Building off existing infrastructure to respond immediately to Ebola infection allowed Nigerian officials to fight the spread of the disease.
Faisal Shuaib, incident manager of the Ebola Emergency Operations Center in Nigeria, skyped an audience of about 60 global health-minded faculty members, staff and students Thursday.
Nigeria is the most populous nation in Africa, with 170 million people. A Liberian brought Ebola to Nigeria when he flew in from Monrovia, Liberia on July 20. Nigerian officials immediately declared a public health emergency and tracked down everyone who had come in to contact with the initial patient.
From Lagos, one of the infected individuals travelled to Rivers State -- the hub of the Nigerian oil industry.
“One of the contacts who got ill travelled to Rivers State and infected two people,” Shuaib said. “Although all possible contacts of this index case were listed, one of them evaded follow-up for days…. There was a lot of apprehension around the potential economic impact of having a full blown outbreak in this city.”
The Federal Ministry of Health collaborated with local agencies to establish the Ebola Emergency Operations Center (EEOC), Shuaib said. The coordinated all outbreak-response activities, ranging from tracking down potential Ebola cases and raising awareness about the spread of the disease.
The government streamlined the emergency response by dividing personnel and resources into four major areas of work: case management, epidemiology and surveillance, port of entry and social mobilization.
“Using an incident management approach, the EEOC harnessed resources to contain the spread of the virus in the major cities,” he said. “Due to the continued outbreak in the sub-region, Nigeria maintains a high level of vigilance to forestall importation.”
Currently, Nigeria’s response to controlling the Ebola outbreak is largely considered a success. They have tracked down and isolated more than 800 suspected cases of Ebola in the country, Shuaib said. Overall there were 19 confirmed cases, resulting in 12 discharges and 7 deaths. Shuaib added that rapid action was necessary, and any delays in responding would have been dangerous.
Shuaib said Nigeria must still be proactive against the disease. He said the country will continue to strengthen the capacity of national- and state-level teams, maintain a core team at the EEOC, maintain focus on key response interventions such as airport screenings and strengthen preparedness in other high risk states.
He added that fear and panic can slow crisis response. Because Nigerian healthcare workers had experience with outbreaks of Lassa fever—a disease caused by a virus similar to Ebola—they were not as afraid interacting with Ebola patients, he said.
Additionally, because of Nigeria’s involvement with the Global Polio Eradication Initiative, medical response infrastructure was already largely in place and easily shifted to controlling the spread of Ebola.
Despite Nigeria’s success, Shuaib noted that they learned several lessons regarding outbreak response. They made the mistake of developing outbreak plans without follow-up to ensure supplies are pre-positioned, human resources are trained and simulation exercises are done. Response workers also assumed contacts would comply with guidelines to practice social distancing once they had been listed and counseled, which was not always the case.
Shuaib’s presentation was part of a week-long series on the West-African Ebola outbreak, sponsored by the Africa Initiative, Duke University Center for International Studies, Duke Global Health Institute and Program in the Arts of the Moving Image.