COM 701 history of public health assignment

Monday, 29 June 2015

First Blog Assignment 2014/15

The recent Ebola outbreak in West Africa caused significant loss of life with huge social and economic losses.

Discuss how the history of this disease and health services in Nigeria impacted positively or negatively on control efforts.

What lessons should be learnt going forward ?.

Your comments are expected within one week from the time of this post. Any comment received after 12 noon of Monday, 6th July, 2015 becomes invalid.

Please be reminded that the exercise forms a part of continuous assessment ratings for your performance in history of public health course.

So feel free to share your comments

Thank you
Teaching Assistant

72 comments:

Unknown2 July 2015 at 15:55
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Unknown2 July 2015 at 15:55
COM 701: Ebola has been in existence in Africa, since 1976...: Ebola has been in existence in Africa, since 1976. Over the past 40 years, sporadic Ebola Virus Disease (EVD) occurred in the Central Afri...http://ajayitumi.blogspot.com/2015/07/ebola-has-in-existence-in-africa-since.html?spref=bl
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Unknown2 July 2015 at 16:24
It's sad to state that this deadly outbreak did emanate sequelae to lapses in our port health system disease control surveillance unit which heralded the entrance of the index case Mr. Patrick Sawyer on July 20th, 2014. However, the resultant non-emergent isolation of his undiagnosed clinical condition resulted in an ugly demise of 8 lives of loved ones and health workers whom displayed professionalism during their course of duty. My view point on the impact of our health system viz a viz control efforts against this lethal scourge is a positive one, as it was multidisciplinary in approach involving stake holders from various sectors creating elaborate public awareness on identification of signs and symptoms, prevention and report of suspected cases via electronic,social and educational platforms nationwide, hence resulting in its eradication 4months later confirmed by W.H.O ( August 20th, 2014). I strongly advocate for strict protocols and measures at our land borders, seaports and airports in view of any suspected infectious conditions. Furthermore, mandatory periodical training of both health and non-health related personnel against infectious and acute illnesses should be implemented at the national, state and local government levels abreast of imminent local,regional/global epidemics viz a viz provision of fully equipped, functional and adequate man-power driven quarantine centres alongside swift preparedness of the national emergency management agency units nationwide.

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Unknown3 July 2015 at 04:43
Ebola, the zoonostic diseases affects both human and non-human primates. Its first outbreak in some parts of Africa mainly in congo and chad basins occured simultaneously in 1976 in Democratic Replubic of Congo and Sudan with very high case of fatality. The concurrent re-emergence of Ebola Virus disease in some part of Africa later informed peopleb about transmission of Ebola virus to humans through the interaction between the humans and the forest.
Prevention of Ebola disease requires improving understanding of populace on the disease epidermology especially the roles of widelife in the transmission of diseases to human.
In most outbreaks, ebola virus is introduced into human population via handling of infected animal carcasses. In these cases, the first source of transmission is an animal found dead or hunted in the forest, followed by person to person transmission from index cases to family and community members or health care staffs, from anthropological point of view, the primary transmission of ebola virus to human population is associated with drastic change in the forest ecosystem. The perturbation of these ecosystem due to extensive deforestation and human activities in the depth of the forest may have promoted direct or indirect contact between human and natural reservoir of the virus, ebola infection has been therefore related to human activities like hunting fruit bats and rodents for bush meat, farming and digging gold which are certain economic activities that many populations depend upon for survival.
All these findings and informations and their implication on health were effectively disseminated to the general populace using the public health measure by the health care providers at all levels of care delivery in conjuction with various programmes and campaign on media and also newspaper effort in publishing pictures and information on ebola virus disease helped keep people of the nation update and vigilant regarding infection and thus serve as a good control measure of ebola disease prevention in Nigeria.
Also, untiring effort of the health workers in caring for the ebola victims in the hospital using barrier nursing also helped to prevent nosocomial spread and transmission to the general populace and thus a great measure for ebola control in Nigeria.
There is also a need in effective surveillance of disease in our sea and air ports by enhancing effectiveness of quarantine measure and this should also extend to our various land boarders for effective prevention of disease transmission from immigrant.
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Unknown3 July 2015 at 15:11
The known history of Ebola which was first identified in the Democratic Republic of Congo (DRC) and Sudan in 1976, the incursion of the disease into Nigeria brought in its wake several implications to the Nigerian state. These implications had negative impact on the social, economic and religious among other sectors of the country. Furthermore, the impact of the Ebola epidemic on economic well being operates through two channels,
First is direct and indirect effects of the sickness and mortality caused by the disease. Ebola also consumes health care resources and subtract people either temporarily or permanently from the labour force.
The second is the behavioral effects resulting from the fear of contagion. This in turn leads to a fear of association with others and reduces labour participation. It also leads to closing of places of employment and land borders, distruption of transportation, restriction of entry of citizens from afflicted countries and reduction in shipping and cargo service.

Finally, i want to believe that Nigerian has learned to be proactive in all sectors with special focus on the Health sector. Part of been proactive will be that at the point of exit and entry, adequate personnel and infrastructure, operational vehicles for contact tracing, quarantine facilities and other sophisticated devices should be made available.
Furthermore, adequate public awareness on Ebola Virus Disease (EVD), high level of preparedness to tame EVD and keeping to the principle of personal hygiene should be imbibed. And also hand sanitizers should made available in all public places.
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Unknown3 July 2015 at 21:33
Brief history of Ebola virus disease (EVD)
First appearance: Congo and Sudan 1976
Family: filoviridae
Genera: Ebola virus
Host: fruit bat and Monkeys
Transmission: human to human contact (blood and body fluids), contaminated surfaces
Incubation period: 2-21 days
Case fatality: average of 50%
The outbreak of 2014 was the hardest hitting and brought to the fore front the issues of Emergency preparedness of our health service system.
It can be said that our health system is weak at best and over the years has faced tremendous challenges with infrastructure decay and relegation by government. But this time we took the bull by the horn. This goes to show we can actually get the job done if we want to. I think lessons learnt from previous programs such as the eradication of some vaccine preventable disease like polio, small pox, measles and previous epidemics factored into the quick and effective management of the Ebola epidemic.

