Ebola…Not quite farewell to an epidemic

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In Nigeria
Sep 1st, 2014
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From Nigeria to Liberia and elsewhere, there are new developments on the Ebola disaster, some good, others bad. As Nigeria faces new realities, two doctors in Liberia recover after taking ZMapp and fears of insurance claim trail flights cancelations, writes Asst. Editor OLUKOREDE YISHAU

ealth Minister Onyebuchi Chukwu was happy to announce that only one patient was still in isolation as a result of the dreaded virus. The development made many feel that eventually Nigeria has caged Ebola and pretty soon, its death knell would sound. Chukwu was, however, cautious and said it was not time for uhuru.

After briefing the Federal Executive Council (FEC) on efforts to contain the deadly disease, the minister said Nigeria is not yet immune to another outbreak.

Chukwu said the virus could still find its way into Nigeria as long as there is any case of Ebola anywhere in the world and there is free movement of persons from country to country.

He said: “Nigeria has been successful in containment of the disease but we have not eliminated the disease. As long as there is any case of Ebola virus anywhere in the world and people are allowed to travel, we are still at risk.

“We are not banning mass gathering and we are not panicking because of the disease. More people have even died from accident than Ebola since the disease came to Nigeria. Ebola is not the greatest killer of Nigerians.

“We don’t want to panic, but we still need to be careful because we are still at risk until the last case is eliminated. Since, we have one case of Ebola, it is still an epidemic because it is deadlier than other diseases.”

Just a day after Chukwu’s cautious note, it emerged that Ebola had killed another doctor, Dr. Ikechukwu Enemuo, this time in Port Harcourt, the Rivers State capital. The doctor was said to have been infected by a diplomat who had contact with the index patient, the late Patrick Sawyer. The diplomat, Olubukun Koye, was said to have gone to Port Harcourt to seek treatment for ill-health. He returned to Lagos after the government insisted all who had contact with the late Sawyer must be at the isolation centre in Yaba. He is said to have since recovered and back with his family. The doctor was not lucky. He was the owner of “Samsteel Hospital” in Rumuokoro, in Obio/Akpor Local Government Area, where he worked as the Chief Medical Director until he died on August 22.

With his death, Ebola has gone beyond Lagos. There is panic in Bayelsa and other states close to the Rivers State capital.

Two employees of the late Dr. Enemuo have shown signs of the disease and have been quarantined, Rivers State Commissioner of Health Sampson Parker

said yesterday. A patient in “Good Hart” Hospital where Enemuo was admitted until he died has also been quarantined. Results of their samples were being awaited. The attendants at the morgue where the late doctor’s body was deposited have been placed under watch. The hospitals where the late Enemuo was treated, the Mandate Garden Hotel, Rumudamanya, where he treated his patient, Koye and his residence have been decontaminated.

Dr Enemuo was the sixth victim and the third doctor to die of the virus in the country.

Parker announced the ban on movement of bodies within and outside the state, adding that before any body was moved, the relatives of the diseased must obtain clearance from the Ministry of Health.

Parker said: “Governor Chibuike Amaechi will be meeting all church leaders in the state tomorrow(today). He will also be meeting with traditional rulers on Tuesday.

“Just as I earlier said, 200 persons that had contacts with the late Enemuo have been traced and put under watch. We have identified 50 high-risked persons, 60 others that had contacts with him are yet being traced.

“Three patients are at the treatment centre now, a Doctor and pharmacist that worked with the victim at the SamSteel hospital and a lady that was at Good Hart hospital while Dr. Enemuo was there. However, their results are being awaited.

“Enemuo’s widow is still in a stable condition in Lagos. Anyone that had any form of contact with the late Dr. should please come up. Ebola is curable, if diagnosed early, people have survived it and more people will. So, there is no need to run away. It is important that churches close their secret admission wards in their various places of worship. Some of them are running into churches and pastors are laying hands on them. It is wrong.

“Movement of bodies within and outside the state must be supervised. Death certificate must be produced to ascertain the cause of death, and the state Ministry of Health must give approval before anybody is allowed to move.

“The UPTH morgue has been decontaminated. However, all the bodies there must be buried under supervision, especially those that were there at the same time with Dr. Enemuo’s body.”

