Guarding against Another Ebola Outbreak in Nigeria

With the recent outbreak of Ebola virus in the Democratic Republic of Congo, Martins Ifijeh writes on the need for the Nigerian Government to activate preventive and surveillance systems at the nation’s borders as part of efforts to guard against the deadly disease

Thirty-nine months after the world experienced the most deadly and devastating Ebola Virus Disease (EVD) outbreak in the history of mankind, it seems to be walking the familiar road again with the re-emergence of the lethal fever in the Democratic Republic of Congo, killing three people already while over 200 persons are currently under surveillance haven been in contact with infected persons.

The World Health Organisation (WHO), confirming the outbreak, says the deaths and incidence rate were so far from the Likati health zone, Bas Uele Province in the Northern part of the country. Noting that it would provide leadership expertise to attain coordinated and effective response to the outbreak, as this would prevent it from spreading the way the 2014 outbreak unfortunately spread.

The last outbreak in 2014 recorded 11,315 deaths and a total 28,675 reported cases. 4,809 deaths were said to have occurred in Liberia, 3,955 in Sierra Leone, 2,536 in Guinea, eight in Nigeria, six in Mali and one in the United States. WHO at the time admitted the death figures were underestimated, given the difficulty collecting the data.

While stakeholders believed the devastating impact of the last outbreak was high because WHO responded too slowly and failed to grasp the gravity of the outbreak, which made it unable to declare the disease a global health emergency on time. Other persons believed the refusal of most countries to raise alert levels in their health institutions and borders was one major reason for the high impact.

For instance, the index case of the outbreak in Nigeria in 2015, a Liberian diplomat, Patrick Sawyer entered Nigeria unhindered and unchecked despite carrying the virus; a single act that caused the deaths of eight persons, including Dr. Ameyo Adadevoh of First Consultant Hospital, who restrained him from leaving the hospital.

It is in this vein that medical experts in Nigeria are calling on the federal government to learn from its past mistake, thereby increasing prevention and surveillance system across all borders in the country.

According to the Nigerian Medical Association (NMA), the federal government should step up surveillance and strengthen response team across the borders and other national routes of entry into the country.

In a statement jointly signed by its President, Prof. Mike Ogirima and Secretary General, Dr. Yusuf Sununu, the NMA called for vigilance by both government and the citizens.

According to them, NMA is ready to partner with the federal Ministry of Health to achieve another resounding success on the prevention and control of the fresh outbreak. “We also wish to call on all health teams to refresh their knowledge on clinical presentation of Ebola, apply universal basic precautions in patients’ care and use the standard protocols of management and reporting of suspected cases.”

It further urged Nigerians not to panic but cooperate with government in securing the nation, especially during surveillance at entry points if the need arises. “We assure all Nigerians of the readiness of our members to do more to safe guards the health of the nation.”

While noting that the recent declaration of outbreak in DR Congo was another major setback to the world, the association said devastation brought about by the last outbreak still remains fresh in the minds of Nigerians.

“West Africa was worst affected with more than 11,000 deaths recorded in the Ebola outbreak in 2014-2015, mainly in Guinea, Sierra Leone and Liberia. Efforts by our government had been acclaimed as one of the best moment the country demonstrated. It shows that where there is political will, success is assured. The role of our fallen heroes, especially late Dr. Adadevoh in the control of the spread of the disease is not only worth remembering but reminds us on the need to make sacrifices for our country.’’

Meanwhile, the federal government has asked health official in the country to test every fever patient – showing symptoms of bleeding – for EVD. It also asked all port health officials to step up inspection of all persons coming into the country.

The Minister of Health, Prof. Isaac Adewole, who said this in a statement by the Director, Media and Public Relations, Mrs. Boade Akinola, directed all Nigerian health workers to maintain a high index of suspicion by screening all haemorrhagic fever patients for Ebola.

Similarly, the minister encouraged members of the public to observe high level of personal hygiene which includes regular hand washing, adding that they should report all cases of fever to the nearest health facility.

“I have directed health workers to increase efforts at ports of entry, and to report any sick person or suspects to ensure that Epidemiologists in the states conduct relevant tests.

“The symptoms to look out for include: fever, fatigue, weakness, dizziness and muscle aches. Patients with more severe cases show bleeding under the skin, internal organs or even from bodily orifices like mouth, nose and ears.”

The minister also urged Nigerians not to panic as the Nigerian Centre for Disease Control (NCDC) was on ground and equipped to secure the health of the citizens.

He said the NCDC had for a while been strengthening states’ capacities to detect, manage and respond to hemorrhagic fevers including Lassa fever, adding that states should begin social mobilisation and media awareness efforts via television, radio, print and social media.

In the same vein, the management of the Federal Airports Authority of Nigeria (FAAN) has assured Nigerians of adequate surveillance at the nation’s airports following the outbreak of the virus in the Democratic Republic of Congo.

The Acting General Manager, Corporate Affairs (FAAN), Henrietta Yakubu, said there was no direct flight from DR Congo to Nigeria., adding that previous preventive measures were still in place at the airport.

She said the management has informed port health officials of the need to increase surveillance. “We don’t have direct flights from DR Congo, we only have from Rwanda
but I want to assure members of the public that we still have all preventive measures in place at our airports,” she said.

“There are sanitisers at our arrivals with the scanning apparatus called thermal scanners being installed by the port health services. The scanners have camera monitors that display pictures aside the capturing of temperature.

“Passengers still fill that form to ensure that passengers arriving the country through our airports are not potential carriers of deadly diseases. The port health officials are always on alert and we will also inform them of the need to increase their surveillance. So, there is no
cause for alarm,” she said.

As part of efforts to quell the present outbreak in DR Congo, the Regional Director of WHO for Africa, Dr. Matshidiso Moeti, said in a statement on Sunday in Abuja that the organisation would work with the United Nations and other partners to halt the spread.

Moeti said WHO had assured the DRC Government of its preparedness to respond to the outbreak after the government’s alarm on it. She stated that the organisation had mobilised technical experts for deployment to Congo, adding that it would also provide leadership expertise to attain coordinated and effective response.

“On May 10, a multi-disciplinary team led by the Ministry of Health and supported by WHO under the new WHO Emergency Programme, andpartners, was deployed to Likati health zone to conduct in-depth field investigation.

“The health zone is situated in the remote, isolated and hard-to-reach Northern part of the country with limited transport and communication networks. These factors have impeded transmission of information about the suspected outbreak. Currently, it takes about two to three days to reach the epicentre from Kinshasa.

“The Global Outbreak Alert and Response Network (GOARN) has been activated to provide additional support if required. Reinforcement of epidemiological surveillance, contact tracing, case management, and community engagement are under way,” Moeti said.

She added that the full extent of the current outbreak of Ebola in DRC was yet unclear, stating that extensive investigation and risk assessmentwere still being conducted.

According to Moeti, WHO does not recommend any restriction on travel and trade to DRC based on available information, adding that the public in DRC should work with health authorities and takenecessary preventive measures to protect their health.

While Nigerian Government and the WHO are taking preventive measures to stop the outbreak from reaching our shores, personal hygiene should be imbibed by all Nigerians.