National preparedness depends on quick accessibility to funds, identifying the problem and campaigns. This we were able to do because the government recognized the volatility of the situation and was able to disburse funds along with cooperation from international organizations, partners and non-governmental organizations.
This involved; contact tracing, monitoring, isolation of potentially infectious people and quarantining of Ebola cases.
Vigorous and effective campaigns. The dissemination of proper information raised the public's awareness of the disease and helped forestall the spread of fear, misinformation and anxiety. The campaign was taken straight to the grass root and community involvement was utilized which helped prevent further outbreak. The people imbibed basic hygiene; hand washing, clean environment, protective wears, prevention of bat meat and also helped report any suspicious case.
Provision of protective gear and training of medical workers and volunteers on the proper use of them
Setting up of a centralized operational center in lagos for reporting, analysis and surveillance made for coordination and cohesiveness.
Decontamination of potentially infectious areas
Screening at borders: This is where we had an initial lapse. After the outbreak in guinea and subsequently Liberia and Seirra Leone, we should have being on high alert at every port of entry. Since we have porous borders monitoring and surveillance would have being the first step. Though it might be difficult to detect anyone who isn't symptomatic but then a routine follow up of every one entering is ideal but expensive in carrying out. This we can learn from. Its better to be proactive than have a fire brigade approach.

Now that we have being declared free of EVD we have all returned to our routine. People have forgotten about hand washing, sanitizers and being generally cautious. The appearance of a new case of EVD in Seirra leone should be a wake up signal for us to pick up on our campaigns on basic hygiene, clean environment, avoidance of bat meat, proper handling of animal carcasses and safe burial practices. We have to maintain an atmosphere of awareness and remind people because we are quick to forgetting.
Also we should build a culture of maintenance of infrastructures and systems put in place to handle this epidemic for use in other emergency situations.
We also have the opportunity to assess our emergency response system and look for ways to strengthen it, Liase with state partners and international bodies. This should cut across the federal, state, local government, community leaders and heads.

The natural history of EVD is still being studied. New discoveries are being made so we should be on alert.

