Ebola Update: Death in Nigeria, Impact on Healthcare Workers, and Containment Measures in Liberia

Jul 29, 2014 | Alexandra Thomsen | Outbreak News

Nations around the world have voiced concern about West Africa’s Ebola outbreak spreading via air travel, with warnings like “Ebola only a plane ride away.” In April, Nigerian Minister of Health Onyebuchi Chukwu admitted that “Nigeria is in danger,” but assured that the government would emphasize education about the disease and implement preventive measures. Unfortunately, on July 25, the first Ebola case was reported in Nigeria. The case was a Liberian man who collapsed at Nigeria’s main airport in Lagos upon arrival from Monrovia, Liberia, and succumbed to the disease soon after. Health Minister Chukwu announced that tests from the Lagos University Teaching Hospital confirmed the diagnosis, although both the WHO and Lagos state government claimed that they were still awaiting lab confirmation as of July 29. Now, the Lagos hospital to which the patient was taken has been quarantined and health officials are monitoring 59 contacts. The WHO is also sending teams to conduct follow-up work in Nigeria and Togo, where the plane made a brief layover.

To date, Ebola has infected at least 1201 people in West Africa and 672 have died. The disease has taken a major toll on healthcare workers—at least 100 have been infected and about 50% have died, according to the WHO. One of Liberia’s most high-profile doctors, Dr. Samuel Brisbane, died of the disease on Saturday. A Ugandan doctor working in Liberia died earlier this month and two Americans have also fallen ill. One, Dr. Kent Brantly, was working with Samaritan’s Purse, a North Carolina-based medical charity, when he began showing signs of Ebola. The other, Nancy Writebol, was working as a missionary with a joint SIM/Samaritan’s Purse team in Monrovia.

On July 28, Liberia implemented several stringent health measures in an attempt to slow the spread of the disease. President Ellen Johnson Sirleaf announced nationwide border closures except at major entry points, including the Roberts International Airport, James Spriggs Payne Airport, Foya Crossing, Bo Waterside Crossing, and Ganta Crossing. She said that preventive measures and testing centers would be established at these entry points. Due to this state of emergency, public gatherings—such as marches and demonstrations—will be restricted. In addition, Liberian government facilities and public places will be required to provide access to hand washing and other sanitization services. Hotels, restaurants, and entertainment centers will be mandated to play short informational clips on Ebola awareness and prevention.

Mistrust of doctors and concerns about stigmatization may mean that the real danger is an “epidemic of fear,” as Tony Barnett, a professor at the London School of Hygiene and Tropical Medicine, put it. Hostile mobs have confronted healthcare workers and physical barriers have blocked them from entering villages. Doctors Without Borders has classified twelve villages in Guinea as “red,” meaning that they may contain Ebola but are too unsafe to travel to. Local residents fear the emergency treatment center set up in Gueckedou because when patients enter, “they don’t leave alive.” These fears may stem from a lack of education about the disease that leads to misunderstanding about its transmission and treatment as well as mistrust of the outsiders who come to help. Some believe that Ebola is a curse that can only be healed spiritually, while others believe the disease is just a ruse. One former nurse in Kenema, Sierra Leone spread a rumor that Ebola was invented to conceal “cannibalistic rituals” being performed at the hospital. Because of the widespread fears of Ebola and medical treatment, providing education about the disease will be critical to bringing this outbreak under control. 

For a map on Ebola outbreak news, including articles and up-to-date case counts, visit healthmap.org/ebola.

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