Shortly after our report yesterday [6]that the Liberian man suspected of carrying the Ebola virus has died while quarantined in Nigeria, the local health ministry confirmed that he was indeed the first confirmed Ebola death in the Nigerian city of Lagos, which with a population of roughly 20 million, is the largest city in Africa and the fourth largest in the world. The victim, who worked for the Liberian government, collapsed at Lagos international airport after arriving on a flight from Monrovia via the Togolese capital Lome on Tuesday, according to the Nigerian government. And now the "red alert" scramble begins in Nigeria, with a population fo 170 million, to isolate who else the deceased may have come in contact with.
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Citing the health ministry AFP reports [8]that he did not come into contact with the public in Lagos other than health workers before being isolated at the hospital, although it is not quite clear just how Nigeria made that conclusion so rapidly. Perhaps it too has seen YouTube clips confirming its own line of propaganda beyond any doubt?
The World Health Organization (WHO) said on Saturday that efforts were being made to track down people the victim may have come into contact with on his journey from the Liberian capital.
"Contact tracing under way -- Liberia, Nigeria, Togo. WHO deployed staff to Nigeria to help w/ this & safe handling of remains," the global health body's African region said on its Twitter account @WHOAFRO.
Nigerian Health Minister Onyebuchi Chukwu had previously said all passengers who travelled with the victim on the Togo-based carrier ASKY from Lome had been traced.
But in case this latest instance of propaganda meant to avoid a panic ends up being merely the latest lie, Nigeria is already preparing for plan B: "an emergency operations centre has been set up, coordinated by the Nigeria Centre for Disease Control (CDC), and all hospitals have been equipped to handle emergencies and suspected cases, the minister added."
And while borders have not yet been closed, health specialists have been deployed to all sea ports and international airports to identify any passengers displaying symptoms associated with Ebola.
Needless to say, while Nigeria may hope that a countrywide quarantine is possible and could well be the next step, it would merely make the resulting panic from an epidemic that has claimed nearly 700 people far worse.
In Lagos, Yewande Adeshina, the special adviser on public health to the Lagos State governor, said: "We have taken delivery of 30 personal protective equipment (sets) from the federal ministry of health and they have promised to give an additional 220 for our medical personnel to protect them from any risks... "We are also reaching out to private clinics, hospitals and health facilities in the state to promptly report any suspected case to the authorities."
Information Minister Labaran Maku said a radio and television public awareness campaign about Ebola has been running for several months on state media and would continue. Spread by close contact with an infected person through bodily fluids such as sweat, blood and tissue, it can fell victims within days, causing severe fever and muscle pain, vomiting and diarrhoea -- and in some cases, organ failure and unstoppable bleeding.
Ebola's arrival in Lagos has prompted fears of its spread, since the overcrowded megacity is a regional and international transport hub and a base for many foreign multinationals with offices in Africa's largest economy.
As noted above, at this point now that the worst outcome has been confirmed it is all about containment:
WHO spokesman Tarik Jasarevic said tracing people who have been in contact with an infected person was key in both rural and urban areas, although that may prove more complicated in cities.
"When there is an outbreak, it is important to see whom the people have been in contact with and follow them for 21 days," he said by phone from Sierra Leone.
One of Britain's leading virologists said while Ebola's arrival in Lagos was "certainly not welcome", Lagos' more developed public health care infrastructure and accessible population compared to affected rural areas could work in its favour.
"The important thing to remember is that Ebola is not a virus that transmits easily, for example, by respiratory droplets. There has to be very close or physical contact," Professor Ian Jones told AFP in an email exchange.
"If this is prevented the outbreak can be stopped in its tracks. In this regard the authorities' statement that all contacts have been traced and quarantined is very reassuring," said Jones, from the University of Reading, west of London.
Indeed, "authorities' statements" that "everything is contained" are taking place with increasing regulatory in the past decade. Sadly, virtually every time they end up being a lie. Hopefully this time it's different.
In the meantime, we wonder just how the government of Sierra Leone will spin its own Ebola crisis, following the report from yesterday [9]that an Ebola patient was broken out of hospital by her family and is now loose in the city of one million.
Finally, here is the latest summary of Ebola deaths and cases in West Africa from the WHO [10]:
[11]