There was tension among workers and patients of the University of Port Harcourt Teaching Hospital (UPTH) Friday, following the news of the presence of the remains of Dr. Enemuo in the hospitals mortuary.

As Nigeria deals with this new reality, Liberia has some good news. The World Health Organisation yesterday announced that two doctors who were treated with the experimental drug ZMapp have recovered and issued certificate of discharge. Three of them received the treatment, but one died last week. The two health workers become the first Africans to survive after taking the experimental drug. Two American, who contracted the virus in Liberia, have also survived after taking the drug.

Dr. Senga Omeonga and physician assistant Kynda Kobbah were discharged from a Liberian treatment center at the weekend. Both indicated that they will return to work soon.

The WHO said they were received by Liberian President Ellen Johnson-Sirleaf after being discharged. A third person who was infected and treated with ZMapp died last Sunday.

The lethal virus has spread to five countries in West Africa — Liberia, Guinea, Sierra Leone, Nigeria and Senegal — during this year’s outbreak. Senegal confirmed its first case of the virus on Friday, one week after closing its border with Guinea, the Senegalese Press Agency reported.

There have been 3,069 probable, confirmed and suspected cases of Ebola in West Africa — more than 40 per cent of which have occurred within the past three weeks, according to the WHO. Some 1,552 of those have died.

It also emerged yesterday that there are concerns about likely insurance claims from flights cancellations by airlines. London-based insurers are facing claims for cancelled travel and events. Insurers said they are receiving claims relating to the outbreak.

Amanda Lewis, an underwriter at insurer Aegis, said: “The outbreak has caused some isolated event cancellations. Losses are being reported into the London market and I would expect that to gain some momentum. People’s perception is that it is the whole of Africa. The detail gets lost in the hysteria.”

Lewis added that even when disease is covered, insurance contracts do not generally cover losses caused by the fear of a disease rather than the disease itself. Insurers started excluding disease outbreaks in standard contracts as a result of the SARS epidemic in 2002.

In Senegal, which recorded its first case a few days ago, the WHO said the effort to contain Ebola is “a top priority emergency,”. The government continues tracing everyone who came in contact with a Guinean student who tested positive for the deadly disease in the capital, Dakar. Senegal is the sixth country in Africa with the epidemic. Guinea, Congo, Sierra Leone, Liberia and Nigeria are the others.

Senegal, said WHO, faces an “urgent need” for support and supplies including hygiene kits and personal protective equipment for health workers.

“These needs will be met with the fastest possible speed,” the WHO said.

The U.N. agency also provided new information on the movements of the 21-year-old student in the city before he was diagnosed with Ebola.

The student showed up at a hospital in Dakar on August 26 but did not reveal that he had been in contact with other Ebola victims, said Senegalese Health Minister Awa Marie Coll Seck.

He said Senegalese authorities were alerted next day by an epidemiological surveillance team in neighboring Guinea that it had lost track of a person it was monitoring three weeks earlier, and that the person may have crossed into Senegal.

Seck said the student was tracked to the hospital in Dakar and was immediately quarantined, and a test confirmed he had Ebola.

The WHO said the student arrived in Dakar by road on August 20 and stayed with relatives “in the outskirts of the city”, before going to a medical facility on August 23 seeking treatment for fever, diarrhea and vomiting.

He was treated for malaria and continued staying with his relatives before going to the Dakar hospital on August 26.

“Though the investigation is in its early stages, he is not presently known to have traveled elsewhere,” said the WHO.

A doctor was quoted yesterday as saying the Guinean student “is doing very well,”.

“This morning when I called the hospital, the doctor told me that the patient had no complaints and that his fever had disappeared,” said Dr. Gallaye Ka in an interview with the private radio station RFM.

The WHO believes the epidemic could affect as much as 200,000 people before it will eventually be reined in.

For now, there is no approved rug or vaccine for the dreaded disease. ZMapp and others are still being tested. While some have survived after using ZMapp, others have died despite taking it.

Countries, such as Canada, are developing vaccines for the disease. Pharmaceutical companies are reluctant to invest in Ebola drugs because it is the sort of disease that comes once in a while and disappears, a situation which is not good for commercial purpose.

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