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Published On: Tue, Jul 29th, 2014

Nigerians and the fear of noxious Ebola

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Ebola VirusNigerians, who have been contending with the deadly siege of Boko Haram menace ravaging some parts of the north, and to some extent, the south west, with attendant deaths of thousands of people are now facing a new treat of the most deadly disease in the world, Ebola. Adesoji Oyinlola, in Lagos, felt the pulse of the people after it claimed its first victim, a Liberian citizen, Patrick Sawyer.

Patrick Sawyer, who boarded a flight in Liberia, had a stopover in Ghana, changed planes in Togo, and then arrived in Nigeria, where authorities said he died days later from Ebola, one of the deadliest disease ever known to man.

Checks by Peoples Daily revealed that People are more apprehensive for the simple fact that the disease, described by medical experts as highly contagious, and spread at the speed of light, could pose more health hazards to the people. Moreover, it is believed that those who boarded same flight with Sawyer will have more cause to worry as no one knows for sure just how many people he came into contact with the day he boarded a flight in Liberia to Nigeria, transiting in Ghana and to Togo.

The man identified as Patrick Sawyer, according to Nigeria authority, arrived Lagos last Sunday from Liberia and died on Thursday night at the First Consultant Medical Centre, Obalende, Lagos, said state officials.

However, during a press briefing in Abuja last week, the Minister of Health, Onyebuchi Chukwu, said the patient died on Friday last week and not Thursday as widely reported.

“Despite the urgent specialised barrier nursing care provided for the patient in a Lagos Hospital, the patient unfortunately passed away in the early hours of July 25, 2014,” Mr. Chukwu said.

Mr Sawyer, an employee of the Liberian Ministry of Finance, came to Lagos to attend a conference.

 Mr. Chukwu said the Federal Ministry of Health was alerted on a suspected case of the disease involving a 40-year old male travelling from Monrovia, Liberia to Nigeria on Asky Airline via Lome to Lagos on Tuesday.

He said the passenger had fever and other symptoms of the disease at the airport and was quickly isolated by Port Health Division officials and transported to the hospital.

He said the patient was subjected to thorough medical and laboratory evaluation which confirmed the diagnosis of the disease. Mr. Sawyer was said to be in a stable condition earlier on Thursday, and plans were being made to return him to Liberia but his condition got worse in the evening.

The result of tests conducted on Mr. Sawyer was still being awaited when he died.

In what appears as calculated attempt to allay the fears by the people, the minister assured the public that the Ministry of Health was presently working with other ministries, agencies and international organizations to prevent the spread of the disease.

He said that all passengers that the patient came in contact with have been traced and are also being investigated medically. Lagos State health officials said the hospital where the man died has been cordoned off and about thirty people believed to have had contact with him quarantined.

Mr. Chukwu said, in line with global best practices, all ports entry in Nigeria including airports, seaports and land boarders have been placed on red alert as staff of the ministry of health are already positioned in the locations and surveillance beefed up.

The minister however reassured the public that the Ministry of Health was presently working with other ministries, agencies and international organizations to prevent the disease spread.

He also said that tertiary health institutions in Nigeria have been equipped to handle any emergency that may arise from the disease.

Also, drugs and medical consumables are pre-positioned while the health ministry is working with all the states across Nigeria to contain the situation.

However, the minister admonished Nigerians to be vigilant, ensure personal and environmental hygiene and also report any suspected case to the nearest health facility.

He also said that emergency operation centre have been established and coordinated by the Nigerian Centre for Disease Control, NCDC, advising Nigerians to call 08023210923, 08097979595 and 07067352220; or email ebolainfo@health.gov.ng for inquiries.

Checks by Peoples Daily revealed that Ebola virus disease (EVD) or Ebola hemorrhagic fever (EHF) is the human disease caused by Ebola virus. Symptoms start two days to three weeks after contracting the virus with a fever, throat and muscle pains, and headaches. There is then nausea, vomiting and diarrhea along with decreased functioning of the liver and kidneys. At this point some people begin to have problems with bleeding.

The disease is first acquired by a population when a person comes into contact with the blood or bodily fluids of an infected animal such as a monkey or fruit bat. Fruit bats are believed to carry and spread the disease without being affected by it. Once infection occurs, the disease may be spread from one person to another. Men who survive may be able to transmit the disease sexually for nearly two months. To make the diagnosis, typically other diseases with similar symptoms such as malaria, cholera and other viral hemorrhagic fever are excluded. The blood may then be tested for either antibodies to the virus, the viral RNA, or the virus itself to confirm the diagnosis.

Prevention involves decreasing the spread of the disease from infected monkeys and pigs to humans. This may be done by checking these animals for infection and killing and properly disposing of the bodies if the disease is discovered. Properly cooking meat and wearing protective clothing when handling meat may be helpful, as may wearing protective clothing and washing hands when around someone sick with the disease. Samples from people with the disease should be handled with an extra degree of caution.

