The confirmation Thursday, by Health Minister, Onyebuchi Chukwu that the number of confirmed Ebola cases in Nigeria has risen to 11, should alarm the federal government and officials of various health agencies in the country. The figure, which includes three deaths and eight people who are being treated at a special isolation unit in Lagos, shows the situation can only get worse before it gets better. For a country like Nigeria, which can’t claim to have done well in healthcare delivery, this is not cheery news, given the grave impact of the debilitating virus on the socio-economic wellbeing of the people. In the absence of a potent vaccine, Ebola poses real danger to public health.
Within weeks, the hemorrhagic Ebola fever, which has killed over 1,000 people in Guinea, Liberia and Sierra Leone triggered a national emergency response in Nigeria, which became the fourth West African country affected after a Liberian government employee Patrick Sawyer, brought Ebola to Lagos on July 20. Sawyer died in hospital on July 25. Now posing a serious threat to the entire West Africa sub-region, it is quite appropriate that the Nigerian government has been quick to alert citizens to the danger of a disease that could wipe out people if not arrested on time.
Ebola’s high fatality rate is due to internal hemorrhage. The symptoms are similar to those of common flu or malaria. Generally, between two and 21 days after infection, a patient feels weak with headaches, muscle aches and chills. Next is high fever, coupled with diarrhea and nausea. The infected person then dies of severe internal bleeding of the gastrointestinal tract, spleen and lungs and the virus is spread through exchange of blood and other bodily fluids. It is therefore advisable that people immediately report any feverish conditions. Adding Ebola to the even more native diseases like yellow fever and cholera could compound the public health situation in Nigeria. It is important to stress that Ebola infection is a vector-born disease carried by bats. Having contact or eating bush meat could predispose one to Ebola. Besides, keeping the immediate surroundings clean and regular washing of hands are essential. Fruits and vegetables should also be thoroughly washed before consumption. So, personal hygiene is very important.
The frightening morbidity rate of Ebola is a maximum incubation of 21 days, so anyone who does not become symptomatic within three weeks of exposure is believed to be safe. This has probably informed the misplaced euphoria by Nigerian officials who have already gone to town celebrating their “success” in containing the virus. Information Minister, Labaran Maku, told reporters after the weekly Federal Executive Council (FEC) meeting, presided over by President Goodluck Jonathan, that the disease had not reached the proportion of an epidemic, noting that so far only 10 persons had been tested positive, including the late Sawyer. He said two citizens, one of them being the nurse who handled the Sawyer and the second one was the protocol officer, who welcomed him at the airport and helped in conveying him to hospital. He said: “apart from those who made contacts with the late Sawyer, and the secondary contacts with those who handled his case, there has not been any known case in Nigeria that has the probability of contracting this virus. Nigeria has responded with the best international standards that can be imagined.”
This development is a positive one for health officials, as a spread of the outbreak beyond Lagos would put significant strain on Nigeria’s weak healthcare system. Granted that Nigeria has not recorded a case outside Lagos but there were fears that the nurse who treated Sawyer and contracted the virus travelled to Enugu, where she began showing symptoms before being transported back to Lagos for treatment. About 198 cases of Ebola infections have been established in the country. Of these, 177 are said to be in Lagos, while the remaining 21 who had contact with the nurse in Enugu are being monitored. The number of people under surveillance for possible infection in Lagos was reduced from 177 to 169, while 15 of those being monitored in Enugu had been cleared, with only six still being watched.
Maku explained that “there is a strong team in Lagos which has been set up by the emergency response centre that is tracing every contact that has been made with either the index case or with primary contacts. So far the number of people that have been traced is 198. Out of this number, 177 are in Lagos and they are being traced, some are in quarantine, some are being monitored by health specialists, with their movements being monitored. This is because one of the nurses that was involved in the treatment of the index case unfortunately disobeyed medical instructions and somehow travelled to Enugu. We have no problems as all those who had been in contact with her, including her husband are also under quarantine and so the medical team had been able to trace all those who made contacts with her.”
The Information Minister occupies a strategic office, whereby he should know better. It is incumbent on Maku to reassure the public. Such over-confident rhetoric is not what Nigerians expect at this time. To begin with, the relative ease with which the nurse “disobeyed medical instructions” and travelled to Enugu, where she contaminated others is worrisome and does not inspire confidence; amid the claims of due diligence flaunted by Maku. It is clear that Maku’s statement has raised more questions than answers. Let it not be that he is raising false hopes and giving Nigerians a false sense of security against the deadly virus.
The outbreak of Ebola disease in West Africa has confounded the international community, for until now, the disease had always been confined to Central Africa, Sudan, Congo and Uganda. The disease was named after River Ebola in the Democratic Republic of Congo, where it was first discovered in 1976. Since then, there have been 15 Ebola epidemics in Africa killing over 3,000 people, according to the World Health Organization (WHO); which raised the concern that the West Africa Ebola strain is the most challenging variant the world has ever seen. That Nigerian authorities have raised alarm over the outbreak of the deadly disease has therefore helped to sensitize members of the public to take precautionary measures.
The latest Ebola outbreak is a challenge to Nigerian officials to be proactive and avoid being caught unawares. Basic social amenities that make for good hygiene in an improved environmental condition should be given priority even as people are nudged in the direction of high personal hygiene. With a decrepit healthcare infrastructure, poorly motivated healthcare personnel, very low doctor to patient ratio, among others, the situation can’t be any worse for an Ebola outbreak. Pessimists see the task of containing Ebola as a mission impossible. They dismiss the hand-sanitization campaign launched by the President in response to Ebola as akin to taking a knife to a gun fight! No doubt, there has been commendable effort at containing Ebola to Lagos and Enugu; but the fight against the deadly virus requires much more than hand sanitizing; the fear of Ebola should inform the wisdom of preparation.
