Nigeria's disease control agency has identified 53 people as contacts of the country's confirmed Ebola patient and ordered hospitals across the country to isolate suspected cases immediately, without waiting for laboratory confirmation.
According to the Nigeria Centre for Disease Control and Prevention (NCDC), the 53 contacts include 44 workers at the health facility where the patient was treated and nine additional contacts, among them the patient's husband, driver and chef, as well as clinic staff and members of the sample-collection response team. All 53 are being monitored for 21 days after their last possible exposure.
According to the NCDC, the confirmed case is a 42-year-old woman who returned to Nigeria from Uganda via Addis Ababa on October 3 and was confirmed with Ebola disease caused by the Bundibugyo virus in the Federal Capital Territory on October 20. The agency's situation report dated October 24 said the patient had improved remarkably while receiving care in isolation.
NCDC Director-General Dr. Jide Idris also disclosed two additional suspected cases at a press briefing in Abuja on Sunday, October 25. According to the NCDC, those two cases are not confirmed, and laboratory testing is required to establish whether the people involved are infected. A suspected case reported earlier in Rivers State has tested negative, according to the agency.
The directive to hospitals is the centrepiece of the response. According to Dr. Idris, any suspected case must be promptly separated from other patients and reported to the relevant public health authorities, and health workers should not wait for laboratory confirmation before taking precautions. The agency has also urged health facilities to strengthen screening, triage and infection prevention, to ensure health workers have adequate protective equipment, and it has reactivated screening at airports.
To support compliance, the NCDC has approved a weekly payment of 100,000 naira per person for those placed in isolation or quarantine, after some contacts raised the cost of feeding and maintaining their families. According to Dr. Idris, being identified as a contact does not mean a person has Ebola; the monitoring is designed to catch any possible infection early and prevent further spread.
What happens next depends on the laboratory results for the two suspected cases and on the 21-day monitoring period for the 53 contacts. Nigeria recorded its first Ebola case in more than a decade on October 20, and the agency says about 12 public and private laboratories are available to test for the virus, with laboratory capacity strengthened since the case was confirmed.
Image credit: Electron micrograph of an Ebola viral particle by CDC / Dr. Frederick A. Murphy, via Wikimedia Commons (public domain).