…Agency reveals how travel history raised suspicion, says 44 identified contacts are mostly hospital workers
The Nigeria Centre for Disease Control and Prevention (NCDC) has revealed how a woman who arrived in Nigeria from Uganda was treated for malaria-like symptoms at a private hospital in Abuja for several days before medical personnel suspected Ebola virus disease.
The agency disclosed that the woman arrived in Nigeria on October 5, developed symptoms on October 7 and presented at the private health facility in the Federal Capital Territory on October 11.
However, it was not until the patient failed to respond to treatment and doctors obtained further details about her recent travel history that concerns about a possible Ebola infection emerged.
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The Incident Manager of the National Ebola Disease Response, Dr Odianosen Ehiakhamen, disclosed these details during an interview on Arise Television on Tuesday.
His account provided fresh insight into the circumstances surrounding Nigeria’s first confirmed imported Ebola case and the contact-tracing operation involving 44 people.
“The patient arrived in the country on the 5th of October and experienced the first set of symptoms on the 7th, and then presented at that facility on the 11th,” Ehiakhamen said.
He explained that the woman initially presented with symptoms resembling malaria, prompting the attending medical team to commence treatment for the illness.
According to him, the patient’s failure to improve led the doctors to investigate her medical and travel history more closely.
The discovery that she had recently travelled from Uganda subsequently raised suspicion about a possible Ebola infection.
“The honourable minister has just highlighted, presented on the 11th to a private health facility and was managed for malaria-like symptoms,” he said.
Ehiakhamen explained that the hospital eventually contacted the NCDC’s event-based surveillance system, prompting an immediate response involving national and FCT public health officials.
“Just until yesterday, 4pm, they reached out to our event-based system and called, and that was how we were able to link up with our colleagues from the FCT, and then immediately moved to the centre to ensure that the sample was collected,” he stated.
The NCDC official said the response team promptly visited the hospital, obtained a case investigation form and gathered relevant information from the attending physician.
He disclosed that collecting the patient’s blood sample proved challenging and required a specialised medical procedure before the specimen could be transported for laboratory analysis.
“By 9pm, the sample was already on its way to the lab. In fact, we had difficulties in collecting samples; you required colleagues to carry out a venous cutdown to be able to even get samples that were sent to the lab,” he said.
According to him, preliminary laboratory findings subsequently indicated Ebola infection, but the response team requested repeat testing before communicating the results to the NCDC Director-General and the Minister of Health and Social Welfare.
The Federal Government had earlier confirmed the case and announced that the patient had been isolated and was receiving medical care.
The Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, also disclosed that 44 contacts had been identified for monitoring as part of efforts to prevent further transmission.
Providing clarification on the contacts, Ehiakhamen said most were healthcare workers and support personnel at the private hospital where the patient had received treatment.
“For the 44 contacts, they are majorly healthcare workers and support staff of the hospital, because everything has happened within the hospital,” he explained.
The clarification suggests that the immediate contact-tracing exercise is concentrated largely on people who may have encountered the patient during her hospitalisation.
However, being identified as a contact does not mean that an individual has contracted Ebola.
Ehiakhamen said Nigeria had begun preparing for a possible Ebola outbreak months before the confirmation of the imported case.
According to him, the NCDC activated an Incident Management System preparedness structure on May 15 and subsequently conducted a risk assessment to evaluate the country’s readiness.
The assessment examined surveillance systems, available personnel, response capacity, infection prevention and control arrangements, medical countermeasures and training requirements.
He disclosed that approximately eight high-risk zones were assessed as part of the preparedness exercise.
“Of course, I talked about a risk assessment that we had conducted in May. It tended towards moderate risk, but to have a heightened preparedness, we had to go for a high risk. And, of course, that initiated an alert for us,” he stated.
The incident manager said the agency had also developed and distributed case definitions to health facilities to improve the early identification and reporting of suspected infections.
He explained that Nigeria was drawing on the experience of personnel involved in containing the 2014 Ebola outbreak, alongside health professionals trained through the National Field Epidemiology Training Programme and World Health Organisation-supported workshops.
“Because Nigeria had experienced this same situation in 2014, it was important for us to identify colleagues who responded and were still in the country because they are actually going to be our focal persons,” he said.
“We have the National Field Epidemiology Training Programme, that we have a rich workforce. The WHO also has been able to conduct surge training workshops. And so, we have a huge workforce to be able to respond around the country.”
Ehiakhamen added that the agency had investigated several suspected Ebola infections in the past, with laboratory tests subsequently ruling out the disease.
He said the NCDC was also assessing the speed of its response to alerts, sample collection and laboratory testing, with the aim of improving turnaround times across its diagnostic network.
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The agency hopes to strengthen these capabilities using existing polymerase chain reaction (PCR) laboratories that already support responses to Lassa fever, diphtheria and other infectious diseases.
The latest disclosures highlight the importance of obtaining detailed travel histories from patients presenting with fever and other symptoms that may resemble common illnesses.
Ebola can initially present with fever, headache, weakness and muscle pain before progressing to more severe symptoms, including vomiting and diarrhoea.
Health authorities have urged healthcare professionals to maintain heightened vigilance and immediately report suspected infections, particularly where patients have recently travelled from affected areas.
The NCDC continues to coordinate surveillance and contact tracing in Abuja, while the confirmed patient remains under medical care.
