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How Nigeria dealt with Ebola virus outbreak

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Sawyer

The outbreak of Ebola Virus disease (EVD) in 2014 remains unprecedented both in the number of cases, deaths and geographic scope. The World Health Organization (WHO) on March 25, 2014, reported that Guinea’s Ministry of Health had reported an outbreak of the disease in four southeastern districts, with suspected cases in the neighbouring countries of Liberia and Sierra Leone being investigated.

The impact of the outbreak was more alarming in three continents, Africa, Europe and North America, with 10 countries that include Guinea, Liberia, Sierra Leone, Senegal, Nigeria, Mali, Spain, Italy, United Kingdom and the United States of America affected.

Over 11,300 people were reportedly killed, while over 28,000 were infected. In Guinea, a total of 86 suspected cases, including 59 deaths was reported as of March 24, 2014

In Nigeria, the first case of the deadly disease was recorded when Patrick Oliver Sawyer, a Liberian diplomat arrived the country via Murtala Mohammed International Airport Lagos on July 20, 2014.

He was said to have cared for a sibling with the virus, who eventually died from the disease on July 8, 2014 in his home country, Liberia. Upon arrival and during check by the medical personnel already stationed at the airport in response to combat the outbreak, Sawyer was identified as being unwell and admitted at the First Consultant Hospital, Obalende, Lagos, where he later died on July 24, 2014.

The Federal Ministry of Health in collaboration with the Nigeria Centre for Disease Control (NCDC), the same day, declared an Ebola emergency in Nigeria. The outbreak in the country resulted in 19 confirmed cases of the virus infection and eight deaths.

Following the laboratory confirmation of EVD in Sawyer’s blood sample, Dr. Ameyo Adadevoh placed him under isolation for quarantine despite pressures from the Liberian government to release him.

To manage the crisis, the Federal Government under President Goodluck Ebele Jonathan instituted control measures. A huge sum of money was made available to manage the outbreak. The Lagos State government spent an estimated N1 billion to contain the virus, even as the then governor of the state, Mr. Babatunde Raji Fashola co-ordinated the outbreak control activities.

A crucial first step in the Nigerian response was the vigilance of aviation and health authorities in Lagos, which identified and promptly isolated the first case in the country. As a follow up to the isolation, the federal government swiftly moved and approved a special intervention plan to contain and prevent the spread of the disease in the country. The sum of $11.5 million was released to support implementation.

To support the already very aggressive and successful response by the Lagos State Government through its emergency operation centers, the federal government also provided an additional $1.2 million.

Also, the Nigerian Center for Disease Control (NCDC) worked in close partnership with state governments, WHO, UNICEF, Médecins Sans Frontières and the US Center for Disease Control and Prevention to establish the Emergency Operations Center at the Central Public Health Laboratory in Yaba, Lagos and another in Rivers State where a case was also reported.

Partnerships and coordinated efforts led to increased awareness of the disease by the general public and markedly improved case management centers, underpinned by an aggressive and successful contact-tracing program.

State governments also acted swiftly in establishing emergency coordination offices, identifying isolation centers in readiness for potential outbreaks, sensitizing their populations, and worked with federal authorities.

Additional Ebola containment interventions put in place by the Nigerian government and its partners include banning transportation of corpses both international and interstate. Establishment of an EVD treatment and research group with the mandate to carry out extensive research into the virus; establishment of six testing centres nationwide, training of health workers in Ebola containment related courses.

Other containment measures include: Delay in the reopening of schools, subject to the status of the Ebola epidemic; ensured adequate provision of protective gear and resources to field personnel; providing support for isolated patients or suspected cases, promotion of anti-stigmatization campaign to protect Ebola-free victims, given that stigmatization may further make contacts and suspects to go underground, and when they don’t come out, they jeopardize the life of those they come in contact with, including their families

Also, the use of social media platforms, the traditional media such as Newspapers, Radio and TV stations and SMS platforms played critical role in the sensitization of the public.

The 2014 EVD outbreak in Nigeria was effectively controlled using the incident management approach with massive support provided by both the private sector and international community.

Private sector players like the Dangote Foundation also made significant contributions towards the disease eradication efforts. The emergency operation center in Lagos received about $1 million from the Dangote Foundation to augment its operational costs, as well as the salaries of staff and volunteers for six months. The foundation also provided 12 units of thermal scanning systems for the four international airports in Nigeria.

In addition, the foundation sponsored the training of 160 staff of Federal Ministry of Health and Port Health Services, and donated 3,800 sets of personal protective equipment to the NCDC.

The European Centre for Disease Prevention and Control (ECDC) on October 9, 2014, acknowledged Nigeria’s positive role in controlling the effort to contain the EVD outbreak, saying: “We wish to thank the Federal Ministry of Health, Abuja, Nigeria, and the staff of the Ebola Emergency Centre, who coordinated the management of cases, containment of outbreaks and treatment protocols in Nigeria.”

According to the organisation, Nigeria’s quick responses, including intense and rapid contact tracing, surveillance of potential contacts, and isolation of all contacts were of particular importance in controlling and limiting the outbreak. Complimenting Nigeria’s successful efforts to control the outbreak, the WHO declared the feat “a piece of world-class epidemiological detective work.” WHO’s representative in Nigeria officially declared Nigeria Ebola free on October 20 after no new active cases were reported in the follow up contacts, stating it was a spectacular success story.


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