Ebola Patients Target Healing Homes in Nigeria as Lagos Confirms Cremation

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Doctors taking care of Ebola Virus Disease in Sierra Leone
From right Director NCDC, Professor Nasidi, Commissioner for Health, Lagos State, Dr. Jide Idris and Special Adviser to the Governor on Health, Dr. Adesina
From right Director NCDC, Professor Nasidi, Commissioner for Health, Lagos State, Dr. Jide Idris and Special Adviser to the Governor on Health, Dr. Yewande Adesina

The private hospital was demobilized and primary source of infection eliminated. Decontamination process in all affected areas have commenced. The role of the Management of that hospital and their ability to detect a high risk patient within 24-hrs is commendable

July 28, 2014 – Nigerian Government on Monday confirmed that the Liberian, Mr. Patrick Sawyer who died in Lagos of Ebola Virus Disease(EVD) has been decontaminated and the body cremated.

At a press conference addressed by the Federal and Lagos State Government in Lagos, health officials said the ash is in the custody of government and that it will be given to the Liberian government when officials of Liberian government come for it.

“We have the ash after the cremation, it will be given to the Liberian government when they come for it”, Commissioner for Health, Lagos State, Dr. Jide Idris said at the press conference.

He said government has identified 59 contact persons including hospital contacts and airline contacts. He said the Sawyer flew into Nigeria aboard a Liberian airline KP50 and that none of the contact persons have developed symptoms of the EVD.

He said government has procured equipment which have been given to the hospital to assist the hospital. He thanked the hospital for promptly detecting the disease.

He said the patients arrived Nigeria on the 20th of July, fell in the plane and collapsed at the airport before he was taken to First Consultant Obalende, Lagos. He said the Lagos State Government was notified two days later and that he died two days after.

He said people do not contact the ailment by mere contact and that it takes two to 21 days for the disease to manifest itself.

Director Nigerian Centre for Disease Control (NCDC) Professor Abdusalami Nasidi said Nigerians should desist from eating bat as at this moment since bats are known to be carriers. He appealed healing homes to watch out for Ebola patients whom he said are now coming into Nigeria for healing.

See full text of the briefing

Doctors taking care of Ebola Virus Disease in Sierra Leone
Doctors taking care of Ebola Virus Disease in Sierra Leone

Press Briefing On Ebola Outbreak by Lagos State MOH and Federal Ministry of Health, Monday 27, 2014.
Protocols,
Ladies and Gentlemen of the press.

1. Brief background:
On the 20th July 2014, a 40 year old male Liberian arrived at the Murtala Muhammed International Airport Lagos from Monrovia via Lome on Asky Airline Flight No KP50, on his way to Calabar for the 8th ECOWAS Retreat of Heads of Offices meeting, as a senior ECOWAS official in Liberia. His plane was reported to have had a brief stop at Accra and Lome, and the aircraft was changed at Lome.

He was also reported to have fallen ill while on board and remained very ill on arrival at the airport in Lagos on Flight No: . He was then assisted by various airport and ECOWAS protocol staff to a private hospital named First Consultant Medical Centre, Obalende, and Lagos. An initial diagnosis of suspected Viral Haemorrhagic fever was made. He was admitted and investigations were carried and supportive treatment was commenced. The private hospital immediately notified the State Ministry of Health who also notified the Federal Ministry of Health. The patient however died at about 6.50am on the 25th July 2014.

2. Laboratory Investigation:
Preliminary laboratory investigation conducted by the NCDC AI virology laboratory of the Lagos University Teaching Hospital and the World-Bank Funded African Centre of Excellence for Genomics of Infectious Diseases (ACEGID) Redeemers’ University detected viral DNA and in both blood and urine samples obtained from the patient were positive for the Pan Filo virus analysis and Ebola Zaire MGB virus strain- specific analysis. Samples were also collected for further confirmation at the WHO Collaborating laboratory for Ebola in Dakar.
3. Interventions

Coordination
The NCDC/FMOH in collaboration with the Lagos State Ministry of Health and WHO eatablished an Incident Command Centre that coordinates the Rapid Response Team activities on the field. Five working groups were established, namely (i) Contact tracing, Surveillance & Laboratory (ii) Health education/Social mobilization (iii) Case management and infection prevention/control (iv) Logistics (v) Data management. An Emergency Operations centre was also activated at the conference room of Central Public Health Laboratory in Yaba, Lagos, which also serves as the secretariat. WHO provided technical support and action plan was developed. The Port Health Services of the FMOH, in collaboration with the Federal Ministry of Aviation have put in motion mechanisms to track down all contacts at high risk.

