In late July this year, the international airport in the bustling Nigerian metropolis of Lagos received an extremely unwelcome visitor. A man from Liberia, a West African nation where Ebola is rampant, had been caring for his sister when she came down with the disease. Refusing to stay in quarantine, he had taken a flight out of the country and brought the deadly virus to Africa’s largest city, a major air, sea and land hub in the region. In Lagos, with a population size similar to that of Mumbai and a large slum population, there was the frightening possibility of the virus spiralling out of control.
The city’s ‘dense population and overburdened infrastructure create an environment where diseases can be easily transmitted and transmission sustained’, commented a journal paper on the outbreak that ensued. The potential for a dangerous conflagration increased when a close contact of the Liberian man secretly slipped out of quarantine and went off to seek medical treatment in Port Harcourt, Nigeria’s oil hub. The doctor who treated him died of Ebola later and was found to have had an alarming number of high-risk contacts with various people. Yet, thanks to the rapidity with which the Nigerian government acted, the virus has been snuffed out. ‘Nigeria is now free of Ebola virus transmission’, the World Health Organization declared categorically on October 20.
Nigeria’s resounding success comes as a useful antidote to the fear evoked by the desperate situation in the West African countries of Guinea, Liberia and Sierra Leone where Ebola is still out of control. Africa’s most populous nation has now shown that even when a traveller brings the disease in, developing countries can, with quick and decisive steps, stamp out the virus. As has been demonstrated in Ebola outbreaks that occurred in earlier years, the key lies in swiftly identifying and isolating infected persons, tracking down all their close contacts and meticulously monitoring those individuals for signs of infection.
Nigeria utilised trained personnel, technology and management methods put in place to control polio outbreaks, to trace contacts and look for Ebola cases. Altogether, nearly 900 contacts were located. It is worth noting that ultimately the country reported only 19 confirmed cases, many of the victims were healthcare workers, several of whom acquired the virus from the Liberian man before he was diagnosed with Ebola. Seven of the confirmed cases died, giving the Nigerian outbreak a case fatality rate of 40 per cent, substantially lower than the 70 per cent estimated for the ongoing outbreaks in Guinea, Liberia and Sierra Leone. Other nations, including India, must learn from Nigeria’s achievement.