The Nigeria Centre for Disease Control and Prevention has said the woman who tested positive for Ebola arrived in Nigeria on October 5, developed symptoms two days later and presented at a private health facility in the Federal Capital Territory on October 11.
The Incident Manager of the National Ebola Disease Response, Dr Odianosen Ehiakhamen, disclosed this during an interview on Arise TV on Tuesday.
He explained that the patient was initially treated for malaria-like symptoms before her travel history to Uganda raised suspicion among the attending doctors.
The Federal Government had on Tuesday confirmed Nigeria’s first imported case of Ebola virus disease in the Federal Capital Territory after a woman who recently travelled from Uganda tested positive for the infection.
The Minister of Health and Social Welfare, Prof Ali Pate, said 44 contacts had been identified for monitoring, including healthcare workers, patients, caregivers and people who might have travelled with the woman.
The patient was isolated and receiving medical care, while health authorities intensified contact tracing to prevent further transmission.
Ehiakhamen, who is also an Assistant Director at the NCDC, said the hospital alerted the agency on Tuesday after the patient failed to improve, leading to the collection of samples for laboratory testing.
“The patient arrived in the country on the 5th of October and experienced the first set of symptoms on the 7th, and then presented at that facility on the 11th. And so has been in that facility on the 11th.
“The reason you would have maybe so much of colleagues at the national involved in this response, especially with the FCT, is because, of course, our domain is in the FCT,” he said.
He explained that the attending doctors became suspicious when the patient did not respond to treatment and decided to obtain a more detailed medical history, which revealed her travel history to Uganda.
“The honourable minister has just highlighted, presented on the 11th to a private health facility and was managed for malaria-like symptoms.
“And just until yesterday, 4pm, they reached out to our event-based system and called, and that was how we were able to link up with our colleagues from the FCT, and then immediately moved to the centre to ensure that the sample was collected,” Ehiakhamen said.
He praised the FCT health authorities for their prompt response, saying the team provided a case investigation form and obtained information from the attending physician.
He added that the samples were sent to the laboratory by 9pm on Tuesday, with preliminary results available the following morning.
The team, however, requested repeat tests before the findings were communicated to the NCDC Director-General and the Minister of Health.
“By 9pm, the sample was already on its way to the lab. In fact, we had difficulties in collecting samples; you required colleagues to carry out a venous cutdown to be able to even get samples that were sent to the lab. And by this morning, we already had preliminary results, but we wanted repeats,” he said.
Ehiakhamen said the 44 contacts identified in connection with the case were mainly healthcare workers and support staff at the hospital where the patient was treated.
“For the 44 contacts, they are majorly healthcare workers and support staff of the hospital, because everything has happened within the hospital,” he said.
He said Nigeria had begun preparations for a possible Ebola outbreak months before the confirmed case, following developments involving the disease in other countries.
Ehiakhamen disclosed that the country activated an Incident Management System preparedness structure on May 15 and conducted a risk assessment to determine the level of readiness required to respond to a possible outbreak.
He said the preparedness measures covered surveillance, response capacity, available personnel, infection prevention and control, medical countermeasures and training. About eight key high-risk zones were also assessed.
“Of course, I talked about a risk assessment that we had conducted in May. It tended towards moderate risk, but to have a heightened preparedness, we had to go for a high risk. And, of course, that initiated an alert for us,” he said.
The incident manager said the country had also developed case definitions and shared them with health facilities to improve the identification and reporting of suspected cases.
He added that Nigeria was drawing on the experience of health workers who participated in the 2014 Ebola response, as well as personnel trained through the National Field Epidemiology Training Programme and World Health Organisation-supported surge training workshops.
“Because Nigeria had experienced this same situation in 2014, it was important for us to identify colleagues who responded and were still in the country because they are actually going to be our focal persons.
“We have the National Field Epidemiology Training Programme, that we have a rich workforce. The WHO also has been able to conduct surge training workshops. And so, we have a huge workforce to be able to respond around the country,” he said.
Ehiakhamen said the presence of several national response officials in the FCT was linked to the location of the confirmed case, adding that other states had personnel capable of supporting outbreak responses.
He also said the NCDC had investigated several suspected Ebola cases in the past, many of which tested negative after samples were collected and analysed.
“And this is not our first scare; we’ve had very many scares that we had to travel to go take those samples, that always came out negative. And that was how this situation was.
“It was a signal that, you know, and we thought that it was important for us to have those samples collected and then see exactly what it is,” he said.
He added that the agency was monitoring the time taken to respond to alerts, collect samples and conduct laboratory tests, with the aim of improving turnaround times across its network of laboratories.
“We hope that we are able to replicate this everywhere in all the PCR labs that have been identified that are actually in our network. We’re already using those labs, especially for Lassa, diphtheria, and other outbreaks,” Ehiakhamen said.