6 August 2014

Nigeria: Ebola - Lagos Traces Persons Who Made Contact With Infected Doctor

Photo: Samaritans Purse
An Ebola patient in the isolation ward (file photo).

The Lagos State Government has started compiling a comprehensive list of all persons who may have had contact with the female doctor infected with Ebola Virus Disease (EVD).

The doctor contracted the disease from the Liberian national, Mr. Patrick Sawyer, when she battled to save his life at the First Consultants Medical Centre, a Lagos-based hospital, before his death two weeks ago.

The state government has also affirmed that the doctor afflicted with the virus is still alive, insisting that the mode of transmission of the disease is through direct contact with broken skin, contaminated materials, secretions and the consumption of certain animals, locally termed "bush meat."

This is just as panic over the spread of the virus has continued to grow nationwide, which was worsened by the fact that there was no official statement on the laboratory results of seven other persons who had been quarantined alongside the female doctor, after they had had contact with the Liberian who died at First Consultants.

However, THISDAY learnt that two of the nurses from First Consultants who were quarantined with the others, were already exhibiting signs of the Ebola virus, raising fears among authorities of its spread to others they may have come in contact with.

Speaking at a press briefing yesterday in Lagos, the state Commissioner for Health, Dr. Jide Idris, said the contact tracing was part of measures to contain the spread of the dreaded virus.

Idris, who addressed the conference alongside his Special Duties counterpart, Dr. Wale Ahmed, urged members of the public to be vigilant and careful in relating with people who are facing health challenges.

He explained that contact tracing "is essential and very important to stop the spread of the deadly virus. In the case of the newly infected person, we have contacted her family and have opened a comprehensive list of both primary and secondary contacts of the infected person.

"There is no panic as long as basic precautionary measures such as hand washing, adoption of appropriate waste management and enhanced personal/environmental hygiene are adhered to. This is a call for everyone to be vigilant, especially with regard to relating with people who are ill."

The commissioner appealed to health workers to reconsider their decision to continue with the ongoing strike, saying it would be more difficult "to control the spread of the disease if indigenous health workers shy away from helping suspected and infected cases".

He expressed appreciation for the role health workers had played in "the course of contact tracing, case management and decontamination. The challenge is a clarion call for all volunteer health workers including doctors, nurses, environmental health workers and Phlebotomists to complement our workforce.

"I appeal to striking doctors and other health workers to sheathe their swords and embrace team work. We also count on the cooperation of the good people of the state, which the federal government may need in the course of taking decisions in the overriding interest of the public".

He said the dreaded virus could only be transmitted through direct contact with the body fluids of an infected person, adding that until an infected person "becomes seriously sick with the virus, the carrier is not infectious".

"We need to again highlight the mode of transmission of the virus. Once a person is infected, the virus is transmissible through direct contact with broken skin, mucous membrane and secretions of an infected person or through direct contact with materials and surfaces that have been contaminated by the infected person.

"This is a call for vigilance as human-to-human transmission is only achieved by physical contact with a person who is acutely and gravely ill from the Ebola virus through body fluids such as urine, stool, saliva, breast milk and semen," he stressed.

The commissioner added that in Africa, infection had also occurred through the handling of infected chimpanzees, monkeys, guerillas, fruit bats, antelopes and porcupines, noting that there had been no case of transmission by domestic animals such as pigs.

Idris also confirmed that the female medical doctor who attended to the index case of Ebola at First Consultants was the only confirmed case to date out of the eight primary contacts under clinical surveillance and care.

"Her being infected is largely due to the fact that she was a primary contact when the index case presented. At that point in time, the disease was not known to have been imported into the country," Idris said.

He explained that relevant digital platforms had been set up for ease of reference, information and communication flow and that the platforms include Help line: 0800 EBOLA HELP (0800326524357); Website: www.ebolaalert.org; Facebook: fb.com/ebolaalert; and Twitter: @ebolaalert.

Panic Spreads as Lab Results are Awaited

Despite the attempt by the Lagos State Government to allay concerns, panic among Nigerians continued to spread yesterday over the spectre of the disease.

This was not helped by the fact that the authorities chose to remain mute on the laboratory results of seven other persons who had been quarantined in a ward in Lagos.

The Minister of Health, Prof. Onyebuchi Chukwu, had said on Monday that the results of two persons were being awaited, while another 70 persons were also under surveillance. In addition, results from Anambra and Akwa Ibom States, where corpses of suspected Ebola victims had been flown to, were being awaited.

A Federal Ministry of Health official, however, told THISDAY on the condition of anonymity that the report the minister gave was still the latest and the status quo remained the same.

"We are yet to get any result on the latest development," he said. Another ministry source also informed THISDAY that the time span between moving the blood samples from Nigeria to the World Health Organisation (WHO) virology laboratory in Senegal might have caused the delay.

When THISDAY contacted the Project Director of the National Centre for Disease Control (NCDC), Prof. Andullraman Nasidi, the director kept mute on the status of the results.

But speaking to THISDAY, the Co-chairman of the Treatment Research Group Committee on the Ebola Virus Disease (EVD), Prof. Innocent Ujah, said the committee's first meeting went smoothly.

Ujah explained that all "the terms of reference the government asked us to look at will be followed as we move along, including the implementation".

Ujah, who also doubles as the Director General, Nigerian Institute of Medical Research (NIMR), however, declined to state whether the committee would visit persons who had been quarantined, but stressed that he was optimistic that the committee would accomplish most of its mandate.