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Unknown4 July 2015 at 06:59
Ebola hemorrhagic fever is an emerging zoonotic viral disease that historically has occurred in rural areas of Central Africa. The Ebola virus was first identified in humans in southern Sudan in 1976 but likely occurred as early as 1972 in Tandala, DRC. The virus causes severe morbidity and high mortality in humans and wildlife. The rapid response using all available public health assets, coupled with organizing the response using proven structures for the delivery of public health in Nigeria, as well as very tight coordination of all the players involved made Nigeria Ebola-free today. Improving future outbreak responses, the following must be taken into consideration.
1. National preparedness efforts should consider how resources can be quickly made accessible to fund the early stage of any outbreak and response. 2. The Nigerian public must have specific information about Ebola/ emerging diseases and early information provided by the press, in advance of official information from the Health Authorities, must be accurate so as not to create a nationwide scare. 3. Preparedness activities should include orientation training and retraining of physicians, nurses, and attendants to safely provide services with attention to infection control procedures and quality treatment at an appropriately designed facility.
Nigeria has been certified free of Ebola. Indeed, now more than ever, is the time for Nigeria to imbibe the saying that ‘prevention is better than cure’ – prevention costs far less lives than excellent rapid emergency response. Certainly we require more than appropriate law and its enforcement to fight Ebola – which, for all we know, may still be lurking around the corner – or any other public health emergency. We could not emphasis more on the need for continued, sustained public education, improvement in sanitary conditions and healthcare infrastructure. Training of emergency officials, development of research capacity, and professional ethics are essential. Above all, comprehensive legislation is foundational and has an important place in the arsenal to fight public health challenges.
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Oyindamola "Dammie" Awofisoye 4 July 2015 at 15:21
Since Ebola disease first surfaced about four decades ago in Congo, there has been recurrent outbreaks of varied intensity and mortality rates. The Ebola outbreak of 2014 was the largest, longest and had the highest mortality in history. The earlier outbreaks typically involved one or two countries at a time. The last outbreak however affected 10 countries, across 3 continents, causing at over 11,000 deaths. Also previous cases were limited to equatorial Africa, but the index case in the last epidemic was in West Africa. Globalization and development which has brought more road networks, faster travel to such rural areas (where smaller outbreaks used to occur) contributed increased transmission. Infectious disease surveillance and control is still poor and some high-risk traditions were still widely practiced. These encouraged the spread of Ebola. The history of Ebola’s high mortality rate, lack of effective curative treatment and its overstated “blood everywhere” presentation led to widespread fear and panic which posed a major challenge for controlling the outbreak. People avoided the hospitals and nursed their sick at home which made it spread faster.
Health services in West-Africa, including Nigeria has had a poor and unbalanced development. Challenges include poor coverage, and ineffective administration of the primary health system, reactive approach to health care, poor trust of the health system and ignorance among the general populace. Available expertise has not translated to adequately positive outcomes (perhaps due to lack of an enabling environment). In view of this background and the large population of Nigeria, it was not surprising that the world was alarmed when the outbreak spread to Nigeria. It was expected that the epidemic would take a worse dimension. However, because Lagos (where Nigeria’s index case surfaced) was relatively more developed (compared to the rural areas where the epidemic started in Guinea) was probably helpful. Also the recent intense efforts to eradicate polio in Nigeria had perhaps honed the skills of public health officers in Nigeria. With these advantages, efforts such as creating media awareness on preventive measures, case definitions and what to do on suspecting a case was helpful in addressing the outbreak. Intensive contact tracing and monitoring was also vital in controlling the outbreak.
Moving forward, Nigeria should realise that the threat from outbreaks of infectious diseases are never really over. If it’s not Ebola today, it will be MERS or bioterrorism tomorrow. Thus, systematic surveillance for emerging diseases should be continuous. Adequate public health attention should also be given to our ports of entry into the country, and intensified during outbreaks in any part of the world. Basic hygiene measures by individuals and universal precaution by health workers should be consistent. Nigeria needs to invest in her health care system at every level - especially at the primary care level, with full community involvement and participation. We also need to build adequately trained and funded response systems which can be activated in times of outbreak, disasters or humanitarian emergencies. We should also monitor outbreaks (and other challenges) occurring in other countries even far countries which do not appear to have obvious implications for us. The western world learned this almost too late; the amount of support given to Guinea and Sierra Leone in the earlier stages of the outbreak was grossly deficient. Additionally, there should be incentives for the biopharmaceutical industries to research and develop vaccines/medications for “orphan diseases”.
Overall, the 2014 Ebola outbreak was an eye opener on the impact of outbreaks in a globalized world, the importance of strong community involved-health systems, surveillance and implications of late response by the international community. These lessons should prepare Nigeria, and indeed the world at large to prevent and curtail future outbreaks.
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Unknown4 July 2015 at 16:14
Ebola Virus Disease (EVD) has been around for a while (since 1972). While some of my colleagues dealt justice to its history on this blog, I would beg pardon to stay away from repetition.
I was appalled at the level of scare and panic an infectious disease could bring to a nation of 180million people. It was just too deadly that it has a mortality ratio of about 50%. On a large scale, were we ready for an outbreak of such deadly disease at such proportion? No, but the Nigerian health system got lucky to have history written on a positive note solely due to the fact that we got the index case in Lagos. A highly sophisticated state with a large part of educated population. Nonetheless it managed to bring to the consciousness of everyone basic hygiene concepts in prevention of disease transmission. The political tone of having a performing opposition government played a big role in the success story. Of course the rivalry between the central government at the time of outbreak and Lagos state is well known, this prompted the Federal power to act sanely, supporting the rapid response efforts of the state in containing the disease from further spread. Thankfully, this ebola didn’t emerge through the northern part of Nigeria, else we would have a different story to tell today.
Basically education goes a long way in the success of the EVD situation as always does with the emergence of any disease outbreak. I know not of a single genomic research being undertaken in Sub-Saharan Africa on EVD despite being around this long. My point and sincere opinion is that we still have a long way to go. The containment effort was good enough to get Nigeria Ebola-free but we have dropped guard again in terms of public readiness for eventuality and reality of occurring disease epidemics. We need to do more in periodic public enlightenment, training and re training of health and social workers, and we need to research on these diseases to provide a cure for ourselves as the economic loss due to epidemics would be greater. The Virus still lurks in Sierra Leone and Guinea, how prepared we are at the ports of entry into our country is of great importance in preventing re-emergence of the disease again.
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Unknown4 July 2015 at 18:41
