The Nigeria Centre for Disease Control and Prevention has disclosed that the woman who tested positive for Ebola arrived in Nigeria on October 5, developed symptoms on October 7 and sought treatment at a private hospital in the Federal Capital Territory on October 11.
The Incident Manager of the National Ebola Disease Response, Dr Odianosen Ehiakhamen, revealed this during an interview on Arise Television on Tuesday.
He said the patient was initially treated for malaria-like symptoms but became a suspected Ebola case after doctors reviewed her medical and travel history and discovered that she had recently visited Uganda.
The Federal Government confirmed Nigeria’s first imported case of Ebola virus disease in the FCT on Tuesday, following the woman’s positive test result.
The Minister of Health and Social Welfare, Professor Ali Pate, said 44 people who had contact with the patient had been identified for monitoring. They include healthcare workers, hospital support staff and others who may have been exposed to the infection.
Ehiakhamen explained that the hospital contacted the NCDC after the patient failed to respond to treatment, prompting further investigation and laboratory testing.
“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,” he said.
According to him, the attending doctors initially managed the patient for malaria-like symptoms before her travel history raised concerns about a possible Ebola infection.
He said the hospital alerted the agency through its event-based surveillance system at about 4pm on Tuesday, after which officials from the NCDC and the FCT health authorities moved to collect samples.
“The honourable minister has just highlighted, presented on the 11th to a private health facility and was managed for malaria-like symptoms,” Ehiakhamen said.
He added that collecting the samples was challenging and required medical personnel to perform a venous cutdown to obtain the blood needed 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. And by this morning, we already had preliminary results, but we wanted repeats,” he said.
The incident manager said the response team requested repeat tests before communicating the findings to the NCDC Director-General and the Minister of Health.
Ehiakhamen disclosed that most of the 44 identified contacts were healthcare workers and support staff at the facility 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 said.
He said Nigeria had strengthened its preparedness for a possible Ebola outbreak months before the case was confirmed, following developments involving the disease in other countries.
According to him, the country activated its Incident Management System preparedness structure on May 15 and conducted a risk assessment to determine the level of readiness required.
The exercise covered surveillance, response capacity, personnel, infection prevention and control, medical countermeasures and training. About eight key high-risk zones were also assessed.
Ehiakhamen said the assessment initially indicated a moderate risk, but the authorities adopted a higher level of preparedness as a precaution.
He added that the NCDC had developed and circulated case definitions to health facilities to help medical personnel identify and report suspected cases promptly.
The agency is also drawing on the experience of personnel who participated in Nigeria’s 2014 Ebola response, alongside workers trained through the National Field Epidemiology Training Programme and World Health Organisation-supported emergency response 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.
Ehiakhamen noted that the NCDC had investigated several suspected Ebola cases in the past, with laboratory tests subsequently returning negative results.
He said the current case highlighted the importance of reporting unusual illnesses, collecting samples promptly and improving the speed of laboratory investigations.
“And this is not our first scare; we’ve had very many scares that we had to travel to go take those samples, that always came out negative,” he said.
The NCDC, he added, was monitoring the time taken to respond to alerts, collect samples and obtain laboratory results, with the aim of improving turnaround times across laboratories in its network.
He said the facilities already supported testing for diseases such as Lassa fever and diphtheria and could also contribute to the country’s response to other public health emergencies.