Outbreak investigation
The private hospital was demobilized and primary source of infection eliminated. Decontamination process in all affected areas have commenced. The role of the Management of that hospital and their ability to detect a high risk patient within 24-hrs is commendable.
Contact tracing

So far a total of 59 contacts have been registered consisting 44 Hospital contacts (38 Healthcare workers and 6 laboratory staff) and 15 Airport contacts comprising 3 ECOWAS staff-driver, Liaison, and Protocol officer, Nigerian Ambassador to Monrovia, 2 Nursing staff and 5 Airport passenger handlers.
As of the time of this report, 20 contacts had been physically screened of which 50% type 1 contact and 50% had had type 2 contact.

Airline manifest has not been provided by the airline at the time of this report and therefore the precise number of passenger contacts is yet to be ascertained, especially as two flights were involved (Monrovia-Lome and Lome-Lagos). There was no report of medical incident filed and the General Declaration report of the flight was Case management/Infection Prevention and control.

An isolation ward has been designated by the Lagos State Ministry of Health at the Infectious Disease Hospital, Yaba for case management. The designation of three other health facilities is underway.

A total of 100 PPEs were procured by the NCDC/FMOH and distributed to the private hospital and the State Ministry of health. WHO also donated 250 PPEs to the NCDC/FMOH.

Adhering strictly to WHO guidelines, the body of the deceased patient was decontaminated using 10% sodium hypochlorite and cremated, with the permission of the government of Liberia. A cremation urn has been prepared for dispatch to the family. The vehicle that conveyed the remains was also fully decontaminated.

Health Education
Two Press conferences were granted by the Lagos State commissioner of Health and by the Minister of Health and Minister of Information informing the public of the outbreak, creating awareness about the disease while allaying fears. They also enlightened the public on the preventive measures and advised early presentation to the nearest health facility in the event of the symptoms.

A call-in Team was established for the public to dial in and obtain information on the Ebola Virus Disease.

Toll-free lines were obtained from a telecommunication service provider to be used for answering questions, creating awareness, and receiving notifications of any suspected case.

Public awareness creation through social media such as Twitter and Facebook accounts was also activated.

Communication
The Director of NCDC/FMOH, the Honourable Commissioner of Health Lagos State and the Minister of Health were designated as the only authorized spoke-persons of the response activities.

WHO provided a template for daily SITREPS.
Community involvement
Recognizing the importance of involving the community early in the response, traditional and religious leaders were alerted about the disease and requested to report promptly to health care workers. The dissemination of IEC materials and sensitization meetings are ongoing.

7. Recommendations:
The Joint Federal and State Team on the basis of all experiences gathered from the response to this outbreak recommends the following
Mobilize funding for response activities, logistics and supplies
Train and orientate health staff on the Ebola outbreak response Standards

Operating Procedures
Supply laboratory diagnostic supplies or activate the mobile VHF laboratory
Provide adequate Personal Protective Equipment (PPE)
Organize psychosocial support and provide incentives to health personnel involved in Ebola outbreak response
Design key messages in the local language and intensify public enlightenment in the local languages
Involve the community in response activities

Conclusion:
We can categorically state that as of today we have only one case of imported Ebola and ond death. No Nigerian is infected, but all contacts are being actively followed.

We call on all Nigerians to be calm and not panic and do hereby assure them that both the State and Federal Governments and up in arms to ensure that the virus did not escape and that no Nigeria is infected with this virus.
We thank you

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