The continuing ebola outbreak in Weat Africa has infected eight times the number of people than all previous outbreaks combined. On 20 July 2014, a well-warned but apparently wilfully non-compliant diplomat from Liberia, who had been instructed not to leave the country until cured of his infection, left the country and arrived in Nigeria with the
disease.He was treated at a private hospital until his illness was identified as Ebola .Thus the Ebola
virus was able to spread to his contacts in the hospital and their families before appropriate control measures could be taken.
Once public health officials recognised these problems, Nigeria put in place the maximum public health control measures such as;
1. Tracing and relevant surveillance of all primary, secondary and tertiary contacts of every suspected or confirmed case of EVD in their homes and place of work.
2. Securing the borders against land importation of the disease with monitors at all the land entry and ports.
3. Approval for more money to procure additional materials that are needed to combat the EVD outbreak.
4. Life insurance and incentives for all participating in the exercise including contracts tracing and case management.
5. Local government education and mobilisation such as provision of simple fliers to tell the public about Ebola symptoms and what they can do to prevent it.
6. Running jingles in indigenous languages and pidgin to educate people on personal hygiene especially hand washing.
The activities amounted to far greater effort and coordination than ever before. In November 2014, the World Health Organization declared Nigeria entirely free of the disease. Nigeria’s success in control and total elimination of this infection is widely recognised as significant, not only for the
developing countries, but for the global community at large.
Two negative events also provided lessons;
1.Poor management at the beginning (including rumour and stigma management) led to many otherwise avoidable deaths: a rumour spread that drinking or bathing with strong salt solutions protected one from the virus.
2. The unnecessary deaths of several people occurred when they concealed their disease instead of coming early for treatment upon noticing signs or symptoms of the disease. Most early reporters of the disease survived.
Global communities, including various arms of the United State Government and of the UN and the World Health Organization, all came and helped as much as they could. Control efforts proceeded in a cooperative and mutually respectful manner.
Lessons learnt going forword
1. Government health services – starting with the
district/local government, community and primary
health-care systems should be competently and professionally led (by properly trained
and supported medical health officers), so as to
produce the necessary grass-roots action for disease
control.
2. The national health system should be able to assist the state governments in the face of similar threats in the future.
3. National public health, including the international and port health services, should also work in collaboration with all the lower levels of the public health system with much data and skills-sharing.
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Unknown4 July 2015 at 22:09
Ebola is a well known disease to Africans and the global community but everyone chose to pretend it doesn't exist despite demonstrating its ability to cause epidemic in previous outbreak because the world felt it was outside their borders. However, EVD got its deserved attention when it spread beyond its initial borders and threaten the global community. This has always been the trend when it comes to public health issues.
Nigerian success story is more of luck than our preventive measures .many of our errors are yet to be corrected. its disgraceful to know that thermometers and other preventive protocols were only initiated after the index case was reported. mr patric sawyer passed through our port freely despite being symptomatic and on a direct flight from an affected country. this clearly show that there was no response plan.
Nigeria is lucky that he presented to a world class private institution with international best practice, well trained, motivated and up to date staffs with clear action plan that responded appropriately. it would have been a disaster if he presented to a public institution. its unfortunate that our public institutions are still in the same shameful state. the public should be kept up to date and properly educated on important public health issues. doing that after cases are reported will only cause panic.local authorities should b empowered to respond appropriately as seen in the case of Lagos state government. I doubt if up to 5 states have the ability to do such expecially when we know that most of our porus entries are situated in those less developed states. the disease would have spread wide before being noticed and contact tracing almost impossible. it is sad to know that we are forgetting too soon and we have let our guards down. all the preventive measures have been abandoned and we are more vunerable now than before expecially when we know that the disease is still close to our borders. measures should not be for political gains or knee-jack approach like the last episode. unfortunately, we are still almost on the same level as no sustainable and implementable protocol is available till date. public enlightenment has stopped. to summarize, we need to build sustainable, functional institutions like the health sector, immigration, emergency response and all other sectors. these institutions should learn to collaborate , work together with minimal bureaucracy while we ensure continuous surveillance and monitoring.
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Abolaji5 July 2015 at 02:52
While trying to avoid repetition in telling the history of Ebola virus it’s important, for completeness sake, to add that Ebola is a member of the Filoviridae family, named after the filamentous shape. The family consists of three broad groups of virus including the Ebola, the Marburg and the newly discovered Cueva.
The Nigerian health system at best is still crawling, faced with a barrage of challenges; provision of basic and essential health care to the people where they live and work is still a mirage, failing primary health care system, disharmony among the various cadres of health workers, incessant industrial actions in the health sector.
The Ebola virus epidemic brought to the fore how real globalization and its effects are. No one country is immune to these effects.
It’s pertinent to say that the outbreak of Ebola in Nigeria is also a reflection of the weaknesses in our health system- the ports.
How did we combat the Ebola scourge? We were fortunate that the primary and index case’s first point of visit was Lagos State, a cosmopolitan city. Necessary machineries were also set rolling armed with the three main principles of epidemic control- patient isolation, contact tracing and community understanding.
Other highlights:
• Fund availability, to a reasonable extent
• Availability of international aids
• Isolation centres built in strategic locations
• Information unit set-up, creating awareness and educating the general populace
• Formation of the rumour management team, working in tandem with the community
• The political atmosphere
We were declared Ebola free but not without losing loved ones. However, the world is a global village and we cannot be blinded to the fact that Ebola is still with us (new cases found in Liberia and Sierra-Leone) as well as other deadly diseases.
In light of this, we cannot afford to let our guard down. All hands must be on deck to combat the unending challenges facing our health system, make the primary health care more efficient, strengthen the borders, improve surveillance, increase research and capacity building and engage the public.
At this point in our lives the importance of the creation of the office of the surgeon-general occupied by a seasoned professional of epidemiology and public health with clear-cut roles cannot be overemphasized.
All this will set us in good stead in preventing and combating the occurrence of similar outbreaks in the future.
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Anyanwu Faith5 July 2015 at 03:09
Brief history of Ebola Virus Disease:
Ebola virus belonging to the family, Filoviridae
First outbreak: 1976, Congo and Sudan
Recent outbreak: 2014 (across continents)
Primary hosts: Fruit bats and monkeys
Transmission: Animal-human (zoonosis) and human-human (blood and other body fluids, contaminated surfaces, contact with bodies of dead patients)
Incubation: 3-21 days
Main symptoms: Headache, fever, nausea, vomiting, sore throat, muscle pain, skin rash, bleeding- internal and external.
Case fatality: 50-65%
Recovery: Complete (though virus can survive in the testes for up to 6 months)

