Tuesday 29 July 2014

Ebola: 59 persons under watch •Passengers who flew with dead victim to be screened •Hospital where victim died closed

2014-07-29 07.19.09

59 contacts with the dead Liberian, who was infected with Ebola Virus disease, had been identified and now under watch, while 20 had been physically screened.

This was disclosed at a joint ministerial press briefing of the Lagos State Ministry of Health and Federal Ministry of Health, in Lagos, on Monday.

At the briefing, addressed by the Lagos State Commissioner for Health, Dr Jide Idris, it was also affirmed that no Nigerian had been infected by the dreaded disease.

The airline that flew him to Nigeria, according to the state government, had, however, not yet provided the flight manifest.

The state government called for calm, assuring that its collaborative efforts with the Federal Government were enough to ensure that the disease did not spread.

Idris added that health authorities were being very pro-active about the detection of the Ebola virus in the Liberian who was on his way to Calabar, Cross River State, for a conference, by ensuring that all contacts were being actively followed.

He said part of the measures taken after the death of the Liberian was the demobilisation of the private hospital where he was admitted and elimination of primary source of infection, adding that the decontamination process in all affected areas had commenced.

He added that the corpse of the victim had since been cremated, and the ash awaiting further directives from the Liberian Embassy.

He commended the role of the management of the hospital and its ability to detect a high-risk patient within 24 hours.

“Adhering strictly to World Health Organisation (WHO) guidelines, the body of the deceased patient was decontaminated using 10 per cent 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,” he added.

In terms of contacts tracing, Dr Idris informed that so far, a total of 59 contacts were registered, consisting of 44 hospital contacts (38 healthcare workers and six laboratory staff) and 15 airport contacts, comprising three ECOWAS staff-driver, liaison and protocol officers, Nigerian Ambassador to Monrovia, two nursing staff and five airport passenger handlers. 

He explained that out of the number, 20 contacts had been physically screened, of which 50 per cent were of the type one contact and another 50 per cent, type two contacts, adding that the airline manifest had not been provided yet.

“The airline manifest has not been provided 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 a medical incident filed,” he said.

Dr Idris added that an isolation ward was designated by the Lagos State Ministry of Health at the Infectious Disease Hospital, Yaba, for case management, while the designation of three other health facilities was underway.

The commissioner added that a call-in team was established for the public to dial in and obtain information on the disease while toll-free lines were obtained from a telecommunications service provider to be used for answering questions, creating awareness, and receiving notifications of any suspected case.

He added that accounts in social media, such as Twitter and Facebook, were also activated for the purpose.

Idris stressed that in recognising the importance of involving the community early in the response, traditional and religious leaders had been alerted to the disease and requested to report promptly to health-care workers.

Special Adviser on Health, Dr (Mrs) Yewande Adeshina, also appealed to operators of traditional health care centres to be wary of patients with fever symptoms, who show signs of extreme weakness and diarrhea.

President of the Nigerian Academy of Science, Professor Oyewale Tomori, also at the briefing, said all the contact persons were being screened on a continuous basis, to look for any possible signs of the disease.

He commended the timely action taken by the Lagos State government and the private hospital, adding that there was absolutely no need for people to panic.

Others at the briefing were the Special Adviser to the Governor on Information and Strategy, Mr Lateef Raji; Permanent Secretary, Ministry of Health, Dr Modele Osunkiyesi; Permanent Secretary, Health Services Commission, Dr Hamid Balogun and the Permanent Secretary, Primary Health Care Board, Dr Kayode Oguntimehin.

NCAA suspends ASky Airline •Inbound passengers now for screening
Shola Adekola - Lagos

THE Nigerian Civil Aviation Authority (NCAA) has announced, with immediate effect, the suspension of the operations of the Togolese-based airline, ASky Airline, into Nigeria.

NCAA said the suspension was necessary, in order to prevent the spread of the Ebola virus into Nigeria, even as it stated that it also had the responsibility to protect Nigerians from the deadly disease.

Acting Director-General, NCAA, Mr Benedict Adeyileka, announced the suspension at the Aviation House, headquarters of the agency, at the Murtala Muhammed Airprot, Lagos, on Monday.

The regulatory body had also directed the Directorate of Air Transport Regulation (DATR) to write a letter of investigation to the airline.

NCAA further stated that it would write to other airlines operating into and out of Nigeria, to ensure they put in place all necessary preventive measures during screening of passengers, which would include indicating countries earlier visited by the passengers.

A source close to the agency said its management, on Monday afternoon, held a meeting with the management of the airline and informed it of plans to suspend its operations in Nigeria, a situation, which did not go down well with the airline.

ASky Airline is an important player in the West, East and Central Africa regions, operating 80 flights into Lagos and Abuja weekly.

The acting NCAA boss, in a statement, said it took the action since the representatives of the airline could not offer evidence or capacity to prevent recurrence.

Adeyileka said the International Civil Aviation Organisation (ICAO) had prescribed measures (Standard Practices) in Annex Nine to the Convention, which a state must take to prevent the spread of communicable disease in the event of an outbreak.

