Tuesday, 2 September 2014

Expect more Ebola virus cases in Nigeria – FG

The Federal Government has disclosed that more Nigerians are likely to test positive to the Ebola Virus Disease, EVD, following the confirmation of fresh cases of the disease in Port Harcourt, the Rivers State capital, even as the Lagos State Government says it is in control of the outbreak in Lagos.

Minister of Health, Professor Onyebuchi Chukwu, who spoke in Abuja yesterday during the 2nd Emergency National Council on Health Meeting on the outbreak of EVD in the country, said the last may not have been heard about the EVD outbreak as contacts currently under surveillance may come down with the disease.

“It is expected that a few more contacts will develop the EVD, especially in Rivers State before Nigeria will see the last case of EVD. While it is encouraging that so far, all confirmed cases of EVD in Nigeria have their roots in the index case, Mr. Patrick Sawyer, great vigilance is required particularly at our ports of entry to ensure we do not have cases of EVD from other sources other than Mr. Sawyer,” he remarked.

Chukwu, who explained that the Federal Ministry of Health is awaiting report of a repeat test being conducted on two health officials of the hospital where the first Port Harcourt case, Dr. Ikechukwu Sam Enemuo, died of EVD after successfully treating the ECOWAS official who imported the virus into the state, however noted that the Incident Management Committee had deployed a strong team to Rivers State to work with the state government so that the situation can be effectively managed.

On the ECOWAS Commission staff, Chukwu said: “He died from EVD. It was his death that led to the investigation that revealed introduction of EVD to Port Harcourt and the beginning of tracing of second and third degree contacts in Port Harcourt. Arrangements are being made to decontaminate the body in readiness for proper disposal of his remains. His death brings to six the total number of persons who have died from EVD in Nigeria.”

Updated summary of EVD in Nigeria

Giving an update on the current status of the EVD outbreak, in the country, the minister said: “The total number of confirmed EVD cases in Nigeria is 17 (including the index case). In Lagos, the total number managed is 14, seven successfully managed and discharged; five deaths recorded and two presently on treatment in isolation.

“In Port Harcourt one death, a doctor who treated a secondary contact of Sawyer’s, has been recorded (did not benefit from standard management); one patient under treatment (no stand treatment) and patient fully recovered.

“Total number of survivors in Nigeria (as of September 1, 2014) is 11; total number of deaths in Nigeria (as of September 1, 2014) is six.

“A surviving primary contact of the index case (Patrick Sawyer): an ECOWAS Commission staff that became symptomatic, evaded surveillance in Lagos, travelled to Port Harcourt and infected his attending physician. Presently, he does not have viraemia but other laboratory tests for antibodies confirm that he had suffered from EVD. He is under quarantine in Lagos at the moment undergoing further tests to ensure he is totally free from the virus.”

Further, he stated; “A female patient who was on admission in the same hospital where the late Port Harcourt Doctor was also admitted. She is presently under treatment in the Isolation ward in Rivers State.

“Two other contacts of the late Port Harcourt doctor (one of the doctors who managed him and a pharmacy technician working in the late doctor’s hospital) are symptomatic and have been admitted in the isolation ward in Rivers State. They have tested negative to the EVD but the laboratory tests will be repeated to reconfirm their status.

Shedding more light on the surveillance, Chukwu said: “Now as of 31st August, 2014, the number of contacts under surveillance in Lagos stands at 72 while in Port Harcourt, the total number of contacts under surveillance stands at 199. There is nobody under surveillance in Enugu presently and no case of EVD in Enugu State. As of 31st August, 2014, 278 contacts have completed the 21-day observation period and have been discharged from surveillance.

EVD not over yet, but we are in control —Fashola

Also, at a press briefing in Lagos yesterday, Governor Babatunde Fashola assured residents that through concerted effort by health workers the state government had been able to contain the spread of the deadly Ebola Virus Disease, EVD, imported into the state by the index (first) case, late Mr. Patrick Sawyer, an American-Liberian citizen even as he confirmed receipt of the N200 million intervention fund from the Federal Government last week.

Fashola spoke while receiving Personal Protective Equipment (PPE) and other items for the treatment of Ebola cases from a delegation from MTN, Nigeria, led by its Chairman, Dr. Pascal Dozie, at the Lagos House, Alausa, Ikeja.
The governor, while commending health workers who risked their lives to save Ebola patients said: “They stood up to be counted when there was dire need, when there was fear even at the highest levels of government. But in spite of those fears some men and women stood up to be counted. We will talk about them later.

“The real problem is the sufficiency of experienced virologists and Ebola specialists in managing and when the sub-region is challenged on many fronts that capacity thins out. That really is the problem, so it is not always a money problem. As at this time it isn’t really an equipment problem. It is a human capacity problem.
“With the stage we are now and like I said before, we do not need to panic, Ebola virus is not automatic death sentence. A lot of knowledge is being gained on daily basis even at this moment about the behaviour of the virus and that knowledge will help the scientists to prepare even better to respond to an outbreak.