Health services in Nigeria: Impact on control efforts:
The positive impact of the Nigerian health services on Ebola control efforts will include the following and more:
1. Swift government recognition of the potential fatality and gross negative impact of the disease/epidemic leading to; rapid disbursement of funds, deployment of relevant, specialized personnel, international and stake-holder partnerships, establishment of a Control Center in Lagos for monitoring, surveillance, contact-tracing and analysis and providing Ebola Help Lines for reporting suspected cases. All of these measures provided a coordinated and proactive framework from which the scourge was combated.
2. Multidisciplinary approach with massive involvement of the media- audiovisual (TV, radio), print and social media; increased vigilance due to grass-root involvement and massive public awareness and education on the disease, its signs and symptoms, simple preventive measures as well as the facts, myths and misconceptions about the disease.
These led to noticeable willingness and swiftness of the population to adopt and apply simple preventive measures of good hand washing with soup and running water, use of hand sanitizers, avoidance of bush meat and reporting of suspected cases.
3. Provision of protective gears at the ports- sea and air and at the health facilities, and the training of relevant personnel on how to use them. This allowed for prompt, hands-on screening of individuals, isolation of the suspected cases and quarantine of the confirmed cases. Regular updates were also given on the welfare of the confirmed cases under treatment. This further increased public enlightenment on the emerging disease outcome.
4. The sheer resilience and strong will-power of Nigerians also contributed immensely to the successful fight against the Ebola Virus Disease; a scourge which prior to its unceremonious entry through the country's port, had a fatality rate reaching 90-95%.

Going forward:
While we still celebrate the outstanding success that we as a developing country with a staggering but vulnerable population, achieved in the fight against Ebola, a lot still need to be done to optimize and sustain: our emergency response services; good health care and research funding; training and re-training of relevant, specialized personnel; vigilance at the sea and airports as well as our land borders and cultural practices of simple good hand washing and other basic hygiene.
Ebola Virus Disease is not gone yet. Fresh cases have been reported in Liberia within weeks of its supposed containment, with up to 200 contacts so far. The fight is therefore not over yet.