There is no specific treatment for the virus with efforts to help people including giving the person either oral rehydration therapy or intravenous fluids. The disease has a high death rate: often between 50% and 90%.

Peoples Daily findings also bring to the fore that the epicenter of Ebola is Guinea, Liberia and Sierra Leone where more than 900 people have been infected so far with the deadly virus with 630 deaths. There is no drug or vaccine to treat the virus and it has up to 90 per cent fatality rate.

According to the findings, Ebola is transmitted from fruit bats and apes to humans who hunt them for food and is further spread to other humans when they come in contact with the blood or body fluid of an infected person.

Symptoms include, fever, headache, chills, diarrhea, nausea, vomiting, sore throat, backache, and joint pains. Later symptoms include bleeding from the eyes, ears and nose, bleeding from the mouth and rectum, eye swelling, swelling of the genitals and bloody rashes all over the body.

In what appears to be a proactive measure to curb the spread of the deadly disease, Lagos State government issued an alert last week advising people to observe high hygienic standard including washing of hand and thoroughly washing and cooking their meat before eating.

Addressing newsmen in Alausa on Friday, the state Commissioner for Health, Dr. Jide Idris, who was joined by his Information and Strategy counterpart, Mr. Aderemi  Ibirogba, the Special Adviser to the Governor on Public Health, Dr. Yewande Adeshina, and the Special Adviser on Information and Strategy, Mr. Raji Lateef, confirmed that Sawyer, before his death, tested positive to Ebola virus in the test conducted in the country.

According to him, “The patient we heard, died over night and ever since then we have tried as much as possible to contain it, we need to sanitise, we need to treat the body properly, we need to dispose of the body properly and those are the things we are working out right now. These are the processes we need to follow and we are following, and we are doing this in conjunction with the staff of the Federal Ministry of Health.

“There is a protocol; we are talking with the hospital involved and the staff. After dealing with the body we have to deal with the hospital, to sanitize the hospital. More importantly too, there is the need for us to do contact tracing. We are doing that with the World Health Organisation; we are going to trace all the contacts that the man came in with and the plane he came on.

“Since we have got the manifest, we are going to trace all of them. Each one of them is going to be questioned; there is protocol for questioning and the contacts are going to be followed in the next 21 days to see if any of them developed any symptoms. This is what we are in the process of doing.”

With respect to the borders, he said there are people manning the borders, seaports and airports in Lagos, saying the state government was in contact with the Federal Government officials in charge of the borders.

He said: “First and foremost, we need to dispose of the body properly; there are issues involving diplomatic relationship and we need to get consent from Liberia, which the Ministers of Health and External Affairs are dealing with right now.  But we have to preserve the body, sanitise the hospital and ensure that the virus that killed the adult does not spread.”

Idris urged Lagosians not to panic, saying that treatment centres would be set up in the state to deal with any possible spread of the disease.

 Described as a global problem, expert said International travel has made the spread of disease via airplanes almost routine. Outbreaks of measles, polio and cholera have been traced back to countries thousands of miles away, experts say.

Two American aid workers in Liberia have tested positive for the virus and are being treated there. U.S. health officials said Monday that the risk of the deadly germ spreading to the United States is remote.

The mere prospect of Ebola in Africa’s most populous nation has Nigerians on edge.

A cross section of Nigerians who spoke to Peoples Daily, said they are particularly concerned about taking the bus, which is the only affordable way to travel in Nigeria.

“It’s actually making me very nervous. If I had my own car, I would be safer.

 “The doctors are on strike, and that means they are not prepared for it. For now I’m trying to be very careful”, said a Lagos based lawyer who does not want his name in print.

Also, medical experts described the disease further, saying, it’s an unprecedented public health scenario: Since 1976, when the virus was first discovered, Ebola outbreaks were limited to remote corners of Congo and Uganda, far from urban centers, and stayed within the borders of a single country. This time, cases first emerged in Guinea, and before long hundreds of others were stricken in Liberia and Sierra Leone.

Those are some of the poorest countries in the world, with few doctors and nurses to treat sick patients let alone determine who is well enough to travel. In Sawyer’s case, it appears nothing was done to question him until he fell sick on his second flight with Asky Airlines. An airline spokesman would not comment on what precautions were being taken in the aftermath of Sawyer’s journey.

Liberian Assistant Health Minister Tolbert Nyenswah told The Associated Press last week that there had been no screening at Liberia’s Monrovia airport. That changed quickly over the weekend, when President Ellen Johnson Sirleaf said a new policy on inspecting and testing all outgoing and incoming passengers will be strictly observed. She also announced that some borders were being closed and communities with large numbers of Ebola cases would be quarantined.

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