Another African country confirms Ebola case, becoming fifth affected by regional outbreak

Nigeria has become the fifth African country affected by the current regional Ebola outbreak after laboratory tests confirmed an imported case in the country’s capital, Abuja. The confirmation brings the outbreak to Africa’s most populous country widening the public-health and economic risks associated with a virus that has already crossed several national borders.

• Nigeria has confirmed an imported case of Ebola Bundibugyo virus disease in Abuja.
• The confirmation makes Nigeria the fifth country affected since the regional outbreak began in the DRC.
• Authorities have identified 44 contacts, while the patient remains isolated and under medical care.
• Investigators have not established where she contracted the virus, although she visited eastern DRC and travelled through Uganda.

The patient is a woman who arrived in Nigeria on 3 October and began showing symptoms four days later. She sought treatment at a private health facility in Abuja on 11 October.

Laboratory tests confirmed on 20 October that she had been infected with the Bundibugyo virus, the Ebola strain driving the outbreak that began in the Democratic Republic of Congo in May.

She has been isolated and is receiving medical care. Nigerian authorities have identified 44 contacts, including health workers, patients, caregivers and people who may have interacted with her during her journey.

The World Health Organisation⁠ said Nigeria’s Centre for Disease Control and Prevention had activated its incident-management system. WHO and other partners are supporting contact tracing, case investigation and infection-control measures at the private hospital where the patient was treated.

Where the patient contracted Ebola remains unclear

Initial reports linked the patient to Uganda because she arrived in Nigeria on a flight from the East African country. However, Ugandan authorities said she had only passed through Uganda after travelling to eastern DRC for business.

She reportedly had no symptoms while transiting through Uganda.

Uganda’s health ministry said travelling through the country did not establish that the infection occurred there. It added that Uganda had no active confirmed Ebola cases at the time of Nigeria’s announcement.

Investigators are reconstructing the woman’s movements and possible exposure to determine where she contracted the virus.

Uganda previously recorded 20 cases during the present outbreak. Fifteen were imported from DRC, while five were locally acquired among contacts and health workers. Eighteen patients recovered and two died before the outbreak in Uganda was declared over in August.

Kenya has reported nine cases linked to an imported infection involving a man who travelled from DRC. Its health ministry said the cases belong to one cluster and that there was no evidence of transmission outside the identified group.

WHO confirmed that Nigeria is the fifth country to detect the virus since the DRC declared the outbreak on 15 May. The organisation did not name all five affected countries in its Nigeria announcement.

Why the Nigerian case matters beyond public health

An Ebola case in Abuja could have consequences extending beyond Nigeria’s health system.

Nigeria has Africa’s largest population and one of the continent’s busiest domestic and international travel networks. Abuja is a major diplomatic and administrative centre, while Lagos serves as an important commercial and aviation hub.

A wider outbreak could affect passenger movement, business activity and investor confidence, particularly if governments or airlines introduce additional screening and travel requirements.

WHO has advised against imposing travel or trade restrictions on affected countries. It has instead urged governments to strengthen surveillance, laboratory capacity, infection control and monitoring at borders and other entry points.

The economic consequences will depend largely on whether Nigerian authorities contain the infection and prevent transmission beyond the identified contacts.

No approved vaccine specifically for this strain

The Bundibugyo virus is different from the Zaire Ebola strain targeted by existing approved vaccines and treatments.

WHO says there is currently no vaccine licensed specifically against Bundibugyo virus disease and no approved treatment targeting the strain.

Ervebo, the only licensed Ebola vaccine, was developed for the Zaire strain. There is insufficient evidence to establish whether it protects people from Bundibugyo, meaning it should only be used against the current strain within an approved research programme.

Patients primarily receive supportive care, including fluid replacement, symptom management and treatment to prevent complications. Early diagnosis and medical attention can improve their chances of survival.

Nigeria draws on its 2014 experience

Nigeria previously confronted Ebola in July 2014, when an infected traveller arrived in Lagos from Liberia.

The resulting outbreak produced 20 confirmed cases and eight deaths. Authorities contained the virus through rapid contact tracing, isolation, public communication and coordination between federal and state health agencies.

WHO declared Nigeria free of Ebola transmission on 20 October 2014, exactly 12 years before laboratory tests confirmed the new Abuja case.

Health Minister Muhammad Pate said Nigeria would draw on the systems and experience developed during the earlier emergency.

The immediate test is whether authorities can trace every person exposed to the patient, prevent infections among healthcare workers and stop the imported case from becoming a local outbreak.