Vanguard (Lagos)

20 August 2014

Nigeria: Brave Doctor, Adadevoh Loses Ebola Battle

Photo: Vanguard
Dr. Ameyo Stella Adadevoh.

LAGOS-- FRONTLINE medical Doctor, Ameyo Stella Adadevoh, who saved the country from potential epidemic of the Ebola Virus Disease, EVD, yesterday, fell to the vise-grip of the disease which she contracted while attending to the index (first) Ebola case, the late American-Liberian, Patrick Sawyer.

Dr. Adadevoh was infected when she forcefully restricted Mr. Sawyer to his bed after he tried to remove the drip administered on him.

Observers said, yesterday, that her action probably saved many Nigerian lives because, if Sawyer had succeeded in forcing himself out of the hospital, it would have been difficult to trace those who had contact with him.

Minister of Health, Professor Onyebuchi Chukwu announced the death, yesterday evening, of Dr Adadevoh.

'With this unfortunate development the total number of Ebola Virus related deaths in Nigeria now stands at five. The other two patients currently under treatment in the isolation wards are stable and are being taken care of,' he stated.

News of her death coincided with confirmation that the last three patients in the isolation centre may be discharged this week.

With her death, Nigeria has recorded five Ebola deaths, of which one was the index (first) case, Patrick Sawyer, one medical doctor, two nurses and the ECOWAS staff. Nigeria also has five Ebola survivors and three more expected to be discharged later this week.

Dr. Adadevoh, an experienced consultant physician and endocrinologist was Lead Consultant with First Consultants Medical Centre, Obalende, Lagos, came into the limelight shortly after the dramatic visit of Sawyer, and will be remembered as the first Nigerian confirmed to test positive to the Ebola virus. A holder of an MBBS from the University of Lagos, UNILAG, as well as a Diploma in Endocrinology from the University of London, the deceased practised in the United Kingdom and Nigeria for more than three decades.

She was a member of the Nigeria Medical Association, NMA, the British-Nigerian Association and a Fellow of the National Postgraduate Medical College.

Anxiety

Anxiety had escalated over her health in the last one week which necessitated a group of concerned friends, families and associates to seek assistance from the United States of America.

The call which attracted attention of the public and government, however, did not yield the much expected result, as she succumbed to the cold hands of death. A source confirmed to Vanguard that spirited efforts to save her life proved abortive. It was gathered that she died Monday night.

According to the source, the late Dr Ameyo Adedavoh could not make it due to the serious contact she had with the late Sawyer.

"She tried to fight the disease. She fought a good fight. She saved Nigeria from imminent Ebola epidemic. She was the one that stopped late Sawyer when he became violent and was able to stop him. It is unfortunate we lost her. She is a heroine, even in death," the source stated.

Meanwhile, three more patients may be discharged any moment from today. According to the source that pleaded anonymity, among the three people that made it include a woman who gave birth in the hospital (First Consultants) and later returned for vaccination.

"The conditions of the three patients left in the isolation centre remains stable. I cannot say when they will be released but all I can tell you is that they are in stable condition and will be released any time from now. It could be tomorrow or next. But they are in good health," the source said.

Cure for Ebola from survivors' antibodies?

Meanwhile, in continuation of the search for a possible cure for Ebola Virus Disease, EVD, the Lagos State government is exploring several options among which is the collection and examination of antibodies from the blood of the Ebola survivors.

Commissioner for Health, Dr. Jide Idris, disclosed this yesterday, during a tour of the Ebola Isolation facility at Mainland Hospital, Yaba, Lagos.

He said: "We are exploring the possibilities of collecting and examining the antibodies possessed by the patients for possible prospects of a cure.

"The patients were admitted into the isolation centre based on the result of tests conducted on them. But after some treatment, they survived the virus, and the test conducted on them again showed negative."

Idris said the survivors were treated based on their symptoms, but explained the need for more virologists in the fight against the deadly virus because EVD patients are not like other patients.

"The activities within the isolation centre are very crucial, and one has to understand the protocol even if he or she has the expertise in managing the patients.

"For Ebola cases, there is specific training one has to go through, and one of the measures is that the safety of the people must be considered paramount. This is because the slightest mistake from any of the health officials can cause infection."

It could be recalled that four patients who have survived the virus were discharged from isolation on Monday by the combined federal and state government teams and their international partners. Earlier over the weekend, a female doctor had been discharged after surviving the virus.

This development brings the number of survivors of Ebola in the country to five while three other patients yet to scale the hurdle have been moved to the 40- bed capacity isolation centre in the hospital.

WHO commends Nigeria

Also, the World Health Organisation, WHO, has commended Nigeria's response to the current Ebola Virus disease outbreak, noting that efforts to contain the cases in the country have paid off.

In an assessment of the situation in Lagos, the global health body said the situation looks reassuring and encouraging, noting that at present, all 12 confirmed cases are all part of a single chain of transmission.

"Those infected by the initial case include medical staff involved in his treatment, a patient in the same hospital, and a protocol officer in very close contact with the patient. The initial patient was vomiting frequently during travel and upon arrival. No one on the same flight was infected.

"The full recovery to date of one infected contact is additional good news. It counters the widespread perception that infection with the Ebola virus is invariably a death sentence. Evidence suggests that early detection and supportive therapy increase the prospects of survival.

