Ebola Panic in North-East Nigeria: Suspected Cases Trigger Urgent Response and Investigations

The Nigeria Centre for Disease Control and Prevention (NCDC) recently announced that two suspected cases of Ebola Virus Disease (EVD) in Adamawa State have tested negative for the virus after two rounds of laboratory testing. This update came swiftly after the agency initially reported the identification of two suspected cases in Nigeria’s North-east region, triggering immediate public health response measures including isolation and contact tracing.

The individuals investigated in Adamawa State were identified as a 34-year-old pilot and his wife, a medical doctor, who were admitted to the isolation centre of Modibbo Adama University Teaching Hospital (MAUTH), Yola, on October 29. The pilot developed symptoms such as fever on October 13, prior to a trip to Kenya on October 14, where he reportedly remained well. Upon his return to Yola on October 25, his symptoms resurfaced and intensified, including fever, nausea, vomiting, fatigue, headache, cough, bleeding gums, and nosebleeds. His wife subsequently developed similar symptoms after caring for him. Both presented with symptoms suggestive of Ebola on October 30. State health authorities collected samples which were then transported to the National Reference Laboratory, ultimately yielding negative results for EVD. Following the incident, 17 to 18 contacts linked to the couple were identified and line-listed for monitoring.

Despite these negative test results, Nigeria continues to operate under heightened surveillance due to its only laboratory-confirmed Ebola case to date, which involved a woman who traveled from Uganda to Abuja and tested positive on October 20, 2023. This patient was subsequently medically evacuated to Switzerland for continued treatment at the request of her home country. Genomic analysis of the virus detected in the Nigerian patient revealed its close relation to the Bundibugyo strain identified in Kenya’s first imported case, though it was clarified that this finding does not establish the Nigerian patient was infected in Kenya.

The World Health Organization (WHO) previously indicated that Nigeria could not yet be declared Ebola-free because health authorities were still monitoring individuals who had contact with the confirmed patient. Initially, 53 contacts were being monitored, a number that later increased to 62. Dr. Chikwe Ihekweazu, WHO Executive Director of Health Emergencies Programme, explained that countries must complete a mandatory 42-day surveillance period—comprising 21 days of monitoring followed by another 21 days of observation—before being declared Ebola-free. He also commended Nigeria's swift response, noting that laboratory confirmation and case management were conducted promptly, reflecting no deficit in the country's capacity to manage such cases.

Globally, the current Ebola outbreak, caused by the Bundibugyo virus, began in the Democratic Republic of the Congo (DRC) in May. While the outbreak remains largely concentrated in the DRC, it has spread beyond its borders. Nigeria is one of five countries that have detected the Bundibugyo virus, alongside Kenya, Uganda, and an imported case in France. As of October 28, WHO reported 10,274 confirmed cases and 4,992 deaths in the DRC, nine confirmed cases and two deaths in Kenya, 20 confirmed cases and two deaths in Uganda, and one confirmed case in Nigeria, with one imported case in France. The overall confirmed cases stood at 10,305 with 4,996 deaths across affected countries.

The NCDC continues to urge Nigerians to maintain good hand hygiene, practice enhanced sanitation, and follow public health guidance. Director-General Jide Idris emphasized avoiding speculation and the spread of unverified information, encouraging frequent handwashing, use of alcohol-based sanitizers, and immediate care at designated facilities if unusual symptoms arise. Ebola is a severe viral disease that spreads mainly through direct contact with the blood or other body fluids of an infected person. Nigeria's coordinated response to the 2014 Ebola outbreak, which involved various government agencies and health workers like the late Dr. Ameyo Stella Adadevoh, earned international commendation for successfully containing the virus and preventing wider transmission.