigeria, Aug. 4, 2014. Sunday Alamba—AP

Fears that Africa's most populous country would become a tinderbox for the disease have so far not come to fruition

Ebola is still running rampant in parts of West Africa. Over 1,500 people have died in Guinea, Sierra Leone and Liberia, where authorities have risked unrest by imposing nationwide curfew and quarantine zones.

But in nearby Nigeria, the government has largely contained Ebola in a single cluster traced back to the first imported case, and reported a total of only six deaths. The death of a doctor in Port Harcourt, in the south of the country, initially raised fears of a second outbreak when it was revealed on Thursday—but it soon emerged that his infection was also linked to the first Ebola case.

Health experts say that while more Ebola cases can’t be ruled out, Nigerian authorities quickly and effectively reacted to contain the disease, tracking people who had contact with patients, conducting widespread testing and quarantining suspected victims. “The response of the government has been robust,” said John Vertefeuille, who leads the Nigeria Ebola response team of the U.S. Centers for Disease Control and Prevention (CDC).

Ebola arrived in Nigeria on July 20, when Liberian-American financial consultant Patrick Sawyer flew from Liberia to Lagos, Nigeria’s commercial capital. Sawyer collapsed at the airport and was taken immediately to hospital, reducing chances of infecting more people in Lagos, a city of more than 21 million people.

He infected a few people before he was isolated, as doctors didn’t initially suspect Ebola and didn’t take full precautions. All other confirmed cases were traced back to him; eight have recovered, with only one case still being treated in isolation.

When the government realized Ebola had arrived on Nigerian soil, it acted quickly to coordinate international health organizations including the CDC, the World Health Organization, and recently Médecins Sans Frontières. It invited those groups to “come to the table and… insert themselves into those structures that the government has formed,” said Vertefeuille.

The work is divided into the management of confirmed cases who are treated in an isolation center in Lagos, and epidemiology and contact tracing, key to containing the virus.

Confirmed cases are treated in isolation, while those the victims made contact with pre-diagnosis are visited daily at their homes. If they develop symptoms, they too are taken to quarantine and tested. Nigeria began its program of contact tracing with Sawyer, and currently has more than 100 people under surveillance in Lagos.

But one man slipped through the net, Health Minister Onyebuchi Chukwu said Thursday. A Nigerian man who had contact with Sawyer developed symptoms and evaded surveillance, traveling to the oil industry hub of Port Harcourt last month, where he was treated by a doctor for his symptoms.

The man recovered and returned to Lagos four days later, after a manhunt for him had begun. The doctor, however, had contracted the virus and died on Aug. 22. The government has now begun contact tracing for him, and 70 people are now under surveillance there.

The man who escaped surveillance was an isolated case, Chukwu said. The fact that most people being treated at hospital have survived and were soon discharged has encouraged people under surveillance to cooperate. “Initially when we started we had one or two stubborn cases, but now they’re all cooperating,” he said.

As well as taking a rapid response approach to Ebola cases, the government has also been acting to stop the spread of misinformation about the disease. It has been issuing bulletins explaining how the disease spreads, and attempting to dispel rumors about unorthodox “cures” that have spread on the streets and on social media.

Benjamin Akinola, a 65-year-old retired army officer, said he and his wife bathed with and drank water with salt after a rumor suggested it could prevent Ebola. They stopped after hearing on the radio that it led to the death of some people. “People stopped it, and this is what the government is telling us,” said Akinola.

The government has also been pushing for better personal hygiene practice. Guards at supermarkets, banks, restaurants, and clubs will often spray people’s hands with sanitizers before entering.

The public relations operation seems to be working. Lawrence Obioha, a 43 year old newspaper seller in Lagos said initially fewer people attended his Sunday church service out of fear of Ebola. “Gradually it’s picking up,” he said. “There’s a lot of relief now that they know that at least there’s a response to treatment.”

While fears that Africa’s most populous country would become a breeding ground for the disease have so far proven unfounded, officials in Nigeria are under no illusion that the virus has been stamped out. “We have not eliminated the disease. We have not eradicated it,” said Chukwu. Over 200 remain under observation, and the infection is still raging in Sierra Leone, Guinea and Liberia. The battle against Ebola will continue in Nigeria for some time yet.

“This really could be a long and a hard fight,” said David Daigle, a spokesman for the CDC team on Ebola in Nigeria. “We’re optimistic, but we know that this is like a forest fire and if there’s just one ember left in place it could easily start back up.”

TIME Innovation

Five Best Ideas of the Day: August 28

1. New Orleans is at the heart of a new HIV epidemic, and only massive health system reform can remedy the situation.

By Jessica Wapner in Aeon

2. From dismantling Syria’s chemical arsenal to hunting down Joseph Kony, America’s military missions abroad far outlast the public’s attention span.