However, his co-chairman in the committee, Prof. Karniyus Gamaniel, in a telephone interview with THISDAY, said the committee would not visit those under quarantine yet.

He explained that there were already positive steps as companies had already started to approach the government with remedies to tame the infectious Ebola virus.

In a related development, the Director of Port Health Service, Dr. Sani Gwarzo, informed journalists yesterday that there were strict survellaince at the ports and other entry points to avert the spread of the Ebola virus.

Gwarzo classified the ports of entry into the country into three categories: the airports, seaports and land borders but added that the number of undocumented footpaths are larger than the legal entry points. "Improving our border surveillance is our best bet at this stage," he said.

W'Bank Pledges $200m

Meanwhile, the World Bank Group yesterday pledged a $200-million emergency funding to help Guinea, Liberia, and Sierra Leone contain the spread of Ebola infections and help their communities cope with the economic impact of the crisis as well as improve public health systems throughout West Africa.

World Bank Group President,s Dr. Jim Yong Kim, an experienced medical doctor in the treatment of infectious diseases, said the new financing commitment was in response to the call from both the three African countries hardest-hit by Ebola and WHO for immediate assistance to contain the outbreak.

Speaking at the US-African leaders' summit in Washington DC, Kim said he would brief the bank's Board of Executive Directors as soon as possible on the latest state of the epidemic and seek their approval for the new emergency package.

He said: "I am very worried that many more lives are at risk unless we can stop this Ebola epidemic in its tracks. I have been monitoring its deadly impact around the clock and I'm deeply saddened at how it has ravaged health workers, families and communities, disrupted normal life, and has led to a breakdown of already weak health systems in the three countries."

He said the Breton Woods institution would also step up social safety net assistance for affected communities and families and help to build up public health systems in West Africa to strengthen the region's disease control capacity.

Kim also urged the international community to act fast to contain and stop this Ebola outbreak, stating: "I believe this new World Bank emergency funding will provide critically-needed support for the response to stop the further transmission of Ebola within Guinea, Liberia, and Sierra Leone, which would prevent new infections in neighbouring at-risk countries."

BA Suspends Flights

But as the world rallies to stem the spread of Ebola, British Airways (BA) yesterday announced that it had suspended flights to and from Liberia and Sierra Leone until the end of August, amid concerns over the Ebola outbreak.

The airline normally has four flights a week from London Heathrow to Freetown in Sierra Leone, with a connection to Monrovia in Liberia. BA said the move was due to the "deteriorating public health situation" in the two West African countries. Customers can get a refund or rearrange their flights for a later date. BA's move follows a similar suspension by Arik last week.

Ebola Drugmaker's Stock Rises

But as fear gripped West Africans over the spread of the virus, traders on Wall Street were smiling to the bank, when shares of a US-based company working on a drug to treat the infectious disease surged nearly 40 per cent last week.

Tekmira Pharmaceuticals rose on much higher trading volume than usual because investors were hopeful that health agencies in the United States might approve its drug, known as TKM-Ebola.

But investors buying this stock now need to be extremely careful. CNN reported Monday that two Americans who were infected with the Ebola virus in Liberia were treated with a drug made by privately-held San Diego company Mapp Biopharmaceutical.

Shares of Tekmira, which were up as much as 26 per cent at one point Monday, gave up all of their gains following the CNN report and finished the day down 7 per cent.

Meanwhile, shares of BioCryst Pharmaceuticals (BCRX), another small biotech working on a drug that could be used to treat Ebola, were up more than 5 per cent Monday.

Jason Kolbert, an analyst with Maxim Group who covers Tekmira, said in an interview that it is important to note that the US government is working with several companies on Ebola treatment. So he was not surprised to hear that Mapp's serum was used on Dr. Kent Brantly and Nancy Writebol.

He added that just because another medication was used, does not mean that Tekmira's drug won't eventually prove to be viable.

Human Vaccine Trials Begin Sept

Despite the scramble by drug companies to produce a vaccine for Ebola, it emerged yesterday that an early-stage human clinical trial for an Ebola vaccine is likely to begin as early as September 2014, the US National Institute of Health has disclosed.

Though not the first human vaccine trial for the virus, the study comes after mounting pressure from health organisations to allow experimental treatments to be used on people at high risk of developing the disease.

The vaccine, developed by the National Institute of Allergy and Infectious Diseases (NIAID) Vaccine Research Center, contains no infectious Ebola virus material. Instead, it is a chimpanzee adenovirus vector vaccine containing an insert of two Ebola genes.

Adenovirus vectors are attractive delivery models for vaccine candidates because the virus can be easily manipulated. As a non-replicating viral vector, the vaccine works by entering a cell and delivering the new genetic material.

"If it is successful, it will take until mid- to late-2015 before a limited number of vaccine doses would be ready to administer to health care workers," he said.

Meanwhile, health campaigners have petitioned the US Food and Drug Administration (FDA) asking it to speed up the authorisation of TKM-Ebola, which is widely believed to be a cure for EVD. TKM-Ebola is a promising vaccine on trial.

In the petition entitled, "Fast track drug and vaccine research for Ebola hemorrhagic fever", the petitioners said given that at least one patient has transferred the disease from Liberia to Nigeria by air travel, the possibility of a global pandemic becomes increasingly likely.

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