An outbreak of Ebola Virus Disease (EVD) was confirmed by the government of Democratic Republic of Congo (DRC) on May 8, 2018. As at May 21, there had been 27 deaths, 28 confirmed cases, nine suspected cases and 21 probable cases.
This outbreak has come with real and perceived threats to local, national and global health security, with countries placed on different levels of alert by the World Health Organisation (WHO).
It is worth noting that the DRC has had more Ebola virus outbreaks than any other country in the world. Over the past 10 years, there have been five cases: 2007, from 2008 to 2009, 2012, 2014 and 2017.
The Ebola virus was first identified in the country in 1976 and got its name from the Ebola River, which is situated near the village where it was discovered.
Scientists believe it was initially present in wild animals living in tropical rainforests in equatorial Africa. Fruit bats have also been identified as one of the main hosts as they can transmit the disease while remaining unaffected by it.
The disease spread to humans when they come into contact with blood or other body fluids from infected animals, usually through hunting.
Nigeria Ebola experience
Millions of Nigerians were thrown into panic in 2014, when the first case of EVD was confirmed in Lagos. The virus was, reportedly, imported into Nigeria by a Liberian diplomat, Mr. Patrick Sawyer, who arrived via Murtala Mohammed Airport Lagos on July 20, 2014.
The diplomat had cared for a sibling with EVD in Liberia, who eventually died from the disease. On that same day, the Federal Ministry of Health in collaboration with the Nigeria Centre for Disease Control (NCDC), declared an Ebola emergency in Nigeria.
Sawyer, who died at First Consultants Hospital, Obalende, Lagos, five days later, set off a chain of transmission that infected a total of 19 people, of whom seven died including Dr. Ameyo Stella Adadevoh, who diagnosed the index case.
The EVD cases were not limited to only Lagos state, as Rivers state recorded two confirmed cases of EVD with one dying.
Three months after, the Ebola outbreak in Nigeria was effectively controlled using the incident management approach with massive support provided by the private sector and international community, and Nigeria was on October 20, 2014, declared free of the Ebola virus, by the World Health Organisation (WHO).
Preparedness for another outbreak
Even though in Nigeria, the risk of spread has been classified as moderate by WHO, similar to all countries in Africa, the question being asked is ‘how prepared we for another outbreak of Ebola?’
After the 2014 Ebola outbreak in West Africa, a key lesson was that the preparedness and response capacity of countries requires significant investments to strengthen their health systems
In his reaction to the fresh outbreak of Ebola in the DR Congo, Adewole said the country is prepared to contain any outbreak, stressing that screening and surveillance are ongoing at all entry ports in the country.
Adewole also disclosed that there were designated health facilities close to entry ports in Lagos and Abuja.
Also, the Chief Executive Officer of the NCDC, Dr. Chikwe Ihekweazu, stated that the federal government has strengthened the capacity of the Nigeria Centre to Disease Control (NCDC), to prevent a possible outbreak of the Ebola Viral Disease in the country.
Ihekweazu, who noted that vaccines had been made available to the DR Congo to contain the disease within the affected areas, said passenger screenings for Ebola at the airports, with special focus on flights inbound from East and Central Africa, have been stepped up.
“We have had working groups here that have really worked all the time on increasing our preparedness on Ebola in terms of both prevention and response should an outbreak happen.
“What we have done in the last two weeks is to reactivate those groups. They know what to do, they are beginning to plan and retrain. We know that it is not possible sometimes to completely prevent cases, because one can be incubating the virus even though he or she is not ill yet and come into the country.
“So, what we are doing is to increase our screening at ports of entry, increase education for people coming into the country, focusing specifically on flights coming in from the other parts of Africa especially east and central Africa.
“This is the role NCDC now plays, creating a better health security infrastructure for Nigeria than what we had in 2014. With this, Nigeria is much safer and prepared than it has ever been,” he explained.
The NCDC boss further hinted on the establishment of an Incident Coordination Centre (ICC), late last year to ensure coordination during outbreaks.
According to him, “on the day the DRC confirmed an EVD outbreak, our ICC was immediately activated and placed on alert mode. Although there are no Ebola Virus Disease cases in Nigeria, a coordination group has been set up to mitigate the risk.
“This group of experts have developed and disseminated a public health advisory note to the general public reminding them of what to do to prevent an outbreak and what to do in the event of an outbreak.”
The recommendations in the advisory note includes regular hand washing with soap and water, use of hand sanitizers when soap and water is not readily available, avoiding direct handling of dead wild animals and physical contact with anyone who has possible symptoms of an infection with an unknown diagnosis.
Health workers are also urged to ensure “universal care precautions at all times.”
The Federal Airport Authority of Nigeria (FAAN), has also assured of its preparedness to detect and prevent the entry of EVD at airports nationwide, having mobilised relevant agencies to step up surveillance.
FAAN, which manages all the 22 Federal Government-owned airports across the country, said the agencies, including the Port Health Services, are collaborating effectively to ensure the safety of passengers and airport-users at all time.
The General Manager, Corporate Affairs of FAAN, Henrietta Yakubu, noted that since the first recorded case of the virus in Nigeria, the Authority has not relaxed its surveillance at the airports to forestall any re-occurrence.
“All the equipment and personnel used in combatting the virus in 2014 are still very much at the airports and now complemented and reinforced.
“We have always had thermal scanners in our airports that monitor temperature of passengers and capture their pictures. We still have hand sanitisers in our restrooms too.
“When passengers walk past the scanners, it registers their temperature. If yours is high, you are pulled aside for observation,” Yakubu stated.
Expectation is that given the panic within the polity as well as casualty suffered the ministry of health and government at all levels are equipped
for any contingency.