In the same vein, Arik Air, which had earlier suspended its flights to Monrovia and Freetown, had been advised to maintain the status quo until cleared by NCAA.

The authority said it would write to other airlines operating into and out of Nigeria to ensure they put in place necessary preventive measures during screening of passengers.

Hospital where victim died shut
Moyosore Solarin - Lagos

IN a bid to contain the possible spread of the Ebola virus disease in Nigeria, the World Health Organisation (WHO) and Federal Government have temporarily shut down the hospital that admitted the Liberian, who died from the deadly virus in Lagos. 

Minister of Health, Onyebuchi Chukwu, was reported to have said all other passengers aboard the plane with the deceased Patrick Sawyer were also undergoing tests.

Sources at the said hospital, First Consultants Medical Centre Limited, located at Ikoyi, also confirmed the closure.

According to reports, a statement by the Chief Consultant/Medical Director, Dr B. Ohiaeri and the Senior Consultant Physician and Endocrinologist, Dr A. Adadevoh, confirmed that the hospital was currently undergoing a decontamination process.

“In keeping with WHO guidelines, the hospital is shut down briefly, as full decontamination exercise is currently in progress. 

“The reopening of the hospital will also be in accordance with WHO guidelines,” the statement said.

Speaking on TV Continental in Lagos, on Monday, the state Commissioner for Health, Jide Idris, also revealed that some members of staff in close contact with the victim had also been isolated and being monitored.

“The hospital will be shut for a week and all staff monitored to ensure the virus has not spread,” he said.

Ebola: How to keep safe
By Paul Omorogbe

WHEN reports that Nigeria could experience an outbreak of Ebola virus were out, given the proximity of the country to Guinea and Liberia, where cases were earlier reported, not a few dismissed it with a wave of hand as mere conjecture. But recent events have shown the veracity of the virus.

Transmission

When an infection does occur in humans, there are several ways in which the virus can be transmitted to others. These include: direct contact with the blood or secretions of an infected person and exposure to objects (such as needles) that have been contaminated with infected secretions.

The viruses that cause Ebola high fever (HF) are often spread through families and friends, because they come in close contact with infectious secretions when caring for ill persons.

During outbreaks of Ebola HF, the disease can spread quickly within healthcare settings (such as a clinic or hospital). Exposure to Ebola viruses can occur in healthcare settings where members of hospital staff are not wearing appropriate protective equipment, such as masks, gowns, and gloves.

Proper cleaning and disposal of instruments such as needles and syringes is also important. If instruments are not disposable, they must be sterilised before being used again. Without adequate sterilisation of the instruments, virus transmission can continue and amplify an outbreak.

Signs and Symptoms

Symptoms of the disease include: fever, headache, joint and muscle aches, weakness, diarrhoea, vomiting, stomach pain and lack of appetite.

Some patients may experience rashes, red eyes, hiccups, cough, sore throat, chest pain, difficulty in breathing, difficulty in swallowing, bleeding inside and outside of the body.

Symptoms may appear anywhere from two to 21 days after exposure to the virus, though eight to 10 days is most common.

Some who become sick with Ebola HF are able to recover, while others do not. 

The reasons behind this are not yet fully understood. However, it is known that patients who die usually have not developed a significant immune response to the virus at the time of death.

Diagnosis

Diagnosing Ebola HF in an individual who has been infected for only a few days is difficult, because the early symptoms, such as red eyes and a skin rash, are non-specific to Ebola virus infection and are seen often in patients with more commonly occurring diseases.

However, if a person has the early symptoms of Ebola HF and there is reason to believe that Ebola HF should be considered, the patient should be isolated and public health professionals notified. Samples from the patient can then be collected and tested to confirm infection.

Prevention

Prevention of Ebola HF presents many challenges. Because it is still unknown how exactly people are infected, there are few established primary prevention measures.

When cases of the disease do appear, there is increased risk of transmission within health care settings. Therefore, health care workers must be able to recognise a case of Ebola HF and be ready to employ practical viral hemorrhagic fever isolation precautions or barrier nursing techniques. They should also have the capability to request diagnostic tests or prepare samples for shipping and testing elsewhere.

Barrier nursing techniques include: wearing of protective clothing (such as masks, gloves, gowns and goggles); the use of infection-control measures (such as complete equipment sterilisation and routine use of disinfectant) and isolation of Ebola HF patients from contact with unprotected persons.

The aim of all of these techniques is to avoid contact with the blood or secretions of an infected patient. If a patient with Ebola HF dies, it is equally important that direct contact with the body of the deceased patient be prevented.

Treatment

Timely treatment of Ebola HF is important but challenging, since the disease is difficult to diagnose clinically in the early stages of infection. Because early symptoms such as headache and fever are non-specific to Ebola viruses, cases of Ebola HF may be initially misdiagnosed.

However, if a person has the early symptoms of Ebola HF and there is reason to believe that Ebola HF should be considered, the patient should be isolated and public health professionals notified

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