Nigeria’s outbreak grew from a single airport
case, while in the three other countries the
disease smoldered for months in remote rain-
forest provinces and spread widely before a
serious response was mounted.
Ebola, Dr. Frieden said, “won’t blow over — you
have to make a rapid, intense effort.”
While the danger in Nigeria is not over, the health
minister, Dr. Onyebuchi Chukwu, said in a
telephone interview that his country was now
better prepared, with six laboratories able to make
diagnoses and response teams and isolation
wards ready in every major state.
After the first patient — a dying Liberian-American
— flew into Lagos on July 20, Ebola spread to 20
other people there and in a smaller city, Port
Harcourt.
They have all now died or recovered, and the
cure rate — 60 percent — was unusually high for
an African outbreak.
Meanwhile, local health workers paid 18,500 face-
to-face visits to repeatedly take the temperatures
of nearly 900 people who had contact with them.
The last confirmed case was detected on Aug. 31,
and virtually all contacts have passed the 21-day
incubation period without falling ill.
The success was in part the result of an
emergency command center financed in 2012 by
the Bill & Melinda Gates Foundation to fight polio.
As soon as the outbreak began, it was turned into
the Ebola Emergency Operations Center.
Also, the C.D.C. had 10 experts in Nigeria working
on polio and H.I.V., who had already trained 100
local doctors in epidemiology; 40 of them were
immediately reassigned to Ebola and oversaw the
contact tracing.
The chief of the command center, Dr. Faisal
Shuaib, gave credit to a coordinated effort by the
Health Ministry, the C.D.C., the World Health
Organization, Unicef, Doctors Without Borders
and the International Committee for the Red
Cross.
Also, he noted, Nigeria has significant advantages
over poorer countries where the outbreak is out
of control.
It has many more doctors per capita, some
educated abroad at top medical schools.
Continue reading the main story
Continue reading the main story
It has standing teams of medical investigators,
with vehicles and telephones, who normally trace
outbreaks of other ills like cholera or Lassa fever.
Lagos University Teaching Hospital was able to
do Ebola tests in six hours.
The hospitals where patients were isolated were
equipped to do tests for electrolytes and blood
proteins, both of which must be kept in balance
as patients are fed orally or intravenously to
replace fluids lost to diarrhea and vomiting.
And air-conditioned hospitals let people wearing
protective gear work longer without overheating.
Nigeria also had some luck. Although the first
patient, a businessman named Patrick Sawyer,
was vomiting on his flight in, none of the roughly
200 others on the plane fell ill. Others did after
helping him into a taxi to a hospital.
And a patient in Port Harcourt went to her church
and became violently ill during a ceremony in
which the congregation laid hands on her. But
none became infected.
Dr. Sue Desmond-Hellmann, the Gates
Foundation’s chief executive, said she was
“heartened to see this positive result of the efforts
of so many in Nigeria.”
On July 17, Mr. Sawyer defied medical advice and
left a hospital in Monrovia, Liberia, where he was
being held for observation after caring for his
sister, who died of Ebola, although it was unclear
whether he knew what she had.
Nigerian news reports said he used Liberian
government contacts for permission to leave,
flying to Lagos by way of Ghana and Togo. He
planned to go to an economic development
conference there and then fly back to Coon
Rapids, Minn., for his children’s birthdays,
according to media interviews with his widow.
Taken to a small private hospital after he
collapsed, he denied any contact with Ebola
victims and was initially treated for malaria. He
died on July 25.
“That hospital had zero infection control,” Dr.
Frieden said.
A nurse who helped reinsert an IV line when Mr.
Sawyer was delirious and bleeding wore no
gloves, had a cut on her hand and did not wash
it, he said. She later died.
After malaria treatment failed, Ebola was “high on
the index of suspicion,” Dr. Shuaib said.
He learned about Mr. Sawyer’s diagnosis as he
sat chatting in his office with a colleague.
“I thought: ‘Oh, my God, not Nigeria. Not Lagos.’
I knew the potential for it to spread in a densely
populated place.”
Even though the emergency center swung into
action quickly and aggressive contact tracing was
possible because Nigeria’s Port Health Services
obtained records of Mr. Sawyer’s travel, there
were still problems.
It took 14 days, Dr. Frieden said, for the first
isolation ward to open in a former tuberculosis
ward.
“Health workers initially wouldn’t go in,” he said.
“They were afraid. We ultimately trained 1,800
staff.”
Wards were reconfigured to add space between
beds, put in washing stations with chlorinated
water and create rooms where doctors and
nurses could carefully don and remove protective
gear. The worked in teams of two so they could
watch each other and prevent mistakes.
Also, according to a C.D.C. study released
Tuesday in the Morbidity and Mortality Weekly
Report, inaccurate news media reports before the
government began offering official information
“created a nationwide scare.”
Sales of false cures, including “Blessed Salt,” shot
up, and two Nigerians died of drinking large
amounts of saltwater.
But Dr. Shuaib emphasized that even terrified
Nigerians did not deny the virus’s existence or
attack health workers, as happened in the other
countries. “No conspiracy theories entered the
debate,” he said.
Nigeria’s success shows how important
preparation is, said Dr. Frieden, adding, “Some
countries that could well be the next Lagos still
don’t have a clue about how to deal with this.”
Correction: September 30, 2014
Because of an editing error, an earlier version of
this article misstated the date the Ebola patient
Patrick Sawyer died. It was July 25, not Aug. 5.

SOURCE >> http://www.nytimes.com/2014/10/01/health/ebola-outbreak-in-nigeria-appears-to-be-over.html?partner=rss&emc=rss&smid=tw-nytimes&_r=0

Kk

Political new york times

So shall it be..Amen

Lesson - with sincere heart and concerted effort a nation will always succeed no matter the challenge.
Let's do same in 2015.

EagleNest: Lesson - with sincere heart and concerted effort a nation will always succeed no matter the challenge.
Let's do same in 2015.

word!