“So far, we have eight Ebola patients who have fully recovered from the disease; two are still in isolation while the state has recorded only five deaths so far.”

The governor said what the state government had done and response by the River State Government would be definitive on how to contain the virus in an urban centre where the outbreak had been recorded in the last four decades.

Celebrating Ebola survivors
Commissioner for Special Duties, Dr. Wale Ahmed in his remarks said: “For Ebola victims to be discharged, they must have tested negative three consecutive times and other parameters considered. Ebola virus disease being a viral infection run their course and go like regular common cold, it is not as if it continues to reside in the body. Chances of re-infection may be possible but not that particular strain that has been cured.

“The reason why you have not seen some of the recovered patients coming out is because this case is still little misunderstood. Side stigmatization may accompany it; that’s why these people have not come out.

“As a matter of fact with the permission of the Governor we will actually bring them out and celebrate them for the people to see and know they are not dangerous.

“We have to do some counselling before we go ahead to present them publicly. EVD is not resident here but has reservoir in bats and corpses of somebody who died of it. That’s why we treat those corpses specially, so that it does not constitute any problem.

Sister of late Enemuo quarantined in PH
Meanwhile, sister of the late Dr Iyke Enemuo who died of the Ebola virus in Port Harcourt has been sent to the Ebola quarantine centre in Emohua local government area of Rivers state.

State Commissioner of Health, Dr Sampson Parker who made this known yesterday said she had to be sent there because she showed symptoms of the disease, adding that result of the Ebola test done on her would be released later in the day.

The commissioner said the two other staff of the Samstil Clinic owned by the late Dr Enemuo who were quarantined had been released because result of the Ebola test conducted on them showed that they were negative, adding that only one Ebola confirmed case was at the centre.

“We have brought back the sister of Dr Iyke Enemuo who went to Abia State. She is symptomatic and we have sent her to the quarantined centre.

“The three cases we had at the quarantine centre, two tested negative while one, an elderly lady who was in the same room with the late Dr. Enemuo at the hospital where he was admitted tested positive. The two cases who tested negative were the doctor and pharmacist at the late Dr Enemuo’s hospital. They have left the quarantine centre but we are still watching them within the 21-day period,” he said.
Remains of Enemuo, other high risk corpses for burial in PH

The commissioner who noted that late Enemuo’s wife was in stable condition at the treatment centre in Lagos, however remarked:

“The corpse of late Dr Iyke Enemuo and other high risk corpses in the UPTH will be buried under supervision of the Ministry of Health officials in Port Harcourt so that we don’t expose relatives to danger. The families will be there but will not be allowed to touch the corpse. Families can make suggestions where they should be buried but it will be in Port Harcourt,” he said.

He said there were four volunteer doctors, six expatriate staff and eight volunteer nurses handling cases at the quarantine centre in the state, noting that more persons were being trained.

He further appealed to those who had contact with the late Dr Enemuo but had not shown up to do so, stressing that Ebola was not a death sentence.

“Ebola is not a death sentence. All we need is early detection. We have a lady that moved to Akwa Ibom from the hotel, we are still to get her. Anyone who had contact with Dr Enemuo that is yet to show up should please do, Ebola is not a death sentence,” he pleaded.

On the strategies being adopted for containing the EVD, Chukwu said it had remained the same – focusing on appropriate information, education and communication; sustaining surveillance systems; provision and equipping of isolation wards/centres; provision of adequate care for confirmed cases; active and aggressive contact tracing; and reduction in harmful practices that promote the spread of the virus.

“We have further strengthened our Emergency Operations Centre in Lagos with support from the Dangote Foundation which has made available N152m for the operations of the EOC. On our part, we have continued to ensure that workers at the EOC have requisite knowledge to stay safe while helping to keep track of and provide care for EVD patients. We have also ensured that the workers have been receiving their incentives.

“We have now concluded plans to conduct two major trainings in all the states. The states are, however, expected to cascade these trainings down to the LGAs with support from the development partners, whom we are already talking with in this regard among others. These trainings are Training of Trainer (TOT) for Health Workers on the Ebola Virus Disease (EVD) outbreak and other Viral Haemorrhagic Fevers (VHFs) and TOT for State Health Educators on awareness creation, community sensitization and mobilization. Arrangement has been made to include the military and para-military in the training.”

He said the Nigeria Centre for Disease Control, NCDC, has received approval for the re-production of copies of the protocols and SOPs for management of EVD cases as well as protocol for submitting samples to the laboratories and burying of EVD victims.

“The Federal Government considers it very important to have the right Personal Protective Equipment (PPE) in ensuring adequate protection for our health care workers. We have also decided that all PPEs to be bought should be in line with specifications provided by the WHO. It was also decided that PPEs will only be procured from WHO recommended manufacturers/suppliers. WHO has already supplied us with over 6000 PPEs which we are currently using. However, we have already initiated discussions with the WHO for the procurement of 4000 basic PPEs and 500 Heavy Duty PPEs (for use by the morticians).

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