Nigeria’s Swift Ebola Response Stops Epidemic

Nigeria’s Ebola Response Credited With Stopping the EVD Epidemic Nigeria’s swift and effective response to the Ebola outbreak has been credited with helping to contain the disease. Key factors include enforcing coordination using proven structures, seeding the Ebola EOC with personnel from the national polio EOC, and conducting contact tracing through existing health systems. Despite this, the outbreak did have economic ripple effects. These are highlighted in the results of a consumer survey complemented by semistructured interviews with business operators. Symptoms When Sawyer flew into Lagos on July 20, he brought Ebola with him. His arrival triggered the start of Nigeria’s national emergency response. The Ebola outbreak was the first time Nigeria’s new Emergency Operations Center (EOC) used a system of incident management that had been developed to respond to infectious disease emergencies. This system is credited with helping contain the outbreak early. Ebola contact tracers were trained to travel in teams, visiting houses within radii around homes of Ebola contacts. They were also given GPS devices so they could track the movements of their Ebola contacts and quickly find them if needed. It was a hard job. Two people were needed to draw blood, and even slight pressure from a needle can cause bleeding in someone with hemorrhagic fever. Diagnosis When Ebola first appeared in Lagos in 2014, it was a crisis with global implications. The international community rallied around Nigeria with support, expertise and resources. Teams from Medecins Sans Frontieres, the United States CDC and others were brought into the country to support local efforts. Nigeria’s Ebola response was a model of coordination. Its government quickly established an Emergency Operations Center (EOC), a hub that aggregated all information related to the outbreak. EOCs were critical in keeping medical staff informed and coordinated. In addition, they also helped reduce business costs such as rescheduled meetings and lost opportunities. Many interviewees cited a shift in consumption habits due to fear-based aversion behaviour and misinformation about the disease. However, the EOCs were not without their challenges. Transmission On what seemed to be a routine Monday morning in July 2014, physician Dr. Ameyo Stella Adadevoh began her ward round at First Consultants Medical Centre in Lagos, Nigeria. She spotted a patient who had just flown into the country from Liberia. Based on his symptoms and his travel history, she suspected Ebola. A few days later, his blood sample tested positive for the virus. He died on July 24. Nigeria’s leadership and aggressive response ensured that the outbreak did not explode into a full-scale epidemic. It included a national emergency operations center supported by WHO and a world-class virology laboratory at Lagos University Teaching Hospital. The team developed a staffing plan and deployed community-based surveillance. They also partnered with the media, including local small-town announcers and ‘Nollywood’ movie makers to spread public health messages. Treatment Despite calls for criminalization, forced quarantine and suspension of international air travel, Nigeria’s Ebola response teams focused on building trust through face-to-face contacts, constant media education and daily national briefings. They also enlisted small town announcers and the talents of ‘Nollywood’ movie stars to deliver messages. Dr. Adadevoh’s resistance to outside pressure to release Sawyer was the major factor that allowed her to confine the outbreak mainly to First Consultants Medical Centre. As a result, she is widely considered the person most responsible for saving the rest of Nigeria from a cataclysmic Ebola nightmare. Her efforts were met with spontaneous mourning by the media and households across the country. In contrast, her husband’s death was treated much more coldly. Two weeks after Sawyer’s death, Igonoh developed a fever. She suspected it was malaria, which is common among the people of Nigeria’s tropics. She self-treated with oral rehydration therapy and bananas. Prevention In the face of a global emergency, Nigeria stepped up to the challenge. Its vigorous and rapid public health response is credited with stopping the EVD epidemic and making Africa’s most populous country Ebola-free. On a normal day in July 2014, Dr Ameyo Stella Adadevoh, who worked at Mainland Hospital in Lagos, spotted an ill patient flying into the city from Liberia. Her clinical diagnosis of malaria was wrong, and the patient ended up being Nigeria’s first laboratory-confirmed EVD case. In the days that followed, Lagos state’s public health officials rapidly identified and monitored people who had come into contact with the patient. The swift and robust implementation of these public health measures prevented EVD from spreading across the country, as it did in the ill-prepared countries of Guinea, Sierra Leone, and Liberia. Go Home…