By Kate Brannen in Foreign Policy

3. To look beyond stereotypes and understand the programs and interventions that improve life for young men of color, the U.S. Department of Education invited them to a “Data Jam.”

By Charley Locke in EdSurge

4. Taking a page from silicon valley, incubators for restaurateurs can help get new ideas on the plate.

By Allison Aubrey at National Public Radio

5. So the homeless can work, worship, and transition to normal life, cities should offer safe, flexible storage options.

By Kriston Capps in Citylab

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Infectious Disease

Nigeria Confirms First Ebola Death Outside Lagos

Nigeria Ebola
Nigerian health officials wait to screen passengers at the arrival hall of Murtala Muhammed International Airport in Lagos, Nigeria on Aug. 4, 2014. Sunday Alamba/AP

Doctor who died in southeastern city marks Nigeria's sixth Ebola death

Nigeria confirmed Thursday the country’s first Ebola-related death outside Lagos, the country’s main international transit hub.

The victim, an unnamed doctor who died in the southeastern oil city of Port Harcourt, marks Nigeria’s sixth Ebola death in a recent outbreak of the disease primarily affecting West Africa. He is believed to have been infected by a man linked to Nigeria’s first Ebola case, Patrick Sawyer, who died in Lagos shortly after arriving there from Liberia.

The yet-unnamed doctor had died last Friday, but Nigerian Health Minister Onyebuchi Chukwu waited until Thursday to confirm the case, the BBC reports. The doctor’s wife has been put under quarantine, while an additional 70 people suspected to have had contact with him are being monitored in Port Harcourt.

While the death marks a blow to Nigeria’s efforts to contain the disease, Mr. Chukwu noted that while “the problem is not over . . . Nigeria is doing well on containment, all the disease in Nigeria were all traced to Patrick Sawyer.”

The Nigerian government said Wednesday that schools in the country would not reopen until October 13 in order to help prevent the outbreak from spreading.

Recent figures from the World Health Organization suggest Ebola has infected more than 3,000 people and killed over half of its victims, largely in West Africa. More than 240 health workers have been infected with the deadly virus, for which there is no vaccine or cure, though it is treatable and survivable. Ebola is not airborne, and is spread only when humans come into contact with the bodily fluids of those infected with the virus.

West Africa’s health ministers will be meeting later Thursday to discuss measures to address what’s become the largest-ever Ebola epidemic.

[BBC]

TIME ebola

Nigeria Confirms 2 New Ebola Cases

Nigeria Ebola
Nigerian health officials wait to screen passengers at the arrival hall of Murtala Muhammed International Airport in Lagos, Nigeria on Aug. 4, 2014. Sunday Alamba/AP

The two are the first infected people who didn’t have contact with the ill traveler

Nigeria’s health ministry confirmed Friday two new cases of Ebola in the country, the first people to come down with the disease who didn’t have direct contact with an infected traveler who brought the virus into the country from nearby Liberia.

Nigerian Health Minister Onyebuchi Chukwu said both newly infected people are the spouses of two caregivers who contracted the virus and later died after giving treatment to Patrick Sawyer, the Liberian-American man who flew into the country infected with the virus last month.

Sawyer passed Ebola on to 11 other individuals before he died. The two new infections plus Sawyer bring the total number of Ebola patients in Nigeria during this outbreak to 14, five of whom have died while another five have recovered.

[AP]

TIME Infectious Disease

Ebola Death Toll in West Africa Passes 1,000

WHO Director-General Margaret Chan sits next to Fukuda, WHO's assistant director general for health security, as he addresses the media in Geneva
World Health Organization director general Margaret Chan sits next to Keiji Fukuda, WHO's assistant director general for health security, during a press conference after an emergency committee meeting on Ebola in Geneva on August 8, 2014 Pierre Albouy—Reuters

The World Health Organization said on Monday that the death toll has climbed to 1,013 in the Ebola outbreak that has swept through Guinea, Liberia, Sierra Leone and possibly Nigeria

(DAKAR, Senegal) — The World Health Organization says the death toll in the Ebola outbreak in West Africa has passed 1,000.

The U.N. health agency said in a news release Monday that 1,013 people have died in the outbreak, which has hit Guinea, Liberia, Sierra Leone and possibly Nigeria.

Authorities have recorded 1,848 suspected, probable or confirmed cases of the disease, which causes a high fever, vomiting and bleeding. The outbreak was first identified in March in Guinea, but it likely started months earlier.

The updated WHO tally includes figures from Aug. 7- 9 when 52 more people died and 69 more were infected.

Ebola is highly lethal and there is no licensed vaccine or treatment for the disease, but so far three people infected have received an experimental drug.

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