Ebola could ‘spread faster’ in PH, WHO warns

The incidence of Ebola in Port Harcourt, Rivers State, could “grow larger and spread faster” than what has been witnessed in Lagos, the World Health Organisation (WHO) has warned.

The UN agency put down its fears to “multiple high-risk exposure opportunities” arising from the manner of the outbreak of the disease in Nigeria’s oil capital, unlike the pattern with Lagos when the index case, Patrick Sawyer, was originally the sole risk.

Ebola broke out in Port Harcourt after someone who had close contact with Sawyer abandoned his quarantine in Lagos to seek treatment in the south-southern city.

Although he was treated from August 1 to 3 August at a Port Harcourt hotel by what would turn out to be the city’s index case, the male physician subsequently developed symptoms of weakness and fever on August 11 and died of Ebola on August 22.

His infection was confirmed on August 27 by the virology laboratory at Lagos University Teaching Hospital. The male physician in Port Harcourt is therefore indirectly linked to Nigeria’s first case.

“The case history of the index case in Port Harcourt is important, as it reveals multiple high-risk opportunities for transmission of the virus to others,” WHO said in a statement on its site.

After onset of symptoms on August 11 and until August 13, the physician continued to treat patients at his private clinic and operated on at least two. On August 13, his symptoms worsened and he stayed back at home. He was eventually hospitalised on August 16.

“Prior to hospitalisation, the physician had numerous contacts with the community, as relatives and friends visited his home to celebrate the birth of a baby,” WHO noted.

“Once hospitalised, he again had numerous contacts with the community, as members of his church visited to perform a healing ritual said to involve the laying on of hands. During his six-day period of hospitalisation, he was attended to by the majority of the hospital’s health care staff.

“On August 21, he was taken to an ultrasound clinic, where two physicians performed an abdominal scan. He died the next day.

“The additional two confirmed cases are his wife, also a doctor, and a patient at the same hospital where he was treated. Additional staff at the hospital are undergoing tests.

“Given these multiple high-risk exposure opportunities, the outbreak of Ebola virus disease in Port Harcourt has the potential to grow larger and spread faster than the one in Lagos.”

Who confirmed that its epidemiologists are collaborating with Nigerian health workers to monitor more than 200 contacts, 60 of whom are considered to have had “high-risk or very high-risk” exposure.

“The highest-risk exposures occurred in family members and in health care workers and patients at the facility where the index case was hospitalised,” it said.

“Church members who visited the index case while he was hospitalised are also considered at high risk.”

However, it assured the public that efforts to contain loss of lives were already afoot, as the government, supported by WHO, UNICEF, and MSF (Doctors without Borders), has introduced a number of emergency measures, while more will be introduced this week.

An Ebola Emergency Operations Centre has been activated, with support from the US Centres for Disease Control and Prevention. A mobile laboratory, with RT-PCR diagnostic capacity, is also set up and functional.

“A 26-bed isolation facility for the management of Ebola cases is in place, with plans for possible expansion,” it added.

“Fifteen WHO technical experts are on the ground, while 21 contact-tracing teams are at work. Two decontamination teams are equipped and operational, as is a burial team.

“Social mobilisation efforts have been stepped up, initially targeting key community and religious leaders.”

But it warned that civil unrest, security issues, and public fear of Ebola create serious problems that could hamper response operations, while military escorts are needed for movements into the isolation and treatment centre.