What can Nigeria?s Ebola experience teach the world?

[AlaskaDenise]

What can Nigeria?s Ebola experience teach the world?

My country made mistakes during its outbreak and it is crucial that others learn from this when devising emergency plans

.....world leaders and public health specialists are desperately scrambling to control the west African outbreak. One of the few bright spots is the success of Nigeria in controlling the disease, which could have spiralled out of control in Africa?s most populous country.

......Nigeria had a head start over other west African countries. As one of the last countries to still be polio-endemic, Nigeria has been waging a war against the disease. A strong polio surveillance system backed by an emergency command centre, which was built in 2012 by the Bill & Melinda Gates Foundation, has ensured agency coordination so that polio outbreaks can be identified quickly and stopped. A cadre of 100 Nigerian doctors trained in epidemiology by international experts, who have helped end polio in countries such as India, makes up the backbone of the rapid disease response team.

.....Once that diagnosis had been made, Nigeria mimicked its own polio response and an Ebola emergency operation centre in Lagos was set up. From the polio response team, 40 of the Nigerian doctors trained in epidemiology were reassigned. This centralised hub coordinated the Nigerian health ministry, the World Health Organisation, Unicef, the US Centers for Disease Control and Prevention, M?decins sans Fronti?res and the International Committee of the Red Cross.

.....Nigeria?s health system is fragile but the country is lucky to have a comparatively high number of specially trained health workers and a polio surveillance system, which helped prevent an exponential spread.

[Dani]

Re: What can Nigeria?s Ebola experience teach the world?

I think Nigeria did extraordinarily well, especially given the extreme behavior of the index patient, and the slight delay in diagnosis. However, I'd also have to say that either mistakes were made or there's something about transmission that we don't understand given the fact that there were secondary cases from monitored primary contacts.

As far as I can tell, there were three secondary contacts who were infected. I don't understand how this can happen, given that the primary contacts were all under surveillance at the time they became ill (they were not from the Port Harcourt cluster), and the disease is not spread until one becomes symptomatic. I've not read an explanation for how this occurred.

Either there was some break in the protocol, or Ebola can be transmitted before one becomes symptomatic, but I've not seen it discussed. If there were secondary contacts becoming infected in the US, it would be seen as a failure or raise an alarm regarding transmission. So far, neither of these things have happened in relation to the Lagos cluster of cases.

[JJackson]

Re: What can Nigeria?s Ebola experience teach the world?

The other lesson learnt was just how costly, in terms of man hours expended, it was to contain the transmission chain seed by two individuals. Now all we have to do is repeat it 10,000 times.

[AlaskaDenise]

Re: What can Nigeria?s Ebola experience teach the world?

The other lesson learnt was just how costly, in terms of man hours expended, it was to contain the transmission chain seed by two individuals. Now all we have to do is repeat it 10,000 times.

Right - and all during a time where budgets for healthcare are shrinking. It's all about doing more with less. Stopping highly virulent communicable diseases should be the exception, but how much of a trained, practiced legion of workers can be mustered STAT?

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