How Nigeria Handled theEbola Crisis.

Dr. Jíwit Manuel Concepción Concepción.

Xemide Director.

Introduction

• Since the begining of Ebola Break out many information surrounded the web.

• Many of this information we thought it was misguided because was focusing in the last breed of Ebola.

• We presently do not know if it could be an airborne desease or not, or if it has mutated from previous forms.

• What we are certain is that the letal rate is over 90%.

• Have we understimated Ebola in Europe, is it necessary a militar or a joint public health and emergencysystems reponse???

• We have many doubts, i hope following the one certain country that has controlled the disease NIGERIA could guide correct process on handling this outbreak before it goes pandemic…

Information history at thebegining of the break out.

Confirmed Cases Still 10, 4 Now Dead, No Ebola in Enugu, all Cases Confined to Lagos

• Nigeria has now recorded ten (10) confirmed cases of Ebola Virus Disease (EVD). Out of these, four (4) have died and six (6) are currently under treatment. (It is important to note that the number of confirmed cases remains ten (10) as at today and not eleven (11) as earlier announced this morning. We regret the error which arose from double counting in the process of communicating the additional death from the operational centre in Lagos to the Federal Ministry of Health). The fourth death recorded today was a Nigerian nurse who participated in the initial management of the index case.• http://www.health.gov.ng/index.php/news-media/press-releases/9-

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Four Additional Ebola Patients Discharged Home• The Minister of Health Prof. Onyebuchi Chukwu has announced that

four additional confirmed cases of Ebola Virus Disease who have been managed successfully and are now disease free have been discharged home today. It includes two male medical doctors and one female nurse. The three participated in the treatment of the index case while the fourth person was a female patient at the time the index was on admission. This brings to five the total number of patients diagnosed with Ebola Virus Disease who have now been discharged from hospital.• http://www.health.gov.ng/index.php/news-media/press-releases/9-

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5th death of Ebola Virus DiseasePRESS STATEMENT 19th August 2014• The Honourable Minister of Health, Prof. Onyebuchi Chukwu regrets

to announce the death, this evening, of one of the primary contacts of the index Ebola Virus Disease case, the most senior doctor who participated in the management of the patient, a female consultant physician. With this unfortunate development the total number of Ebola Virus related deaths in Nigeria now stands at five. The other two patients currently under treatment in the isolation wards are stable and are being taken care of.• http://www.health.gov.ng/index.php/news-media/press-releases/9-

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STATUS UPDATE: No New Confirmed Case of Ebola Virus Disease in Nigeria• The Honourable Minister of Health Prof. Onyebuchi Chukwu wishes to

reiterate that at present, Nigeria has only two confirmed cases of Ebola Virus Disease.

• This clarification follows media reports of five new cases in Lagos State. This report should be disregarded.

• The minister reiterates that any doubtful information on the outbreak of Ebola Virus Disease in Nigeria should be verified from the Office of the Honourable Minister of Health who has the sole authority to announce confirmed cases as far as disease epidemics in Nigeria are concerned.• http://www.health.gov.ng/index.php/news-media/press-releases/9-

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Status Update on Ebola Virus Disease in Nigeria as at 22nd August 2014• Nigeria has now recorded the first two (2) cases of Ebola Virus Disease in

secondary contacts of the index case, the Liberian-American.• The two patients are spouses of primary contacts of the Liberian-

American. They are among the secondary contacts who have been under surveillance.

• This now brings to four (4) the total number of Ebola Virus Disease patients currently under treatment at the isolation ward.

• This also means that the total number of cases of Ebola Virus Disease so far reported in the country is fourteen (14). The number of deaths still remains five (5), while the number of those successfully managed and discharged also stands at five (5).• http://www.health.gov.ng/index.php/news-media/press-releases/9-

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Minister of Health releases updated EVD status of Nigeria, gives details of FG's containment efforts• FEDERAL REPUBLIC OF NIGERIA STATEMENT OF THE HONOURABLE MINISTER OF

HEALTH, PROFESSOR C.O. ONYEBUCHI CHUKWU AT THE 2ND EMERGENCY NATIONAL COUNCIL ON HEALTH MEETING ON EBOLA VIRUS DISEASE OUTBREAK IN NIGERIA AT THE BACELONA HOTEL, WUSE II, ABUJA 1ST SEPTEMBER, 2014

• Protocol.

