Government steps up surveillance as Ebola spreads to Nigeria

Surveillance systems have been strengthened at all entry points into the country and hospitals following reports that Ebola had been detected in the Nigerian capital Lagos last week.
World Health Organisation officials prepare to enter Kagadi Hospital in Kibaale District, Uganda, where an outbreak of the Ebola virus started in July 2012. Net photo.
World Health Organisation officials prepare to enter Kagadi Hospital in Kibaale District, Uganda, where an outbreak of the Ebola virus started in July 2012. Net photo.

Surveillance systems have been strengthened at all entry points into the country and hospitals following reports that Ebola had been detected in the Nigerian capital Lagos last week.

The virus has so far claimed at least 670 people in West African countries mainly Guinea Bissau, Sierra Leone and Liberia.

Rwandans have reason to worry because the national carrier, RwandAir, operates direct flights to Lagos.

Speaking to The New Times yesterday, Nathan Mugume, the head of the communication division at Rwanda Biomedical Centre, said they are working closely with Rwanda Civil Aviation Authority on precautionary measures.

“We have developed fact sheets on the disease. They spell out all about the disease, the best reaction if a case is detected, and much more. We have a very good surveillance system used to monitor epidemics,” Mugume said.

Incubation concerns

He, however, said that despite measures put in place, the incubation period of the Ebola virus is an issue of concern, because it incubates within a period of two to 21 days, meaning it can slip into the country undetected.

The incubation period is the time between exposure to an infectious agent and when symptoms and signs are first apparent.

“It is important to understand that the virus’ detection period can go up to 21 days, implying that if somebody was infected and left Nigeria today, they wouldn’t be detected until after 21 days,” he said.

Tony Barigye, the spokesperson for the RCAA, said they have kept an eye on the Ebola outbreak since the first case was reported in Guinea in February.

Barigye said the RCAA, in partnership with Ministry of Health, has for the last two months emphasised communication and public awareness.

Information kits have been designed including pull-up banners and over 2,000 flyers have been distributed at the Kigali International Airport.

“We have also reviewed the infrastructure in place (airport clinic) and proposed recommendations on how to adapt the facility in case of an outbreak,” Barigye said. 

The recommendations include having the airport clinic open 24/7 and an ambulance on standby for 24 hours.

Besides Lagos, RwandAir flies to several cities in West and Central Africa, including Libreville (Gabon), Accra (Ghana), Douala (Cameroon), and Congo Brazzaville.

John Mirenge, the CEO of RwandAir, said the airline is working closely with the Ministry of Health and national civil aviation authorities and the countries where they fly to ensure the epidemic does  not spread to Rwanda.

Ebola was first reported in Guinea, in February, before spreading to Liberia and Sierra Leone.

“We have trained staff and have put all our crew on alert. And in the airports where we operate, we are getting very vigilant and collaborating with other stakeholders there,” Mirenge said.

No case of Ebola has ever been reported in Rwanda.

Some 32 health personnel trained in Ebola preparedness and response and there is an operational rapid response team comprising clinicians, laboratory specialists, and epidemiologists, among others.  

Risk of transmission

The World Health Organisation says person-to-person transmission by means of direct contact with infected persons or their body fluids or secretions is considered the principle mode of transmission.

“There is no risk of transmission during the incubation period and only low risk of transmission in the early phase of symptomatic patients. The risk of infection during transport of persons can be further reduced through use of infection control precautions,” reads part of a WHO risk assessment.

During a household study, the UN agency says, secondary transmission took place only where direct physical contact was involved. It is said that no transmission was reported without direct contact and “airborne transmission has not been documented during previous Ebola Virus Disease outbreaks.”

Meanwhile, reports indicate that Liberia closed most of its border crossings and introduced stringent health measures on Sunday, a day after a 33-year-old American doctor working there for the relief organisation Samaritan’s Purse tested positive for Ebola.

Nigeria’s airports, seaports and land borders have been on “red alert” since Friday over the disease.

The WHO said that in the past week, its regional director for Africa, Luis Sambo, had been on a fact-finding mission to Guinea, Liberia and Sierra Leone, which have 1,201 confirmed, suspected and probable cases among them, according to Reuters.

“He observed that the outbreak is beyond each national health sector alone and urged the governments of the affected countries to mobilise and involve all sectors, including civil society and communities, in the response,” the WHO said.

ABOUT EBOLA (by mayoclinic.org)

There is presently no specific treatment for the disease, which could be transmitted in the course of feeding, holding and caring for victims. Fruits and bats are considered to be the natural host of the virus.

The Ebola virus, which can incubate for up to 21 days, has a fatality rate of up to 90 percent. The virus was first discovered in 1976 in two simultaneous outbreaks in Sudan and in the Democratic Republic of the Congo (DRC), taking its name from the Ebola River where the DRC outbreak was found in a nearby village. 

The World Health Organisation (WHO) defines the disease, formerly known as Ebola hemorrhagic fever, as “a severe, often fatal illness” and “one of the world’s most virulent diseases.”

The city of Lagos is the most populous in Nigeria with a population of about 20 million, and it is also the second fastest-growing city in Africa.

The public is advised to observe personal and environmental hygiene as part of precautionary measures to prevent the outbreak of Ebola disease.

Prevention focuses on avoiding contact with the viruses.

The following precautions can help prevent infection and spread of Ebola and Marburg:

* Avoid areas of known outbreaks. Before travelling, find out about current epidemics by checking the Centers for Disease Control and Prevention website.

* Wash your hands frequently. As with other infectious diseases, one of the most important preventive measures is frequent hand-washing.

* Avoid bush meat. Avoid buying or eating wild animals, including non-human primates, sold in local markets.

* Avoid contact with infected people. In particular, caregivers should avoid contact with the person’s body fluids and tissues, including blood, semen, vaginal secretions and saliva. People with Ebola or Marburg are most contagious in the later stages of the disease.

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