By Sola Ogundipe, Olasunkanmi Akoni, Chioma Obinna, Monsur Olowoopejo & Gabriel Olawale
LAGOS—THERE were fears, yesterday, that six of the eight primary contacts of the late Patrick Sawyer, may have tested positive to the Ebola virus, but are yet to show signs of the disease.
Meanwhile, the Lagos State Government has said that the seven remaining primary contacts currently in quarantine are showing no signs of the Ebola Virus Disease, EVD.
A source, who confirmed this to Vanguard, said the six feared to have tested positive are among those who had serious contact with the late Liberian Ebola victim.
According to the source who pleaded anonymity, the situation is becoming a big challenge even now that the Nigerian Medical Association, NMA, is on strike.
The source advised the Federal Government to take the matter more seriously and deploy all available resources to curtail further spread of the virus, adding, however, that efforts are being made to create more centres for possible isolation of the latest victims.
Already, unconfirmed reports have it that the Lagos State Government was considering setting up an Ebola Centre at the Lagos State University Teaching Hospital, following the facility’s capability to cater for such situation.
“As I am speaking to you this morning, (yesterday) six of the eight contacts that were quarantined have tested positive to Ebola virus, but are not showing signs or symptoms yet. But they are still being monitored. Right now, they cannot be treated because Nigeria has no specific viral drug, and we cannot use the American viral drug.
“There are efforts now to ensure that the country comes up with possible viral drug within the next month to treat infected Nigerians. For now, we are only boosting their immune systems by giving them healthy foods. There is problem on ground and we should be doing what is needed to put an end to it.”
Govt tracking families of infected doctor
At a press conference in Lagos, a medical team comprising officials of federal and state governments in collaboration with World Health Organisation, WHO, said they have commenced tracking of families of the Nigerian doctor, who tested positive to EVD, and seven others under surveillance and monitoring.
Lagos State Commissioner for Health, Dr. Jide Idris, said the infected doctor, who attended to late Patrick Sawyer at a private hospital in Lagos, was the only confirmed case of EVD to date out of the eight primary contacts under clinical surveillance and care. “She is currently being administered on intensive medication,” he noted.
“Her being infected is largely due to the fact that she was a primary contact when the index case presented itself. At this point, the disease was not known to have been imported into the country, ” he said.
Giving an update, Idris disclosed that experts have confirmed that not all persons infected by the disease may die as there are chances that victims detected early may live, depending on how they are managed. He said that the fatality rate is between 40 – 90 per cent.
Idris, along with the Commissioner for Information and Strategy, Mr. Lateef Ibirogba and his Special Duties counterpart, Dr. Wale Ahmed, also debunked rumours about the mode of spread of Ebola, saying transmission is only through secretions from an infected person and contact.
He stressed that the essence of the briefing was to harp on the mode of transmission of EVD for education of the general public, stressing that the disease is transmissible through direct contact with broken skin, mucous membranes and secretions of an infected person or through direct contact with materials and surfaces that have been contaminated by an infected person.
Idris warned the public to be very careful in the treatment of sick people by alerting the necessary authorities of any severe cases of illness.
“Out of 70 contacts from the airline to the hospital, we found out that 14 had serious direct contact with victims; eight of them developed symptoms. Initially, we were following them through telephone conversations, we are checking their temperatures periodically.
“That is why we need people to carry out these activities. We need to train a lot of people. If people refuse, then who is going to do it? We need to trace these people and what they do. Once anyone of these people develops symptoms, he or she is taken back to the place because it is possible they have reached the period of infectivity.
“Having done that, we have to go back to secondary contacts, which are the immediate family members. Right now, we are following them up one after the other. We cannot carry all the families into quarantine. We are developing links with all the secondary contacts for follow up.
“On hazard allowance, this happened in Guinea when it first started. There were issues of cultural practices and, at a point, their medical workers abandoned the patients and it was people from outside that helped.
“This is a serious disease; we are seriously considering proper hazard allowance for all the people who will volunteer to work with us. We are working with the Federal Government on how best to work it out and design proper incentives. We are doing it fast, this is a health emergency.
“This is a call for vigilance as human-to-human transmission is only achieved by physical contact with a person who is acutely and gravely ill from Ebola virus through body fluids such as blood, urine, stool, saliva, breast milk and semen. Burial ceremonies where mourners, including family members have direct contact with patients who died of Ebola, have also played a role in the spread of the disease”, Idris said.
Idris noted that in Africa, infection has also occurred through the handling of infected chimpanzees, monkeys, guerillas, fruit bats, antelopes and porcupine, adding that there has been no case of transmission by domestic animals like pigs.
He called for precautionary measures such as hand washing, adoption of appropriate waste management and enhanced personal and environmental hygiene as relevant, especially when large congregations are expected with a mix of people from other parts of the world.
He said the committee set up by the Federal and Lagos State governments was taking necessary precautionary measures to stop the spread of the disease.
For effectiveness in handling the emergency, the commissioner said the committee had been divided into five units including contact and surveillance tracing, case management, point of entry unit, publicity and data management unit.
The contact tracing unit, he stated, is saddled with the responsibility of tracing contacts of infected person; case management unit has the role of managing established cases while the point of entry manned by Customs and Immigration personnel is charged with the examination of persons entering Nigeria from the various borders.
FG contacts US for experimental drug
As part of moves to mitigate the situation, the Federal Fovernment has reached out to the Centre for Disease Control, in the United States of America, for access to the experimental drug being administered on the two American missionaries infected with Ebola Virus disease.
