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Nigeria at high risk of Ebola virus, NCDC warns

..heightens surveillance, cautions Nigerians against non-essential travels

Nigeria is at high risk of importing the deadly Ebola virus disease (EVD) following an outbreak in Uganda, the Nigeria Centre for Disease (NCDC) warned on Tuesday.

The East African country Uganda, declared an outbreak of Ebola virus which is caused by the Sudan strain on 20th September 2022. This outbreak has also been confirmed by the World Health Organization (WHO).

As of September 29, 2022, the Ugandan Ministry of Health has reported 54 cases and 25 deaths. Since then, the NCDC said its multisectoral National Emerging Viral Haemorrhagic Diseases Technical Working Group (NEVHD TWG) working with partners and stakeholders conducted a rapid risk assessment to guide in-country preparedness activities.

“Based on available data, the overall risk of importation of the Ebola virus and the impact on the health of Nigerians has been assessed as high,” the centre said in a statement.

According to the NCDC, Nigeria is at high risk of importing the virus due to the increased air travel between Nigeria and Uganda, especially through Kenya’s Nairobi airport, a regional transport hub, and other neighbouring countries that share a direct border with Uganda.

The centre added that the likelihood of spread in Nigeria following importation is high due to the gatherings and travel associated with politics, the coming yuletide as well as other religious gatherings and festivals during the last few months of the year.

Other reasons why Nigeria remains at high risk according to centre is because: the Sudan Ebola Virus does not currently have an effective drug for treatment or licensed vaccine for prevention; The extent of the outbreak in Uganda has not yet been ascertained as investigations have shown that some persons may have died with similar symptoms which were not reported to health authorities. In addition, their burials were not conducted safely to prevent transmission.

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The NCDC also disclosed that the case fatality rate of the Sudan virus varied from 41 to 100 percent in past outbreaks.

Despite this risk assessment, the NCDC stated that Nigeria has the capacity, including technical, human (health workforce), and diagnostic – to respond effectively in the event of an outbreak following successful response to the Ebola outbreak in 2014, as well as improvements in our capacity for health emergency response during the COVID-19 pandemic.

“Currently, no case of EVD has been reported in Nigeria. Nonetheless, the Nigerian government through NCDC’s multisectoral NEVHD TWG has put several measures in place to prevent and prepare for immediate control of any outbreak of the disease in-country.”

The NCDC said its Incident Coordination Centre (ICC) is now in alert mode, while development of an incident action plan for the first few cases of EVD has commenced.

The centre added that POE surveillance has been heightened using the passenger pre-boarding health declaration and screening form in the Nigeria International Travel Portal (NITP) platform.

“Passengers arriving from Uganda and persons who transited in Uganda are being followed up for 21 days of their arrival in Nigeria on their health status.

Trained Rapid Response Teams are on standby to be deployed in the event of an outbreak. Public Health Emergency Operations Centres (PHEOCs) in States with major POE i.e., Lagos, Kano, Abuja, and Rivers State are on standby,” the centre further said among others measures.

The centre, however warned Nigerians avoid non-essential travel to locations where the outbreak is reported for the moment; avoid direct contact with blood, saliva, vomit, urine, and other bodily fluids of people with suspected or confirmed EVD; Call 6232 or other dedicated hotlines by State Ministries of Health to ensure all persons with suspected symptoms of EVD described above are promptly taken to designated healthcare facilities by the responsible State Ministry of Health for prompt diagnosis and initiation of supportive treatment; and in suspected and/or confirmed EVD cases, direct physical contact should be avoided by ensuring strict isolation, the use of protective gowns, etc.

Ebola virus disease (EVD) is a severe, often fatal illness affecting humans. The strain responsible for the current outbreak was first reported in southern Sudan in June 1976. Since then, seven outbreaks caused by this strain have been reported (four in Uganda and three in Sudan) with previous outbreaks’ fatality ratio ranging from 41% to 100%.

Just like other types of Ebola virus, people infected cannot spread the disease until the development of symptoms. Symptoms include fever, fatigue, muscle pain, headache, and sore throat later followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function. Symptoms may appear anywhere from 2 to 21 days after exposure to the virus, but the average is 8 to 10 days.

Currently, there are no vaccines or therapeutics for the prevention and treatment of this strain of the virus. However, the early initiation of supportive treatment has been shown to significantly reduce deaths.

Recovery from EVD depends on good supportive clinical care, management of co-morbidities, and the patient’s immune response. People who recover from Ebola virus infection develop antibodies that last for at least 10 years.

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