"Intensive contact tracing, conducted by Nigerian health officials and staff from the US Centers for Disease Control and Prevention, has not, so far, identified any further confirmed cases outside the initial transmission chain," said the WHO.

The global health body added that since the index case which arrived Lagos on July 20 died on July 25, the 21-day incubation period has lapsed, stressing that all 12 cases were confirmed in a WHO-approved laboratory.

"The intensity of the search and monitoring effort raises cautious optimism that further spread of the virus in Nigeria can be stopped.

The search for additional cases continues, as does the current high level of vigilance," the WHO observed.

Epidemiology and surveillance

Between 14 and 16 August 2014, a total of 113 new cases of Ebola virus disease (laboratory-confirmed, probable, and suspect cases) as well as 84 deaths were reported from Guinea, Liberia, Nigeria, and Sierra Leone.

NIPRD seeks upgrade to produce Ebola drug

In a related development, the Nigerian Pharmaceutical Research and Development, NIPRD, has called for an urgent upgrade of its laboratory to be able to produce necessary drugs to cope with the threat being posed by the Ebola Virus Disease, EVD.

NIPRD Director-General, Professor Karniyu Gamaliel, who made the call in an exclusive interview with Vanguard, explained that the institution required what he called "P4" laboratory to complement what they have in stock to be able to meet the current challenges triggered by the EVD.

A P4 lab is a high containment laboratory facility that can safely handle deadly pathogens such as the smallpox and Ebola viruses.

Gamaliel said the laboratory is needed urgently to enable the agency to fast-track research into drugs that could be used as palliative for the EVD.

He remarked that although the agency currently has five departments with fully equipped laboratories, it should operate maximally with 18 or 20 specialised laboratories.

"Our laboratories need a little upgrading with facilities like the P4 bio-safety cabinet which will make the laboratory very competent and very useful, and we insist that the situation is an emergency given the position of Abuja as a centrally-placed city.

"Ebola is a deadly pathogen and the facilities we have need to be upgraded. I went round the facilities yesterday and we don't have the P4 facility but we have a structured laboratory suitable for handling the virus and the various studies that are relevant," he said.

Gamaliel boasted however that the institution had the capacity to identify the virus in the infected persons.

"There are better versions coming in as we speak. We can do with up scaling of such machines that would be required and sample handling machines also which takes samples and stored in a safe way.

"I think we are the only laboratory that can do all those things and also monitor those activities on a door-to-door basis.

" So I think we have a role in analysing the activities of the drugs and the progression of the infection in people already infected so that preventive measures can be carried out appropriately," Gamaliel said.

How and why Ebola kills fast

Speaking on why the Ebola Virus Disease kills fast, Dr Michael Smith of WebMD, said: "Everyone knows that Ebola kills but what exactly does it do? This worm-like virus has a devious way of working. Once it gets in the body, the virus attaches itself to the surface of the cells. Then it invades them, replicates and causes the cells to explode, sending infectious particles flying. From there, Ebola overpowers the immune system. It uses the very cells that are meant to fight infection to travel to other parts of the body, including the liver, spleen, kidneys and brain. It attacks almost every organ and tissue.

"The particle explosion also sets off an overwhelming inflammatory reaction. That's what causes the sudden flu-like symptoms that are the first signs of Ebola. Inside the blood vessels, the virus causes abnormal clotting and bleeding at the same time. Bleeding into the skin causes a red rash that appears all over.

"With the ability to clot normally destroyed, bleeding occurs internally as well as from the eyes, ears and nose. This whole cascade of events causes the organs to fail. The loss of blood, along with organ failure, is what makes Ebola so deadly.

"But if doctors can keep the organs working with intravenous fluids, blood transfusions, a ventilator and other treatments, there's a much better chance they can save lives. The infection moves fast and it can kill in one to two weeks. In the current outbreak, 60 per cent of the people who caught the virus have died. Many more could likely be saved with better access to medical care."

Panic in Ibadan

Following alarm raised in Ibadan yesterday that an Ebola patient was taken to Adeoyo State Hospital, Ring Road, some residents of the area were already considering relocation from the hospital vicinity.

A baby allegedly infected with the virus was said to have been taken to the hospital on Monday.

Though, doctors were yet to confirm from tests conducted on the baby, people in the area were afraid of being infected.

When the baby allegedly showed symptoms of the deadly virus, staff and other patients in the hospital reportedly ran for safety.

Reacting to the incident, the state Commissioner for Health, Dr. Muyiwa Gbadegesin, allayed their fears that it had not yet been confirmed that the baby had the virus.

He hinted that blood samples had been taken and sent to the laboratory at the University College Hospital, UCH, Ibadan for proper analysis.

"We saw a suspected patient. It will be presumptuous to jump into conclusion until the result of the test is out. But it is not likely to be positive. But let us wait for the result of the blood test."

Also, an epidemiologist with the state Ministry of Health, Dr. Abass Gbolahan, also said: "From our records at the Oyo State Ministry of Health, we are not aware of any child said to have the infection.

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InFocus

Nigerian Doctor Dies From Ebola Virus

Dr. Ameyo Stella Adadevoh.

Ameyo Stella Adedavoh, the doctor who first treated Liberian-American Patrick Sawyer, has died. Read more »