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Unknown5 July 2015 at 03:22
Ebola which was first identified in the Democratic Republic of Congo (DRC) and Sudan in 1976. The first source of transmission was an animal found dead or hunted in the forest, followed by person to person transmission, to family and community members and health care staffs. It has an incubation period of 21days and it is transmitted through body fluid from human to human.
The history of Ebola was between July to September, 2014 in Nigeria. The first Nigeria Ebola case was on July 20, 2014 by Patrick Sawyer who flown by a commercial plane into Lagos from Liberia and was confirmed having Ebola while on admission in a private hospital in Lagos. Patrick was exposed to 72people both at the airport and hospital where he was admitted. The index patient died on July 25, 2014. In Lagos, Port Harcourt, Rivers a total of 894 contacts were identified, 19 laboratory-confirmed Ebola cases and one probable case was identified and 8death.
The strategy Nigeria health service used in controlling the outbreak was a whole community approach where everyone discusses how to handle the virus.
• Early contact tracing
• Case-management team took over management of each laboratory-confirmed or suspected case.
• Patients with suspected infection were isolated in the suspected case ward at the Ebola treatment facilities, initially in Lagos and subsequently in Port Harcourt
Ebola affected the country’s economic and social outcomes negatively.
Nigeria was not completely ready, but they identified the index case early and then hit the streets. The lesson learnt was,
• To be proactive in emergency case
• weak health systems and few basic public health infrastructures in place cannot withstand or curtail sudden shocks and outbreak
• Improving human resource development through training and retraining of staffs.
• Proper funding of the health system
• effective surveillance system and laboratory support in place
• All control measures must work together seamlessly and in unison
• Sanitation e.g personal hygiene like washing of hands goes a long way in preventing diseases.
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Unknown5 July 2015 at 12:55
Ebola virus disease (EVD) which is a severe, often fatal illness in humans first occurred in the Democratic Republic of Congo in 1976 in the neighbourhood of the Ebola River from which the name was derived. Since then, the disease has remained confined to Africa with the latest epidemics occurring substantively for the first time in West Africa (majorly in the urban areas), in the countries of Guinea, Liberia and Sierra-Leone; where the disease has now also become endemic. In July 2014, Nigeria had an unprecedented episode of this deadly infectious disease with a potential catastrophic outcome.Though the Nigerian health system may be having a barrage of challenges and despite our usual poor emergency preparedness and response, we were able to respond in the unusual ways that we did to contain this event through a package of interventions, namely good case management, excellent surveillance and contact tracing, a good laboratory service, safe burials and social mobilization. The detection of the disease followed the linkages in alert system, between the health facilities and the response teams. The surveillance system enhanced surveillance for EVD in our health facilities, ports of entry and communities and this impacted positively on our control effort.
We cannot afford to fold our arms at this point since our african neighbors are still battling with the control of EVD, so we need to strengthen our points of entry, tackle our health system’s challenges, enhance our surveillance and monitoring systems and ensure community engagement which is key to a successful control of disease outbreaks.
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Unknown5 July 2015 at 13:19
Ebola has been in existence in Africa, since 1976. Over the past 40 years, sporadic Ebola Virus Disease (EVD) occurred in the Central Africa region. In 1976, two outbreaks occurred simultaneously in Southern Sudan and the Northern DRC. Over the next 36 years, there were about 16 outbreaks in Congo, Sudan, Gabon, Cote d’Ivoire and Uganda with about 1590 deaths and an average case fatality rate of 67%.
In 2014, WHO declared EVD emergency in Guinea. It became the largest, most fatal and protracted EVD outbreak in history. It spread to Sierra Loene then Liberia. Although the outbreak originated from Guinea, but the brunt was bore by Sierra Loene, accounting for nearly 90% of the cases up till date. Ebola was imported into other countries like Nigeria, Mali, Senegal, Spain, UK and the U.S with a total of 27,576 cases and 11,244 deaths, with an case fatality of 41%.
The disease only affected the poor countries initially and rural areas, therefore, little public health attention was paid to it. Also, pharmaceutical industries did not make many efforts to develop vaccines and drugs. The high mortality rate and the mystery surrounding the disease provoked a lot of fear and panic in the general population, which negatively impacted control measures.
Resulting Positive Control Measures and Lessons to learnt
Fortunately, past experience with the Zaire Ebolavirus strain also indicates that early, intense and sustained infection control measures in healthcare settings can substantially reduce the size and geographical scope of EVD outbreaks, which is consistent with the recent Nigerian experience. The number of secondary cases decreased over subsequent disease generations in Nigeria, reflecting the effects of interventions, in particular;
• the intense and rapid contact tracing strategy,
• the continuous surveillance of potential contacts, communication with the public, and the largely effective isolation of infectious individuals.
The intense and rapid contact tracing strategy was achieved with the help of WHO, the US Centers for Disease Control and Prevention (CDC) and other organizations, the Nigerian authorities was able to reach 100% of known contacts in Lagos and 99.8% in Port Harcourt.
Prompt set-up of isolation, treatment and real-time reporting systems
Another important feature of Nigeria's success was that of the federal and state governments very quickly provided financial and material resources, and well-trained and experienced staff. Isolation wards were immediately set up in most tertiary centres and designated as Ebola treatment Centres. Vehicles and specially adapted mobile communications systems were made available and greatly assisted real-time reporting of the changing situation. All identified contacts were monitored on a daily basis for the maximum incubation period of Ebola - 21 days. A few contacts did try to escape during the surveillance period, but they were tracked and special intervention teams returned them to complete the required monitoring.
Communication with the general public
The Nigerian authorities were quick to put out messages to the general public, the idea being that this would get communities to support the containment measures. Various initiatives put out messages and key facts about Ebola on different media was available. House-to-house and local radio campaigns - using local dialects - explained the risks, how to take personal preventive measures and what was being done to control virus spread.
The Nigerian experience offers a critically important lesson to countries in the region not yet affected by the EVD epidemic, as well as to countries in other regions of the world that risk importation of EVD and that must remain vigilant. As a case in point, the recent importation of an EVD case in the United States from Liberia proves that no country is immune to the risk of EVD in a globally connected world, but that rapid case identification and forceful interventions can stop transmission.
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Unknown5 July 2015 at 13:31
The significant social and economic cost of the recent Ebola outbreak cannot be understated looking at its personal, community, national and international impact a lot has already been mentioned. The history of the disease has simply helped in the understanding of the epidemiology of the disease, the determinants, distribution and the deterrents. It has also helped to understand the complete picture of the disease so that a standard case definition had been formed. I totally agree with most of the comment but I need to mention that the propagation of the disease in Nigeria was hastened by global nature of the world where diseases could be transmitted across the globe in a matter of hours. The outbreak brought to the fore the general weakness of the Nigerian health system, the reactive nature of the health system and the laxity of the port health service. Nigeria was fortunate that the index case was in a cosmopolitan part of the country, and in a facility where prompt diagnosis was possible this in a great way limited the casualties the outbreak. The history of the outbreak impacted positively on the management of the outbreak in Nigeria which was successful based on the following.
• Effective case surveillance.
• Good case management.
• Effective inter-sectorial collaboration.
• Good rumor management.
Sadly after the outbreak control the Nigerian health system has gone back to sleep, the awareness of a global threat needs to be handled as such and the need to collaborate with other countries in the effective control of Ebola is paramount likewise is the active surveillance among health workers.
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Unknown5 July 2015 at 13:52
Ebola virus is a highly contagious and deadly virus that can be transmitted from infected animal to human and infected human to human.
Ebola virus disease is formerly known as Ebola hemorrhagic fever
The disease first appeared in1976 in 2 simultaneous outbreaks in Nzara, Sudan and in Democratic republic of Congo.
Ebola virus derived its name from a river called Ebola in Democratic Republic of Congo.
The average case fatality is 50%. The case fatality rates have varied from 25% to 90% in past outbreaks.
The recent outbreak occurred in Nigeria July 2014 when Patrick Sawyer came to Nigeria from Liberia through commercial airline. He went a private hospital in Lagos where he was being managed before it was later discovered that the cause of his illness is Ebola Virus.
The history of this disease and health service has impacted positively on control efforts in the following ways:
The awareness of the disease was all over the country and that helped significantly in controlling the disease. The publicity was all over the country that everyone became aware.
Contact tracing which was done one time, isolation of all that are suspected to have the disease and those that were confirmed to have the disease were quarantined also helped significantly in the control of the disease.
However the recent outbreak in Nigeria had a lot negative effects among which are disruption in academic calendar, schools had to be shut down for some time, those involved in selling of bush meat as means of livelihood entered into crisis just to mention a few.

