Nigerian health officials admit they do not have a list of all the people a Liberian Ebola victim came into contact with in the hours before he collapsed, prompting fears the outbreak could spread.
Patrick Sawyer, a consultant for Liberia’s Finance Ministry, died on Friday after arriving at Lagos airport on June 20, having vomited and suffered diarrhoea on two flights.
The 40-year-old U.S. citizen had been to the funeral of his sister, who also died from the disease.
He was put in isolation at the First Consultants Hospital in Obalende, one of the most crowded parts of the city, home to around 21 million people.
Mr Sawyer took two flights to reach Lagos, from Monrovia to Lome and then onto the Nigerian capital.
So far 59 people who came into contact with Mr Sawyer have been identified by Nigerian health officials, and are under surveillance.
But the airlines have yet to release flight manifests naming each passenger and crew member.
In the immediate aftermath of Nigeria’s first death from the disease, health chiefs shut and quarantined the hospital involved.
Lagos state heatlh commissioner Jide Idris, said the hospital would be closed for a week, and the staff would be closely monitored.
‘The private hospital was demobilised and the primary source of infection eliminated,’ he told a news conference.
So far 59 people who came into contact with Mr Sawyer have been identified by Nigerian health officials, and are under surveillance.
But the airlines have yet to release flight manifests naming each passenger and crew member.
In the immediate aftermath of Nigeria’s first death from the disease, health chiefs shut and quarantined the hospital involved.
Lagos state heatlh commissioner Jide Idris, said the hospital would be closed for a week, and the staff would be closely monitored.
‘The private hospital was demobilised and the primary source of infection eliminated,’ he told a news conference.
‘The decontamination process in all the affected areas has commenced.’
Dr Idris said there was no cause for alarm, adding: ‘So far, a total of 59 contacts have been registered, consisting 44 hospital contacts, 38 healthcare workers and six laboratory staff and 15 airport contacts comprising three Economic Communities of West African States (ECOWAS) staff driver, liaison and protocol officer, Nigerian ambassador to Monrovia, two nursing staffers and five airport passenger handlers.
‘As of the time of this report, 20 contacts had been physically screened, of which 50 per cent had type one contact and 50 per cent had type two contacts.’
But he said the precise number of contacts has not yet been ascertained, because of the airline’s refusal to hand over the list of names.
Dr Idris said there was no cause for alarm, adding: ‘So far, a total of 59 contacts have been registered, consisting 44 hospital contacts, 38 healthcare workers and six laboratory staff and 15 airport contacts comprising three Economic Communities of West African States (ECOWAS) staff driver, liaison and protocol officer, Nigerian ambassador to Monrovia, two nursing staffers and five airport passenger handlers.
‘As of the time of this report, 20 contacts had been physically screened, of which 50 per cent had type one contact and 50 per cent had type two contacts.’
But he said the precise number of contacts has not yet been ascertained, because of the airline’s refusal to hand over the list of names.
Derek Gatherer, a virologist at Britain’s University of
Lancaster, said anyone on the plane near Sawyer could be in ‘pretty
serious danger’, but that Nigeria was better placed to tackle the
outbreak than its neighbours.
‘Nigerians have deep pockets and they can do as much as any Western country could do if they have the motivation and organization to get it done,’ he said.
Nigeria’s largest air carrier Arik Air has suspended flights to Liberia and Sierra Leone because of the Ebola risk, Arik spokesman Ola Adebanji said in an email on Monday.
Dr Idris added: ‘Adhering strictly to World Health Organisation guidelines, the body of the deceased patient was decontaminated using 10 per cent sodium hypochlorite and cremated, with the permission of the government of Liberia.
‘A cremation urn has been prepared for dispatch to the family. The vehicle that conveyed the remains was also fully decontaminated.
‘We can categorically state that as of today, we have only one case of imported Ebola and one death. No Nigerian is infected but all contacts are being actively followed.
‘We call on all Nigerians to be calm and not panic and do hereby assure them that both the state and federal governments are up in arms to ensure that the virus did not escape and that no Nigeria is infected with it.’
Ebola has killed 672 people in Guinea, Liberia and Sierra Leone since it was first diagnosed in February, and more than 1,200 others have become infected.
The latest outbreak is not only the worst in history, judging by the number of deaths, it is also the first to have spread beyond remote West African jungle villages into sprawling urban centres and national capitals.
‘Nigerians have deep pockets and they can do as much as any Western country could do if they have the motivation and organization to get it done,’ he said.
