Health experts have called for sustained contact tracing and surveillance to prevent further transmission of the Bundibugyo strain of Ebola in Nigeria, despite the evacuation of the country’s index patient.

Already, the Nigeria Centre for Disease Control and Prevention (NCDC) is monitoring 54 primary contacts linked to the case, including healthcare workers, domestic staff and others who may have been exposed during medical care, sample collection or related interactions.

Deputy Director and Head of Health Emergency Preparedness at the NCDC, Dr Abiodun Ogunniyi, told The Guardian that evacuating the index patient did not automatically end the outbreak or eliminate the possibility of further transmission. He said investigations were continuing to identify everyone who might have been exposed, including an e-hailing driver identified during follow-up inquiries.

According to him, all relevant contacts must be monitored for 21 days after their last possible exposure, with anyone developing compatible symptoms promptly assessed.

Ogunniyi urged identified contacts to cooperate with public health teams and provide accurate information about their movements and possible exposure.

He called for heightened preparedness in Lagos and the Federal Capital Territory (FCT), citing their international connections, population movements and extensive healthcare networks. However, he stressed that all states must be capable of detecting unusual illnesses, investigating alerts and responding quickly to suspected cases.

He said effective surveillance required coordination among public and private hospitals, laboratories, community surveillance networks and port health services.

Although Nigeria had no known Ebola patient remaining in the country following the evacuation, Ogunniyi said the outbreak’s status must be determined by epidemiological evidence, not the physical presence or absence of the index patient.

The critical questions, he explained, were whether all potential contacts had been identified, whether new suspected cases emerged and whether investigations revealed secondary transmission.

Ogunniyi said Ebola was not spread simply by living in the same city, sharing public spaces or being near an infected person. Transmission generally occurs through direct contact with the blood or other body fluids of an infected person who has developed symptoms, or through contaminated materials.

He urged Nigerians to rely on verified information rather than speculation, warning that misinformation could fuel panic and stigmatise patients, their families and affected communities.

The Federal Government has indicated December 7, 2026, as a provisional date for declaring the outbreak over. Ogunniyi, however, said the date remained subject to the epidemiological situation and fulfilment of the applicable outbreak-ending criteria.

Under World Health Organisation (WHO) guidance, an Ebola outbreak is generally declared over after 42 days without a new confirmed case, calculated from the last relevant event specified in the criteria. This commonly involves the last confirmed patient’s second consecutive negative test, where required, rather than simply the date of evacuation.

He added that early symptoms of Bundibugyo virus disease, including fever, headache, muscle pain, fatigue and sore throat, could resemble malaria and typhoid fever. Diarrhoea and vomiting may develop later, making clinical assessment, laboratory testing and exposure history essential for diagnosis.

Ogunniyi urged healthcare facilities to maintain a high index of suspicion, promptly report suspected cases and implement infection prevention measures before laboratory confirmation where exposure history warrants concern.

With no approved vaccine or established specific antiviral treatment for Bundibugyo virus disease, he said early detection, isolation, expert clinical management and supportive care remained essential.

He advised Nigerians to practise regular hand hygiene, avoid contact with the blood and other body fluids of suspected patients, and refrain from caring for them without appropriate protective equipment and professional guidance.

An alert from a private health facility in the current incident led to an investigation and laboratory confirmation by the NCDC National Reference Laboratory, highlighting the importance of prompt reporting.

Ogunniyi called for stronger surveillance at international points of entry, safe specimen collection and transport, adequate laboratory capacity, and rapid-response teams, isolation facilities, ambulances, and infection-prevention supplies. Cross-border information sharing was also necessary to track potentially exposed people who might have travelled outside Nigeria.

Also speaking, an epidemiologist and Executive Director of Afrihealth for Social Development and Impact (ASDI), Dr Yahaya Disu, warned against lowering the country’s guard while exposed individuals remained under observation.

He said people who had contact with the index patient could have been infected without yet developing symptoms, making compliance with monitoring protocols critical.
Disu urged health authorities to confirm whether they had identified all contacts, ensure they complied with follow-up procedures, and arrange prompt isolation and medical assessment for anyone who developed symptoms.

He warned that failure to disclose exposure or disregard monitoring instructions could undermine containment efforts. Caregivers and healthcare workers, he added, must use appropriate personal protective equipment, observe strict hand hygiene, clean frequently touched surfaces and safely dispose of potentially contaminated waste.

Disu advised anyone who suspected exposure to contact the NCDC through its designated reporting channels or the relevant state Ministry of Health for professional assessment. Suspected cases should minimise contact with others while seeking medical assistance.

He also called on the Federal Ministry of Health and Social Welfare, the NCDC and state health authorities to intensify public enlightenment, particularly in Lagos and the FCT, using traditional media, online platforms, community networks and trusted local voices.

Traditional and religious leaders, he said, should help counter rumours, build public confidence and encourage compliance with health guidance.

Disu identified the West African Health Organisation, Africa Centres for Disease Control and Prevention and WHO Regional Office for Africa as important partners in cross-border cooperation and preparedness.

He maintained that preventing further transmission would require sustained surveillance, transparent communication and public cooperation, urging Nigerians to report possible exposure and follow official guidance without panic or complacency.