The lessons we learnt
Health workers should always take standard precautions when coming in contact with patients regardless of their presumed diagnosis.
There should be strict adherence to regulations at the airports, seaports and land borders.
Maintaining the culture of regular hand wash with soap and water or ashes and water.
Public awareness about the Ebola virus played a significant role in the control of the virus.
It is however not a thing of joy to know that after we overcame the outbreak of Ebola in Nigeria we have gone back to our old practice of not taking necessary precautions.
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Unknown6 July 2015 at 02:42
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Unknown6 July 2015 at 03:38
Ebola Virus disease, previously known as Ebola hemorrhagic fever is a rare and deadly zoonotic disease caused by infection with a virus of the family Filoviridae, genus Ebola virus. Ebola was first discovered in 1976 near the Ebola river in the Democratic Republic of Congo. Since then there has been sporadic outbreak in Africa. Ebola can be contracted through direct contact with blood or body fluids, objects that have been contaminated with body fluids from a person who is sick with the disease or the body of a person who has died from the disease, infected fruitbat or primates.

The history of Ebola Virus Disease and health services in Nigeria had a positive impact in control efforts as explained below. Ebola Virus disease was imported into Nigeria on 20th July 2014 by an infected Liberian man Patrick Sawyer who arrived into Lagos by aeroplane. Five days after his arrival he died in a private hospital and he set off a chain of transmission that infected a total of 19 people of whom 7 died. He was initially treated for malaria but based on patient's failure to respond to treatment and his travel from an Ebola affected country, treating physicians suspected Ebola. While local public health authorities were alerted about the suspected case of Ebola, he was isolated and tested for Ebola which was confirmed positive for acute Ebola Virus Infection. Due to the knowledge about the presence of this deadly disease in Nigeria health officials immediately repurposed technologies and infrastructure from WHO and other partners to help find cases and track potential chains of transmission of Ebola Virus Disease. Port Health services conducted early contact tracing at the airport and worked with the airlines and partners to ensure notification of the outbreak through International Health Regulations (IHR 2005) mechanism. The Federal Ministry of Health, with guidance from the Nigeria Centre for Disease Control (NCDC) declared an Ebola emergency. In Lagos implementing a rapid response using available public health assets was the highest priority. On July 23 the Federal Ministry of Health with the Lagos state government and international patterns activated an Ebola Incident Management Center as a precursor to the current Emergency Operations Center (EOC) to rapidly respond to this outbreak. The immediate establishment of the EOC using an Incident Management Scheme to coordinate the response and consolidate decision making is largely credited with helping contain the disease out early enough. Also strong public awareness campaign with involvement of traditional, religious and community leaders played a vital role.
For future accomplishments the following should be noted

With strong leadership and effective coordination of health officials there will be an obvious improvement in Nigeria health system.

Early recognition of a disease outbreak and strong public awareness campaign is critical for controlling the spread of the disease.

Public awareness programs should not focus basically on Ebola but also on emerging and re-emergence of pandemic diseases.

For Nigeria to have succeeded in eliminating Ebola Virus Disease I strongly believe that much can still be done in Nigeria health system with the available health facilities.

The Nigerian port health system should be more sensitive and prepared to prevent the importation of EVD and other communicable diseases.

There should be continuous training and retraining of health workers, also better working environment should be provided.
Every individual including health officials are members of one community or the other however if we all play our individual roles in the prevention of EVD, there will be no more occurrence of such devastating disease within the country.
Personal hygiene remains an important way of primary prevention of communicable diseases.
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Unknown6 July 2015 at 03:49
Matric no: 121281
COM 701
The recent Ebola outbreak in West Africa definitely has attendant enormous socio-economic losses.
Ebola virus was first discovered in Democratic Republic of Congo (known then as Zaire) when an outbreak occurred in a village near Ebola river. Nigeria has her first incidence of Ebola on July 20, 2014 imported by an immigrant from Moronvia.
Nigeria, definitely was unprepared for such highly communicable disease. Thanks to nature that Lagos was the point of entry. At least, Lagos has one of the best emergency responses in the country. If it has been through a remote village where there are no preparations in place, the spread would have been at an alarming rate.
Lessons to learn
1. There is need for early establishment or institution of isolation centres when there is such disease
2. There’s need for strengthening of the health care system in terms of personnel, infrastructure and funding
3. Health care professionals need training and retraining on management of disease outbreaks
4. Individuals have learnt and need to learn more on the importance of hygiene in the prevention and control of Ebola and other infectious diseases.
5. The health care system need to put structures in place to handle cases of disease outbreak and not rely on ‘fire brigade’ approach
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Unknown6 July 2015 at 03:53
The Ebola virus causes an acute, serious illness which is often fatal if untreated. Ebola virus disease (EVD) first appeared in 1976 in 2 simultaneous outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name. The current outbreak in West Africa, (first cases notified in March 2014), is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined. It has also spread between countries starting in Guinea then spreading across land borders to Sierra Leone and Liberia, by air (1 traveler) to Nigeria and USA (1 traveler), and by land to Senegal (1 traveler) and Mali (2 travelers). The virus family Filoviridae includes three genera: Cuevavirus, Marburgvirus, and Ebolavirus. There are five species that have been identified: Zaire, Bundibugyo, Sudan, Reston and Taï Forest. The first three, Bundibugyo ebolavirus, Zaire ebolavirus, and Sudan ebolavirus have been associated with large outbreaks in Africa. The virus causing the 2014 West African outbreak belongs to the Zaire species.

Transmission
It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.
Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.

Symptoms of Ebola virus disease
The incubation period, that is, the time interval from infection with the virus to onset of symptoms is 2 to 21 days. Humans are not infectious until they develop symptoms. First symptoms are the sudden onset of fever fatigue, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g. oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

Impact of health services in Nigeria on control efforts

Ebola virus came into Nigeria on july 20,2014 by Patrick sawyer. The health services in Nigeria had a positive impact on the control efforts of ebola virus. Because when it was found out that the deadly disease was in the country and due to its fast way of transmission, the minister of health Professor Onyebuchi Chukwu stood up quickly to work on preventions to eliminate the disease, some procedures were taken and they include
• Isolation of those who were infected
• Protective measures for health workers
• Dead bodies to be buried should be burnt
Even though some innocent lives were lost, there was a great positive impact from the health services in Nigeria.
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Unknown6 July 2015 at 03:56
The first Ebola outbreak was reported in 1976 near Ebola River in Democratic Republic of Congo (formerly Zaire).