Nigeria’s largest air carrier Arik Air has suspended flights to Liberia and Sierra Leone because of the Ebola risk, Arik spokesman Ola Adebanji said in an email on Monday.
Dr Idris added: ‘Adhering strictly to World Health Organisation guidelines, the body of the deceased patient was decontaminated using 10 per cent sodium hypochlorite and cremated, with the permission of the government of Liberia.
‘A cremation urn has been prepared for dispatch to the family. The vehicle that conveyed the remains was also fully decontaminated.
‘We can categorically state that as of today, we have only one case of imported Ebola and one death. No Nigerian is infected but all contacts are being actively followed.
‘We call on all Nigerians to be calm and not panic and do hereby assure them that both the state and federal governments are up in arms to ensure that the virus did not escape and that no Nigeria is infected with it.’
Ebola has killed 672 people in Guinea, Liberia and Sierra Leone since it was first diagnosed in February, and more than 1,200 others have become infected.
The latest outbreak is not only the worst in history, judging by the number of deaths, it is also the first to have spread beyond remote West African jungle villages into sprawling urban centres and national capitals.
The fatality rate of the current outbreak is around 60 per cent
although the disease can kill up to 90 per cent of those who catch it.
Highly contagious, its symptoms include vomiting, diarrhea and internal and external bleeding.
David Heymann, head of the Centre on Global Health Security at London’s Chatham House, said every person who had been on the plane to Lagos with Sawyer would need to be traced and told to monitor their temperature twice a day for 21 days.
The World Health Organisation said in a statement that Sawyer’s flight had stopped in Lomé, Togo, on its way to Lagos.
‘WHO is sending teams to both Nigeria and Togo to do follow- up work in relation to contact tracing, in particular to contacts he may have had on board the flight,’ spokesman Paul Garwood said.
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 organization Samaritan’s Purse tested positive for Ebola.
Nigeria’s airports, seaports and land borders have been on ‘red alert’ since Friday over the disease.
Exacerbating the difficulty of containing the virus, Nigerian doctors are on strike over conditions and pay.
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.
‘He observed that the outbreak is beyond each national health sector alone and urged the governments of the affected countries to mobilize and involve all sectors, including civil society and communities, in the response,’ the WHO said.
Highly contagious, its symptoms include vomiting, diarrhea and internal and external bleeding.
David Heymann, head of the Centre on Global Health Security at London’s Chatham House, said every person who had been on the plane to Lagos with Sawyer would need to be traced and told to monitor their temperature twice a day for 21 days.
The World Health Organisation said in a statement that Sawyer’s flight had stopped in Lomé, Togo, on its way to Lagos.
‘WHO is sending teams to both Nigeria and Togo to do follow- up work in relation to contact tracing, in particular to contacts he may have had on board the flight,’ spokesman Paul Garwood said.
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 organization Samaritan’s Purse tested positive for Ebola.
Nigeria’s airports, seaports and land borders have been on ‘red alert’ since Friday over the disease.
Exacerbating the difficulty of containing the virus, Nigerian doctors are on strike over conditions and pay.
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.
‘He observed that the outbreak is beyond each national health sector alone and urged the governments of the affected countries to mobilize and involve all sectors, including civil society and communities, in the response,’ the WHO said.
While the virus’s one virtue is that it isn’t as easily transmitted as flu, it is highly contagious.
The disease spreads through contact with blood, body fluids or contact with tissue from infected people or animals. It has only a 10 per cent survival rate.
People can become contaminated from vomiting and diarrhoea, saliva from a kiss, sweat from a mopped brow, or even, experts believe, a sneeze.
A sufferer will endure a sudden fever, intense weakness, muscle pain, a headache and sore throat.
Then comes vomiting, diarrhoea, a rash and the kidneys and liver shutting down.
As the final stages of the disease take hold, a patient sufferers unpleasant internal and external bleeding.
As the virus punches holes in veins, the result is massive internal haemorrhaging and bleeding from the eyes, ears, mouth and other orifices.
A victim generally dies as a result of multiple organ failure.
Doctors have been warned to look for patients who have sudden onset of symptoms including fever, headache, sore throat and generally feeling unwell within 21 days of visiting affected areas.
People displaying those symptoms should ‘receive rapid medical attention’ and be questioned about their recent travel and those they have come in contact with.
The risk of travellers contracting Ebola is considered low because it requires direct contact with bodily fluids or secretions such as urine, blood, sweat or saliva, experts say.
But experts have warned were the disease to spread to British shores, the country’s health service could be ill-equipped to cope with a sudden influx of victims.
The disease spreads through contact with blood, body fluids or contact with tissue from infected people or animals. It has only a 10 per cent survival rate.