Minister of Health, Prof Onyebuchi Chukwu, who disclosed this, said government was in consultation with the US health body over the possibility of Nigeria getting access to the trial drug, for administration on victims of Ebola in the country.
American doctors, Kent Brantly and Nancy Writebol, who worked with the aid organisation Samaritan’s Purse, and contracted Ebola from another healthcare worker at their hospital in Liberia, have been flown to the Emory Hospital in Atlanta for treatment with the experimental drug. The experimental drug, known as “ZMapp”, was developed by a San Diego-based biotech firm, Mapp Biopharmaceutical Inc. The treatment had never been tried before in a human being but had shown promise in small experiments with monkeys.
Chukwu who expressed optimism about the consultation, noted: “We are in touch with the Americans. Yesterday, I spoke on telephone with the Director of the US Centre for Disease Control and Prevention, Dr Tom Freiden. We spoke at length, and we have exchanged emails. Yesterday, I inaugurated the Treatment Research Group and one of its Terms of Reference is to collaborate with similar working groups across the world. Now that they have started work, they will get in touch with the Americans and understand what they are doing and whether we have access to similar opportunity.”
Further, he said members of the Committee had opportunity of looking at their own options and developing something on potential cure for Ebola.
Nigerian doctors can develop cure
“Nobody says that new, fresh ideas cannot come out of Nigeria. We should not underestimate the intelligence of Nigerians. I do not underestimate the intelligence of our professionals, I believe something positive is going to come out.”
Chukwu, however, noted that the committee was set up specifically for Ebola. It is a standing committee. Its time frame is indefinite and as long as Ebola is an issue, it will work on it. As long as Ebola is relevant they have work to do. If, it develops a treatment, or Ebola goes we will give the members other responsibilities.”
In a related development, the Lagos branch of the Nigerian Medical Association, NMA, has said the ongoing nationwide strike of the Association would not stop doctors in Lagos from volunteering to participate in the treatment of possible Ebola Virus Disease, EVD, patients.
This is coming on the heels of the appeal by the Lagos State Commissioner for Health, Dr Jide Idris on the need for striking doctors and other health workers like; nurses, environmental health workers and phlebotomists to complement the state health workforce.
At a press conference in Lagos to enlighten the general public on mode of infection, symptoms and preventive measures for Ebola, the Lagos State chapter chairman of the NMA, Dr. Tope Ojo, confirmed that already doctors in the state have volunteered to join the team of experts managing patients at the Infectious Diseases Hospital, Yaba, Lagos.
Ojo said already, some of its members had volunteered to join seven of the sub-committees on Ebola.
“Strike or no strike, we must respond to emergencies. Our doctors are at Mainland Hospital, Yaba, where isolated contacts are being monitored. There are seven committees working on the management of the disease at the centre in Lagos and our members are part of of the various committees.
“When there is disaster outbreak, you find out that there will be response by NMA. The issue of strike will not affect our involvement. The NMA is a responsible body and I can assure you that in as much as we don’t pray for natural disasters, NMA will definitely respond. We worked all through the night trying to find out who should be here or there today. It is not a question of if the hospital is on today we work more than what we have been doing,” he added.
“But the committee where we are having challenges getting volunteers is case management. This is the people that work directly with confirmed and suspected cases.
“Look at the protective measures that doctors in Liberia and Guinea wear. They are well protected, yet some of them still caught it. Our doctors are worried about the danger it poses to their lives and they need to be reassured. We understand their fears and we are making moves to confirm the level of preparedness of the government for doctors.”
He further stated that even with the ongoing strike, nothing was lacking in terms of the intervention of doctors. “As I am talking to you, more doctors are volunteering to participate in all the committees that are working on the preventive spread of Ebola.”
He, however, lamented that the NMA strike was a fallout of inability of government to accede to the reasonable demands of the doctors, adding that several negotiations since the beginning of the strike, more than one month ago, have consistently broken down based on government’s inability to accede to the demands.
Hospital matron shows symptoms
Ojo further disclosed that the infected doctor, who is presently on admission at the Mainland Hospital, Yaba, is responding to treatment. “We know that the infected doctor is stable, however, the matron is now showing symptoms. But everybody including the experts from the World Health Organisation are doing all they can.”
He announced that Lagos NMA has set up another committee comprising doctors to work out modalities on informing the public on preventive measures on Ebola and other endemic diseases.
He also announced that the doctors will be carrying out advocacy visits to the markets and public places to also enlighten people on the dreaded disease.
Also speaking, the Secretary of the NMA Lagos, Dr. Babajide Saheed, said the doctors were working closely with the WHO and other stakeholders to contain the risk of the infection to others.
Saheed said: “Not all doctors can attend to an Ebola patient. In fact, you must limit the number of health workers treating affected persons just to contain the risk. “We will be escalating the situation if doctors rush to Mainland Hospital just to attend to patients.”
World Bank Group mobilizes $200m to fight Ebola
Meanwhile, with the latest death toll from the West Africa Ebola epidemic now at 887, the World Bank Group has pledged the sum of US $200 million as emergency funding to help Guinea, Liberia, and Sierra Leone contain the spread of Ebola infections, help their communities cope with the economic impact of the crisis, and improve public health systems throughout West Africa.
Announcing the package in Abuja, World Bank Group President, Dr. Jim Yong Kim, said the new financing commitment was in response to a call from both the three African countries hardest-hit by Ebola and the World Health Organization, WHO for immediate assistance to contain the outbreak.