In the past, factors which contributed to the spread of the disease were extreme poverty, local customs and traditions which favour the spread of the disease ( especially burial rites) , extreme poverty, delay in responding to the outbreak etc

In Nigeria, the battle for the control of the spread of the disease was won with fast and thorough contact tracing policies, vigilant disinfecting practice, port-of-entry screening and rapid isolation.

The cases were identified early and very wide and thorough line-listing was ensured. For example, in the case of Patrick Sawyer, Nigeria's index case of Ebola who entered Nigeria on July 20, 2014. From the single patient alone, a total of 898 contacts were listed, traced and followed up. In addition, contact tracing was enhanced with the use of Mobile GPS technology which was adopted from the Polio Eradication Programme.

Lagos, which was the port of entry of the index case of ebola was meant to be a very good avenue for a widespread outbreak of the disease nationwide. Lagos, with a population of about 21 million people, with a dense population and over-burdened infrastructure which could enhance the spread of the disease. The disease was however controlled effectively because of the effective health care system which is already in place in the state, ensuring effective intersectoral collaboration.
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Unknown6 July 2015 at 05:02
Ebola Virus Disease is a severe haemorrhagic disease caused by a virus of the Filovirus Family. The disease emerged in 1976 in almost simultaneous outbreaks in the DRC and Sudan. It then disappeared and was not recognised again until 1994 and outbreaks have been occuring with increasing frequency since then. The largest outbreak was in West Africa affecting Guineas, Liberia and Sierra Leone. Nigeria, also a West African Country however was not spared a visitation by the disease which was imported into the country by a Liberian; Patrick Sawyer and which led to the death of Dr Stella Adadevoh; a key instrument to helping to curtail the spread of the disease. The Nigerian Health System is poorly developed in terms of personnel availability, equipment availability, awareness programs, maintainance and sustenance cultures, Etc. However, its is commendable yet surprising that Nigeria was able to control the spread of the disease so well that the issue of an epidemic never arose. I, notwithstanding do not think this was due to the functional healthcare system or lack thereof but due to the fact that the EVD is a rapid terminal illness with no respect for socio-econonmic, political or educational class which made the appropriate authorities bring out their 'biggest guns' to fight the spread of the disesea. Also, the fact that the disease had occurred in other countries which helped Nigeria learn from their experience. This helped Nigeria put necessary measures in place using the information gained from the occurence in other countries.Hence, for future purposes, Nigeria needs to improve her healthcare system in terms of remuneration of its personnel, improved surveillance system, procurement and maintainance of equipment, regular training and re-training of personnel, ETC. Like the Boys Scout, Nigeria needs to learn the act of preparation for situations rather than the act of managing situations
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Unknown6 July 2015 at 06:41
The family fibtoviridae consits of two general, the Ebola and Marburg viruses, are the most virulent pathogens of humns. The Zarie species of Ebola virus discovered in an outbreak in Zaria (the present democratic republic of Congo) in 1976, is the causative agent of the 2014-2015 epidemic in West Africa, where the case fatality rate eas estimated to be as high as 70%; although rates in earlier outbreaks reached 80 - 90%.
Epibdemics of Ebola Virus Disease are generally thought to begin when an individual becomes infected through contact with the body fluids of an infected animal. Once the individual becomes ill or dies, the virus spreads to others who come in direct contact with their blood or other body fluids. On rare occasions, Ebola Virus Disease has resulted from accidental laboratory infections, and there is concern that the virus might be used as an agent of bioterbioterrorism.
The incubation period is typically 6-12 days, but can range from 2-12 days.
Patients with EVD usually have a abrupt onset of non specific symptoms and signs, such as fever, malaria, headache and myalgias. As the illnesses progresses, vomiting and diarrhea may develop, often lead develop, often leading to significant fluid loss. Patients with worsening disease display hypertension and electrolyte imbalances leading to shock and multiorgan failure, sometimes accompanied by hemorrhage.
As a result of the 2014- 2015 Ebola epidemic, clinicians worldwide should evaluate patients if they have clinical findings consitent with the disease ( that is fear, and/ or severe headche, weakness, much pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage) and obtain a careful history to determine if they have had a positive exposure to Ebola virus within 21 days prior to the onset of symptoms.
All patients who have or are suspected of having EVD should be promptly isolated. Infected control precautions should included hand hygiene; standard, contact and droplet precautions; as well as the correct use of appropriate personal protective equipment. Hospital infection control staff, as well as the local or state health department, should be contacted immediately.
Monitoring of symptoms and signs of EVD should be performed for asymptomatic persons who have had an exposure to Ebola virus at any risk level (high, some or low risk).
Medical evaluation of symptomatic patients with a history of exposure generally includes testing for Ebola Virus and other likely pathogens. Whether or not laboratory testing for Ebola Virus should be performed depends in part, upon the relative likelihood that a patient was exposed to the virus and the presence of compatible clinical symptoms and/ or laboratory findings.
Rapid diagnostic tests for Ebola Virus infected are in use and are principally based upon the detection of specific RNA sequences by reverse- transcription polymerase chain reaction (Rt-PCR) in blood or other body fluids. Ebola Virus is generally detected in blood samples within 3 days after the onset of symptoms; repeated testing may be needed for patients with symptoms for fewer than 3 days duration.
The differential diagnosis varies markedly at the level of the clinical and epidemiologic circumstances. As an example, travellers returning from West or Central Africa should be evaluated for illnesses commonly seen in those areas e.g malaria.
The Ebola outbreak caused great social and economic losses, the outbreak disrupted so many economic, social and academic activities due to the burden and fear of the disease.
Unfortunately, Nigerians are now at ease just because the country is now free from the virus, all the peventive measures that were put in place during the outbreak are now no where to be found , we are waiting for the next outbreak before we will pick them up again.
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Unknown6 July 2015 at 14:59
The deadly ebola virus responsible for the ebola viral disease is a member of the family filoviride with primary hosts as fruit bats and moneys. It is transmissible from animal to human and from human to other human by contact with infected blood and body fluid. First cases were seen in Congo and Sudan in 1976 and it has been responsible for sporadic outbreaks in rural communities in Africa. The disease however took a new turn in 2014 when it caused its largest epidemic so far emanating from Guinea and spanning 3 continents while affecting 11 countries, Nigeria inclusive and causing over 11,000 deaths.
Nigeria recorded the first urban case of ebola disease when a diplomat arrived in Lagos from Liberia on a commercial flight on the 20th July, 2014. Globalization and ease of international travel coupled with the laxity of the port health services enabled the diplomat easy entry and he was not detected till he slumped at the airport on arrival. The natural history of the disease with its incubation period ranging from 3 to 21 days brings to the fore the possibility of an infected person transmitting the disease agent from one country to another before becoming symptomatic as seen in the Nigerian case.
Control efforts were rapidly deployed on a national level while containment and contact tracing was going on locally in Lagos state. The Lagos state government, Federal Ministry of Health, World Health Organization, Center for Disease Control and the Doctors without borders were frontline in the control efforts. Of note is the fact that the ailing health system of the country with its numerous challenges was paralyzed during the outbreak as medical doctors in government employment were on strike. This prompted the admission of the patient in a private hospital with international standards of operation including safety, isolation and containment measures which were deployed even before the final diagnosis thus saving the country from the worse outcome that would have been seen if the index case had been taken to a government hospital where thousands throng daily with no safety precaution and no emergency plan in place.
Despite the challenges of the health system, Nigeria survived the outbreak with 20 cases and 6 deaths and has since been declared ebola free. Control measures and strategy put in place which helped curb the outbreak includes; a command structure to coordinate activities, adequate surveillance mechanism, detailed contact tracing, prompt diagnosis and adequate treatment, good information and rumor management, intersectoral collaboration with a strong political will backing it all.
Lessons learnt from the outbreak includes among other things the fact that emergency preparedness should be in top gear throughout the year , surveillance at borders and ports should be strenghtened and training of health worker should be a continuous process. Nigerians have also learnt the importance of hygienic practices especially handwashing however sustainability remains a question.
We can only hope that the next epidemic meets us well prepared.
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Unknown11 July 2015 at 15:57
I'd like to commend my colleagues for their insightful comments. I however must point out that the key instrument to Nigeria's EVD success story was left out. Dr Stella Adadevoh; a Doctor at First Consultant Hospital in Lagos attended to, made the smart identification of the case index (Patrick Sawyer) and ensured his isolation. She was Nigeria's saving grace and paid the ultimate price with her life.
The fact that she was not worthy of mention in Nigeria EVD success story goes a long way to show how Nigeria glosses over its problem in the light of some succour. Once again, it is the usual business of out of sight, out of mind! The hand sanitizers and wash-hand basins that plagued the EVD have long disappeared only to re-appear only Godforbid, if the EVD resurfaces again. Is an outbreak the only reason we do the right thing? I guess that's another topic for some other time. Its high time we stopped living by our coping and management skills and put the elements of genuine preparedness in place. Like the Boys Scout, we must always be prepared. While everyone has commended Nigeria for its success, I also am thankful for the success but stand firmly by the fact that the success was due most largely to the earlier occurence of the disease in countries like Sierra Leone and Liberia which gave Nigeria a platform to leverage on. Were Nigeria the first port of call, I'm not sure the coping mechanism would have sufficed and the story may have altogether been different. In reaction to the aftermath of the volunteer health outreach by Nigerian health workers in Liberia and Sierra Leone, I am totally appaled that men and women who chose to serve humanity could be denied of the least possible means of gratification (remuneration). Some were locked in the hotels they lodged in for failure to pay the bills. This is simply a way of sending a message that being humanitarians is a terrible thing to do. The Government needs to make amends quickly and ensure this never repeats itself if ever these gallant men and women chose to serve humanity again. Also, I agree with my colleagues that the availability of International Support coupled with the 'fear-induced' pro-activeness of the relevant Nigerian authorities went a long way. It is high time we woke from our slumber as new cases of EVD have re-emerged in Liberia and Sierra Leone plus if its not EVD today, it could be the Marburg Virus Disease tomorrow. Hence, Nigeria need not count its blessings yet and stay prepared by;
•Constantly and Ceaselessly keeping the populace aware on various disease symptoms, infection mechanism, general hygiene practices, access to healthcare, health-endangering practices, ETC
•Motivation and appropriate remuneration of all cadre of health workers.Also, continuous training and re-training should be explored. Issues such as the disheartening maltreatment of volunteer Nigerian health workers in Liberia and Sierra Leone should never repeat itself.
•Setting up and maintaining an effective disease surveillance system irrespective of the epidemicity or endemicity status of the country.
•Addressing the porous nature of the various transportation sectors and improving surveillance across all transportation sectors. Need we ask ourselves again our Patrick Sawyer gained entry into the country?
•Putting in place a generally improved, well equipped, adequately funded, closely monitored Healthcare System. An enhanced synergy with relevant International bodies should also be maintained.
These said, I pray Nigeria never experiences another EVD era or any other disease oubreak. But as I have constantly reiterated, PREPARATION is key. As, he who fails to prepare is prepared to fail.
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Unknown13 July 2015 at 03:01
I am in support of the veiw that there is enough awareness on ebola disease virus, the main problem we have as Netochi identified, people have turned away from preventive measures to curtail ebola disease, people tend to forget easily the past incidents in this country. What I think we can do to prevent re-surface of Ebola Virus disease is introduction of concept of prevention of infecious diseases in curriculum in secondary schools and tertiary institutions. Also our porus border should be strengthen againt epidemic potential disease, this also include our ports and effective survellance should put in place.
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Unknown13 July 2015 at 03:48
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Anyanwu Faith13 July 2015 at 04:04
I agree with Aiyemowa Gbemisola. The success story of EVD control in Nigeria actually began with Dr Stella Adadevoh and indeed the entire First Consultant Hospital. Her insightful diagnosis of the index case, Patrick Sawyer and their insistence and resilience in restraining him who as alleged, was more or less bent on spreading the virus as much as he could by exhibiting willful irrational behaviour. We salute their bravery and remember their sacrifices!
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Unknown13 July 2015 at 04:09
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Unknown13 July 2015 at 04:20
Apart from hygiene awareness and borders and ports control measures, there still a need for well coordinated epidemiological surveillance committee which will be responsible for all epidemiological response activties, active and passive case finding, contact tracing and rumor verification of suspected cases or death in a community along with logistic team in charge of providing any administrative, technical and logical support for the committee. Also labouratory and research team is needed for collection and storing of samples for all diagnostics confirmation and also responsile for epidemiological studies to determine the origin of out break.
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Unknown13 July 2015 at 07:54
In my own opinion I don't think we are set God forbid there is another outbreak of Ebola, we have relaxed. But I will recommend that we should adhere very strictly to necessary protocols at our land borders and ports so that there will not be another outbreak in our country again.
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