People can become contaminated from vomiting and diarrhoea, saliva from a kiss, sweat from a mopped brow, or even, experts believe, a sneeze.
A sufferer will endure a sudden fever, intense weakness, muscle pain, a headache and sore throat.
Then comes vomiting, diarrhoea, a rash and the kidneys and liver shutting down.
As the final stages of the disease take hold, a patient sufferers unpleasant internal and external bleeding.
As the virus punches holes in veins, the result is massive internal haemorrhaging and bleeding from the eyes, ears, mouth and other orifices.
A victim generally dies as a result of multiple organ failure.
Doctors have been warned to look for patients who have sudden onset of symptoms including fever, headache, sore throat and generally feeling unwell within 21 days of visiting affected areas.
People displaying those symptoms should ‘receive rapid medical attention’ and be questioned about their recent travel and those they have come in contact with.
The risk of travellers contracting Ebola is considered low because it requires direct contact with bodily fluids or secretions such as urine, blood, sweat or saliva, experts say.
But experts have warned were the disease to spread to British shores, the country’s health service could be ill-equipped to cope with a sudden influx of victims.
Hugh Pennington, emeritus professor of bacteriorology at
Aberdeen University, warns: ‘If the disease gets going in Nigeria, it
would be cause for concern. Nigeria has close links with the UK and many
other countries.’
Professor Pennington, an international expert, said yesterday that he was hardly reassured by current efforts to contain Ebola’s spread.
‘This is a very big outbreak, and I get the feeling that whatever is being done to control it is not being done very well. Once you get a fairly large number of cases, it gets a momentum and becomes more and more difficult to control.
‘This is now crossing international borders.’
Professor Pennington, who criticised the UK government over its handling of mad cow disease, warned that Britain would be ill-equipped to cope with a sudden influx of Ebola victims.
Isolating them is critical, he said, but ordinary hospitals simply don’t have the facilities or the necessary highly trained staff. The specialist hospitals that dealt with such diseases have largely closed.
‘If [Ebola] came into London, I honestly don’t know where they’d put the patients,’ he said. ‘We could cope with one or two, but more than that? Let’s hope we don’t have to.’
The big problem with Ebola, he stressed, is diagnosing it. The disease looks much like common flu until it’s too late.
Even the rash that sufferers get after about five days could be confused with other less serious ailments.
‘Ebola patients can often go under the radar, but if they ended up in hospital, giving blood samples and coughing over everyone, it would be potentially disastrous,’ he said.
He adds that it was crucial for British GPs and hospital doctors to start watching out for Ebola.
‘If someone is coming in with flu-like symptoms, it’s crucial to ask them where they’ve been — and whether they’ve been to Africa.’
A cruel irony of Ebola is that those caring for its victims often contract the disease themselves. Recent casualties included one of Liberia’s most respected doctors and two Americans — thought to be Ebola’s first Western victims.
Dr Ken Brantly was the medical director of a Christian aid charity, Samaritan’s Purse, who had been working in Liberia since October.
He contracted the disease despite wearing head-to-toe protective clothing while treating sufferers.
Nancy Writebol, a Christian missionary, had also been working with Ebola victims in the Liberian capital of Monrovia when she became infected.
Dr Brantly, at least, may yet defy Ebola’s grim statistics.
Early treatment improves a patient’s chances of survival, and he recognised his own symptoms and got immediate care.
His wife and two young children were with him in Liberia until flying home to the U.S. a few weeks ago, but they have not yet shown any signs of the disease
Surprisingly, scientists are still not clear exactly where Ebola comes from. The first known outbreak was in 1976 in a remote village near the Ebola river in what is now the Democratic Republic of Congo.
Although most of the cases are understood to have been transmitted from human to human, each Ebola outbreak is initially caused by someone coming into contact with the blood or body fluids of an infected animal, such as a fruit bat, monkey or pig.
According to Dr Ben Neuman, a virologist at Reading University, the disease is spreading so rapidly now because people are ‘rescuing’ Ebola sufferers from hospitals or snatching their dead bodies so they can wash them in accordance with religious custom.
In the first case of an infection in Sierra Leone, a hairdresser in Freetown, the capital, was forcibly removed from hospital by her family, sparking a frantic search to find her before she infected others. She died on Sunday.
Dr Neuman also fears officials in the UK may be hard-pressed to keep out every Ebola sufferer if their numbers become too great.
‘We have to hope they do, though, as in the late stages of infection, you have enough virus in your body to infect everyone on Earth maybe three times over.’
