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Pamela Engel writes that Americans need only look to Nigeria to calm their fears about an Ebola outbreak in the US. Nigeria is much closer to the West Africa outbreak than the US is, yet even after Ebola entered the country in the most terrifying way possible — via a visibly sick passenger on a commercial flight — officials successfully shut down the disease and prevented widespread transmission. If there are still no new cases on October 20, the World Health Organization will officially declare the country "Ebola-free". Here's how Nigeria did it.
The first person to bring Ebola to Nigeria was Patrick Sawyer, who left a hospital in Liberia against the wishes of the medical staff and flew to Nigeria. Once Sawyer arrived, it became obvious that he was ill when he passed out in the Lagos airport, and he was taken to a hospital in the densely packed city of 20 million. Once the country's first Ebola case was confirmed, Port Health Services in Nigeria started a process called contact tracing to limit the spread of the disease and created an emergency operations center to coordinate and oversee the national response. Health officials used a variety of resources, including phone records and flight manifests, to track down nearly 900 people who might have been exposed to the virus via Sawyer or the people he infected. As soon as people developed symptoms suggestive of Ebola, they were isolated in Ebola treatment facilities. Without waiting to see whether a "suspected" case tested positive, Nigeria's contact tracing team tracked down everyone who had had contact with that patient since the onset of symptoms making a staggering 18,500 face-to-face visits.
The US has many of these same procedures in place for containing Ebola, making the risk of an outbreak here very low. Contact tracing is exactly what is happening in Dallas right now; if any one of Thomas Eric Duncan's contacts shows symptoms, that person will be immediately isolated and tested. “That experience shows us that even in the case in Nigeria, when we found out later in the timeline that this patient had Ebola, that Nigeria was able to identify contacts, institute strict infection control procedures and basically bring their outbreak to a close”, says Dr. Tom Inglesby. “They did a good job in and of themselves. They worked closely with the U.S. CDC. If we can succeed in Nigeria… I do believe we will stop it here.”
(Score: 4, Insightful) by khallow on Friday October 17 2014, @12:38AM
BUT infections continue to grow at an exponential rate in the three primary countries affected. It's not "we're all dead by X-mas". But every month that exponential increase happens, the amount of suffering greatly increases and the risk of greater problems increase. For example, about a quarter of all Ebola cases have happened in the last month (corresponding to an increase of a third in total cases every month). That's been true for most of the duration of the epidemic. Eventually, it will saturate (forming a logistics curve), but it's not close to doing so.
Will these societies remain stable to that point and contain Ebola to themselves? I don't think so. Will Nigeria remain Ebola-free when a wave of Ebola-carrying refugees comes over from Benin (which is not currently affected by Ebola) or elsewhere? Of course not and the contact tracing method discussed in this article will be near useless when large numbers of infections are introduced into neighboring countries.
My view is that this is the last window of opportunity before a significant fraction of Africa dies from Ebola or before an epidemic which could last a few months instead lasts many years and affects most of the world.
PS, all the health care officials making noise about the need to continue commercial air traffic in the face of Ebola will change their tune after a few more infections make their way to the developed world. Quarantine isn't perfect (as my discussion of waves of refugees above indicate), but it works better than screening uncooperative passengers.
(Score: 2) by kaszz on Friday October 17 2014, @01:09AM
"Will Nigeria remain Ebola-free when a wave of Ebola-carrying refugees comes over from Benin (which is not currently affected by Ebola) or elsewhere?"
Erect wall, use drones and patrols that shoot on sight?
(Score: 0) by Anonymous Coward on Friday October 17 2014, @02:20AM
Erect wall, use drones and patrols that shoot on sight?
yeah genius, make them all into large ebola infected blood splats. it's morons like you that are making things worse.
(Score: 0) by Anonymous Coward on Friday October 17 2014, @03:54AM
I'm the one around here who usually misses the sarc tag.
-- gewg_
(Score: 1) by khallow on Friday October 17 2014, @12:33PM