• I welcome all members of the National Council on Health to our 2nd Emergency meeting on Ebola Virus Disease (EVD), which although we are making significant progress in curtailing its spread, still remains a National Health Emergency and an International Public Health Emergency by the World Health Organisation (WHO).

• http://www.health.gov.ng/index.php/news-media/press-releases/9-uncategorised/193-minister-of-health-releases-updated-evd-status-of-nigeria-gives-details-of-fg-s-containment-efforts

Updated Summary of EVD Status of Nigeria, by Minister of Health as at Sept. 1 2014• Minister of Health Prof. Onyebuchi Chukwu makes correction/clarification in his opening speech at the Emergency National

Council on Health Meeting at the Barcelona Hotel, Abuja, today

•

• · Total number of confirmed EVD cases in Nigeria = 17 ( including the index case).

• · Total number managed in Lagos= 14.

• · Number successfully managed in Lagos and discharged= 7

• · Number of deaths in Lagos = 5

• · Number presently on treatment in isolation in Lagos = 2

• · Number of death in Port Harcourt (did not benefit from standard management) = 1( a doctor who treated a secondary contact of Sawyer's)

• · Number of patients under treatment in PH = 1

• · Number of patient that was 'treated' in PH (no stand treatment) and fully recovered = 1

• Total number of survivors in Nigeria(as of today) =11;

• · Total number of deaths in Nigeria (as of today) = 6.

• http://www.health.gov.ng/index.php/news-media/press-releases/9-uncategorised/194-updated-summary-of-evd-status-of-nigeria-by-minister-of-health-as-at-sept-1-2014

Status of Ebola Virus Disease in Nigeria Monday, 8th September, 2014

• PRESS BRIEFING BY THE MINISTER OF HEALTH, PROF. C. O. ONYEBUCHI CHUKWU

• STATUS OF EBOLA VIRUS DISEASE IN NIGERIA

• MONDAY, 8TH SEPTEMBER, 2014

•

• It has been 50 days since Ebola Virus Disease was imported into Nigeria through Lagos, and 38 days since it was introduced into Port Harcourt.

• So far, all the cases that have been confirmed in Nigeria are traceable to the index case, the Liberian-American, Mr. Patrick Sawyer.

• As of this morning the total number of confirmed cases of EVD in Nigeria is nineteen (19), fifteen (15) in Lagos, four (4) in Port Harcourt.

• The 19th case is the fiancé of one of the primary contacts of Mr. Sawyer’s who died of the disease. The test results were equivocal but further tests established the disease. He had only mild symptoms and he has since recovered from the illness. He was quarantined but because of the equivocal test result he was not placed on active treatment.

• http://www.health.gov.ng/index.php/news-media/press-releases/9-uncategorised/197-status-of-ebola-virus-disease-in-nigeria-monday-8th-september-2014

Update on status of Ebola Virus Disease in Nigeria Wednesday, 17th September 2014• For one week now, there has not been a single case of Ebola Virus Disease in Nigeria. The

total number of confirmed EVD cases recorded in Nigeria remains 19, with 7 deaths. The South African woman who was taken from the Murtala Muhammed International Airport in Lagos and quarantined on suspicion of EVD tested negative for EVD and other viral haemorrhagic fevers and has since been discharged from quarantine and has left the country. Also, a suspected case reported by NLNG tested negative for EVD.

• A number of contacts are still under surveillance in Nigeria, 4 in Lagos State and 344 in Rivers State. So far, 347 contacts have been discharged from surveillance in Lagos State while 182 contacts have been discharged from surveillance in Rivers State.

