CURRENT SITUATION CASES Total: 21 clinical cases as at 13 September Confirmed: 19 (Lagos 15, Port Harcourt 4) Probable: 1 Suspected: 1 Deaths: 8 (7 confirmed) (Source: WHO published 17 September) The background story of Ebolas importation into Nigeria is below the Updates. UPDATES 18 September Among the efforts to contain Ebola, social mobilization efforts such as education campaigns are being conducted door to door and in public places. 17 September The Ministry of Health has reported that there have been no new Ebola cases in the country for a week. The total number of confirmed cases remains 19 with 7 deaths. There are 4 contacts still under surveillance in Lagos and 344 in Rivers State. Over 520 contacts have been discharged from surveillance in Lagos and Rivers State. 12 September The Ministry of Health reported that the suspected Ebola case in Ile-Ife and the South African woman screened in Lagos both tested negative for the disease. Neither have Ebola. WHOs situation Report #3 advises that the 21 cases (19 confirmed, 1 probable and 1 suspected) are linked to the initial case that arrived in Lagos from Liberia on 20 July. In Lagos, there are 29 contacts still being monitored. More than 300 other people who had been under monitoring remained symptom-free for 21 days and are thus considered not infected. In Port Harcourt, only 5 contacts have completed their 21-day monitoring period. Over 400 remain under surveillance there. A healthcare worker in Port Harcourt is currently being investigated for possible Ebola. 11 September A South African national is being investigated for suspected Ebola disease. The woman had been working in Guinea and Sierra Leone and was travelling home to South Africa. En route, she filled out an arrival health questionnaire at the airport in Lagos and indicated she had some Ebola-like symptoms. Test results are awaited. 9 September There are unverified media reports of a suspected case in Ile-Ife, Osun state. The person is said to have travelled from Port Harcourt and later presented to a local clinic in Ile-Ife with a fever. 8 September The Ministry of Health has reported 19 confirmed cases, 15 in Lagos and 4 in Port Harcourt. The nineteenth case is the fiance of someone who had contact with the index case. The fiance had a mild illness and has already recovered. More than 500 contacts are under surveillance, 27 in Lagos and 477 in Port Harcourt. 5 September There are unconfirmed media reports that some medical facilities designated for military use may have closed their doors to non-military personnel in reposnse to the Ebola outbreak. The World Health Organization update indicates that over 400 contacts are being followed up in both Lagos and Port Harcourt. 4 September Health officials in Lagos have warned the public not to rely on some Ebola testing kits available in the market. It has been found that some fake testing kits are being sold that claim to show very quick results (in about 10 minutes). Officials also clarified that as of now, Ebola testing kits are not being manufactured. Reliable testing can be done only at officially designated diagnostic centres. 22 August The Ministry of Health has confirmed two new cases of Ebola in secondary contacts of the index case. This means Ebola spread from the countrys very first case to another person, and then that infected person spread the virus to a third person. This is the first such instance in Nigeria. Previously, all Ebola cases there had been in contact with a 40-year-old traveller who brought the virus into Nigeria in late July. He flew into the country from Liberia, while he was infected and symptomatic. Then some of his contacts got sick. Now, two people married to those contacts have also gotten sick. These newly-reported secondary cases had been under surveillance for some time. BACKGROUND Nigerias first case was an imported one. All subsequent cases have been linked to this man. In July, a 40-year-old man who had Ebola symptoms flew internationally from Monrovia, Liberia to Lagos, Nigeria while sick. He arrived in Nigeria 20 July. He vomited frequently during the flight and on arrival. The mans sister had died of Ebola in Liberia, and he had unprotected contact with her body fluids before he fell ill and travelled to Nigeria. The man was hospitalized promptly on arrival in Nigeria at the First Consultant Hospital, Obalende, but died 25 July. Some healthcare staff had close, unprotected contact with the patient prior to realising he may have Ebola - including contact with his body fluids. These people subsequently fell ill and are now amongst the countrys secondary cases. Some died. He spread the virus to medical staff who treated him, a fellow hospital patient, and a protocol officer with whom he had very close contact. No one on his flight was infected. A doctors strike that had been underway for more than a month was temporarily suspended in early August so that medical personnel can help with the Ebola outbreak. A State of Emergency was declared, discouraging large gatherings and asking schools to extend summer holidays. As the outbreak continued, the doctors strike was cancelled (instead of suspended) and school closures were extended through mid-October By mid-August, several cases had been reported in Lagos. These included healthcare workers who cared for the countrys index case and an ECOWAS (Economic Community of West African States) official who had contact with that case. A nurse who cared for the index case fled quarantine in Lagos to travel to Enugu, but no community spread took hold in Enugu. A case appeared in Port Harcourt in late August, spread by a man who had contact with the sick traveller in Lagos (the 40-year-old index case). The contact, who is and ECOWAS Commission staff member, then fell sick himself and travelled to Port Harcourt while ill. (This was in violation of a quarantine. He was not supposed to travel since hed had contact with a known Ebola patient.) A doctor was called to his hotel room to treat him 1-3 August. The patient lived, but the doctor was infected. The doctor developed symptoms/became infectious on 11 August but continued to work as a doctor (seeing patients, performing surgery) until 13 August. He died of the disease on 22 August. This doctor is considered Port Harcourts first case. In a situation update on Port Harcourt in early September, the World Health Organization warned the outbreak of Ebola virus disease in Port Harcourt has the potential to grow larger and spread faster than the one in Lagos. The doctor who died on 22 August had many contacts with friends and relatives while infectious, and even during hospitalisation, where WHO says he was attended by the majority of the hospital’s health care staff. His wife and his sister were both infected. A woman who was in the hospital where he had been admitted for treatment was also infected. Over 200 contacts were placed under surveillance, of whom about 60 had high or very high risk exposure.
Posted on: Thu, 18 Sep 2014 23:15:04 +0000
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