Mr Sawyer’s death on Friday has led to tighter screening of airline passengers in West Africa.
Nigeria, Guinea, Liberia and Sierra Leone are now screening air passengers – but doctors say this may not be effective because Ebola has an incubation period of two to 21 days and cannot be diagnosed on the spot.
But some health authorities expressed little confidence in such precautions.
Dr David Heymann, professor of infectious diseases at the London School of Hygiene and Tropical Medicine, said: ‘The best thing would be if people did not travel when they were sick, but the problem is people won’t say when they’re sick.
‘They will lie in order to travel, so it is doubtful travel recommendations would have a big impact.’
Professor Pennington, an international expert, said yesterday that he was hardly reassured by current efforts to contain Ebola’s spread.
‘This is a very big outbreak, and I get the feeling that whatever is being done to control it is not being done very well. Once you get a fairly large number of cases, it gets a momentum and becomes more and more difficult to control.
‘This is now crossing international borders.’
Professor Pennington, who criticised the UK government over its handling of mad cow disease, warned that Britain would be ill-equipped to cope with a sudden influx of Ebola victims.
Isolating them is critical, he said, but ordinary hospitals simply don’t have the facilities or the necessary highly trained staff. The specialist hospitals that dealt with such diseases have largely closed.
‘If [Ebola] came into London, I honestly don’t know where they’d put the patients,’ he said. ‘We could cope with one or two, but more than that? Let’s hope we don’t have to.’
The big problem with Ebola, he stressed, is diagnosing it. The disease looks much like common flu until it’s too late.
Even the rash that sufferers get after about five days could be confused with other less serious ailments.
‘Ebola patients can often go under the radar, but if they ended up in hospital, giving blood samples and coughing over everyone, it would be potentially disastrous,’ he said.
He adds that it was crucial for British GPs and hospital doctors to start watching out for Ebola.
‘If someone is coming in with flu-like symptoms, it’s crucial to ask them where they’ve been — and whether they’ve been to Africa.’
A cruel irony of Ebola is that those caring for its victims often contract the disease themselves. Recent casualties included one of Liberia’s most respected doctors and two Americans — thought to be Ebola’s first Western victims.
Dr Ken Brantly was the medical director of a Christian aid charity, Samaritan’s Purse, who had been working in Liberia since October.
He contracted the disease despite wearing head-to-toe protective clothing while treating sufferers.
Nancy Writebol, a Christian missionary, had also been working with Ebola victims in the Liberian capital of Monrovia when she became infected.
Dr Brantly, at least, may yet defy Ebola’s grim statistics.
Early treatment improves a patient’s chances of survival, and he recognised his own symptoms and got immediate care.
His wife and two young children were with him in Liberia until flying home to the U.S. a few weeks ago, but they have not yet shown any signs of the disease
Surprisingly, scientists are still not clear exactly where Ebola comes from. The first known outbreak was in 1976 in a remote village near the Ebola river in what is now the Democratic Republic of Congo.
Although most of the cases are understood to have been transmitted from human to human, each Ebola outbreak is initially caused by someone coming into contact with the blood or body fluids of an infected animal, such as a fruit bat, monkey or pig.
According to Dr Ben Neuman, a virologist at Reading University, the disease is spreading so rapidly now because people are ‘rescuing’ Ebola sufferers from hospitals or snatching their dead bodies so they can wash them in accordance with religious custom.
In the first case of an infection in Sierra Leone, a hairdresser in Freetown, the capital, was forcibly removed from hospital by her family, sparking a frantic search to find her before she infected others. She died on Sunday.
Dr Neuman also fears officials in the UK may be hard-pressed to keep out every Ebola sufferer if their numbers become too great.
‘We have to hope they do, though, as in the late stages of infection, you have enough virus in your body to infect everyone on Earth maybe three times over.’
Mr Sawyer’s death on Friday has led to tighter screening of airline passengers in West Africa.
Nigeria, Guinea, Liberia and Sierra Leone are now screening air passengers – but doctors say this may not be effective because Ebola has an incubation period of two to 21 days and cannot be diagnosed on the spot.
But some health authorities expressed little confidence in such precautions.
Dr David Heymann, professor of infectious diseases at the London School of Hygiene and Tropical Medicine, said: ‘The best thing would be if people did not travel when they were sick, but the problem is people won’t say when they’re sick.
‘They will lie in order to travel, so it is doubtful travel recommendations would have a big impact.’
(Daily Mail)
 |
Nigeria admits precise number of people Ebola victim could have infected is not known as 59 people are placed under close surveillance |
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