• http://www.health.gov.ng/index.php/news-media/press-releases/9-uncategorised/198-update-on-status-of-ebola-virus-disease-in-nigeria-wednesday-17th-september-2014

Preventive public information

• IEC Materials

• Prevention

• What is Ebola Virus Disease?

• How is Ebola Virus Disease spread?

• What is Viral Haemorrhagic Fever (VHF)s?

IEC MATERIALs

PreventionHOW CAN THE PUBLIC PREVENT THE SPREAD OF EBOLA VIRUS DISEASE WITHIN THE COMMUNITY?• Ebola Virus Disease is an infectious disease affecting humans and

animals such as monkeys, gorillas, Chimpanzees, bats, antelopes, etc. Ebola virus disease is transmitted to a person when he/she comes in contact with the blood or secretions of an infected animal or human (dead or alive).

• Ebola Virus Disease is a virulent killer, there are no specific treatments or vaccine for Ebola virus disease and it occurs in sporadic outbreak. It takes between 2 to 21 days after exposure to the virus for someone to feel sick and show the signs and symptoms of Ebola Virus Disease.• http://www.health.gov.ng/ebolainfo/index.php/prevention

What is Ebola Virus Disease?• Where is Ebola Virus Disease found?

• Though the natural habitat of the Ebola virus is unknown, Ebola virus is normally found in an animal host that is native to the African continent.

Where do cases of Ebola Virus Disease occur?

• Outbreaks of Ebola VD have been mainly restricted to Africa. Confirmed cases of Ebola VD have been reported in the Democratic Republic of the Congo, Gabon, Sudan, the Ivory Coast, Uganda and the Republic of the Congo. Ebola VD is usually spread within a health care setting. However, sporadic isolated cases may occur unnoticed.

How is Ebola Virus Disease spread?

• The manner in which the Ebola virus first appears in a human at the start of an outbreak has not been determined. However, Ebola VD could be spread through the following:

• 1. Direct contact with an infected animal or human;

• 2. Direct contact with the blood and or secretions of an infected person especially within families;

• 3. Contact with contaminated medical equipment such as needles;

• 4. Reuse of unsterilized needles in hospital;

• 5. Eating or handling of the carcass of infected animals;

• 6. Inhalation of contaminated air in hospital environment;

• 7. Use of infected non human primate/bats as food source;

• 8. Non implementation of universal precautions.• http://www.health.gov.ng/ebolainfo/index.php/2-uncategorised/4-a-article

How is Ebola Virus Disease spread?

These animals and many more . . . .

The manner in which the Ebola virus first appears in a human at the start of an outbreak has not been determined. However, Ebola VD could be spread through the following:1. Direct contact with an infected animal or human;

2. Direct contact with the blood and or secretions of an infected person especially within families;

3. Contact with contaminated medical equipment such as needles;

4. Reuse of unsterilized needles in hospital;

5. Eating or handling of the carcass of infected animals;

6. Inhalation of contaminated air in hospital environment;

7. Use of infected non human primate/bats as food source;

8. Non implementation of universal precautions.

What is Viral Haemorrhagic Fever (VHF)s?

• Viral Haemorrhagic Fevers (VHFs) refer to a group of illnesses that are caused by viruses that cause haemorrhage. These diseases which are severe and life threatening include Lassa fever, Ebola virus disease, Dengue haemorrhagic fever, Marburg, Yellow fever among others.

Conclussion

• As we said before the most accurate guide to control Ebola right now is the methods Nigeria HealthDepartment is undertaking.

• I have not read in any other Europe or USA American publication of airborne Ebola, But Nigeria does not rule out an airborne posibility.

• We believe that a strong country fast response and correct and proper information could lead to properhandle of the pandemic.

• We are going to keep this as an ongoing story for development of the crisis.

• All the info i gather is from Nigeria Basic Health home page.

• I dont know Prof. Onyebuchi Chukwu but we congratulate you from far for this great response and saving many human life and your own citizens.