WHO Declares Nigeria and Senegal Ebola-Free

With six weeks of no new Ebola cases, on Monday officials at the World Health Organization (WHO) declared Nigeria officially free of Ebola, just three days after officials declared Senegal Ebola-free. While it is a containment victory in an outbreak that continues to rage in three West African countries, both states are not immune from another outbreak however their methods of containment may be used in future outbreaks.

Nigeria

On Monday, officials at the WHO declared Nigeria Ebola-free after six weeks of no new reported cases. For officials to declare the country Ebola-free, Nigeria had to make it 42 days with no new cases, effectively double the incubation period, verify that it actively sought out all possible contacts, and show negative test results for any remaining suspected cases.

Nigeria had a total of twenty cases after a Liberian-American man, Patrick Sawyer, flew into Lagos international airport on July 20 and collapsed shortly afterwards. As Nigeria had no previous screening procedures in place, the deadly virus ultimately killed eight people, a low number in comparison to the thousands of cases and deaths in other countries, with the disease spreading from Lagos to Port Harcourt before it was contained. Amongst those who died was Dr Ameyo Stella Adadevo, who diagnosed Mr Sawyer and who is credited with helping to contain the outbreak at its source. The last reported case in Nigeria, which is Africa’s most populous country, was discovered on 5 September.

Speaking to reporters shortly after the declaration, Nigerian Minister of Health Onyebuchi Chukwu disclosed “its possible to control Ebola. Its possible to defeat Ebola. We’ve seen it here in Nigeria,” adding “if any cases emerge in the future, it will be considered – by international standards – a separate outbreak. If that happens, Nigeria will be ready and able to confront it exactly as we have done with this outbreak.”

Nigeria has won praise for its swift response to the outbreak. With the epidemic raging in Western Africa since March, officials knew that there was a likelihood that a case of Ebola could surface within its borders. This prompted officials to train health care workers on how to manage the disease and to disseminate information across the country about the disease and how it spreads. Shortly after Mr Sawyer’s death, the Nigerian government declared a national public health emergency. This effectively enabled the Ministry of Health to set up its Ebola Emergency Operations Centre (EOC), which is an assembly of public health experts within Nigeria, and which includes officials from the WHO, Centres for Disease Control (CDC) and medical aid groups such as Doctors Without Borders. The EOC was tasked with contact tracing, implementing strict procedures for handling and treating patients, screening all individuals arriving or departing the country by land, air and sea and communicating with the community. Some EOC workers were involved in going door-to-door to offer Ebola-related education while others worked with religious and professional leaders to spread information about the disease. While in the beginning, there had been some misinformation about available cures and rumours circulating across the country, Nigerian officials used social media in order to increase awareness efforts and publicized those patients who had been successfully treated and discharged from hospital. While other regional countries opted to close their borders with those affected countries, Nigeria chose to keep its borders open with Guinea, Liberia and Sierra Leone, indicating that such a move would have been counterproductive. According to Dr Faisal Shuaib of the EOC, “closing borders tends to reinforce panic and the notion of helplessness….When you close the legal points of entry, then you potentially drive people to use illegal passages, thus compounding the problem,” adding that if “public health strategies are implemented, outbreaks can be controlled, and that closing borders would only stifle commercial activities in the countries where economies are already struggling due to Ebola.”

Despite being declared Ebola-free, Nigerian authorities are preparing for any additional outbreaks as the current Ebola epidemic in West Africa is far from over and a spread to additional countries, including Nigeria and Senegal, remains possible. Nigeria has not slowed down its training and preparations for the possibility of more cases, with Dr Shuaib disclosing “outbreak response preparedness is a continuous process that requires constant review of the level of the response mechanisms in place to ensure that the health system is ready to jump into action at all levels.” 

Senegal

On Friday, the WHO declared Senegal, which borders with Guinea, clear of the disease. The agency made the assessment after the West African country went forty-two days, without reporting any new cases. The WHO has commended the Senegalese government’s efforts at preventing the spread of the virus. In late August, Senegal had one confirmed case of Ebola, an imported one from Guinea, which prompted officials to monitor seventy-four contacts of the patient and increase surveillance at the country’s entry points.

In new figures released by the UN health Agency Friday, 4,555 people have died of confirmed, suspected or probable cases of Ebola, with almost all of the deaths occurring in Guinea, Liberia and Sierra Leone. A total of 9,216 cases have been reported. An estimated 70% of those infected with the deadly disease have died in those countries. The situation in all three West African countries has continued to worsen, with deaths attributed to the disease on the rise in all three.