Although the number of secondary cases in Nigeria remains small (less than 10), alarm bells are ringing because Nigeria is (by far) the most populous nation in Africa (177 million), and these cases have turned up in the mega-city of Lagos, with a population of more than 21 million people.
By comparison, the combined populations of Guinea, Sierra Leone, and Liberia runs only about 20 million.
Overnight, Nigeria Minister of Health Onyebuchi Chukwu declared a state of Emergency (see CNBCAfrica report Ebola is a national emergency: Nigeria health minister), as did Liberia yesterday.
While all Ebola affected regions are of concern - stopping the virus from spreading in Nigeria – particularly in the hugely overcrowded city of Lagos, is now a top priority, and the major reason why the CDC activated their Emergency Operations Center last night, going on full alert.
The CDC issued the following press release, explaining this move.
The Centers for Disease Control and Prevention (CDC) is rapidly increasing its ongoing efforts to curb the expanding West African Ebola outbreak and deploying staff to four African nations currently affected: Guinea, Sierra Leone, Liberia, and Nigeria.
The outbreak began in March 2014 in Guinea and spread to the neighboring countries of Liberia and Sierra Leone. It recently spread to Nigeria through a traveler from Liberia. On Aug. 5, the CDC issued an Alert Level 2 Travel Notice for travelers to Nigeria, notifying travelers to the area to practice careful hygiene and avoid contact with blood and body fluids of people ill with Ebola. A Warning Level 3 Travel Notice remains in effect for Guinea, Liberia, and Sierra Leone advising people to avoid nonessential travel to these countries.
CDC’s 24/7 mission is to prevent, detect, and stop disease outbreaks wherever they occur and to protect America’s health by improving public health both at home and abroad. CDC has contributed to the World Health Organization’s (WHO) efforts to control the Ebola outbreak in West Africa since the start of the outbreak. CDC now is taking a more active role, and has been invited by WHO to provide leadership on the technical front. The CDC has activated its Emergency Operations Center to its highest response level.
“The bottom line with Ebola is we know how to stop it: traditional public health. Find patients, isolate and care for them; find their contacts; educate people; and strictly follow infection control in hospitals. Do those things with meticulous care and Ebola goes away,” said CDC Director Tom Frieden, M.D., M.P.H. “To keep America safe, health care workers should isolate and evaluate people who have returned from Guinea, Liberia, and Sierra Leone in the past 21 days and have fever or other symptoms suggestive of Ebola. We will save lives in West Africa and protect ourselves at home by stopping Ebola at the source.”
CDC is rapidly sending more disease-control experts to the four nations currently reporting cases. As CDC announced last week, 50 additional disease control experts will be in the region within 30 days. Some staff have completed their deployments and are rotating out of country but overall staff numbers are increasing. As of Monday Aug. 4, CDC staff deployments are:
- Guinea: 6 currently deployed,
- Liberia: 12 currently deployed
- Nigeria: 4 currently deployed
- Sierra Leone: 9 currently deployed
This sustained, agency-wide response will continue until the outbreak is under control, an effort expected to take three to six months.
In West Africa, CDC disease detectives are directing efforts to pinpoint cases and their contacts using a new tool developed at CDC. This Epi Info viral hemorrhagic fever (VHF) application speeds up one of the most difficult parts of disease detection: finding everyone exposed to the virus. Other CDC experts will educate the general public about how to avoid Ebola infection; ensure that healthcare personnel strictly follow protocols that protect them against infection; strengthen laboratory aspects of the response; and improve communications among all stakeholders (the public, patients and their families, healthcare workers, governments and non-government organizations, and the media).
CDC efforts are not confined to West Africa. At home, CDC has updated infection-prevention protocols for hospitals where travelers with suspected Ebola exposures may present for treatment; for aircraft crew and airport personnel; and for laboratories handling specimens from suspected Ebola cases.
U.S. hospitals can safely manage patients with Ebola disease. The key factors are isolation of patients, diligent environmental cleaning and disinfection, and protection of healthcare providers. Providers in U.S. hospitals should wear gloves, fluid resistant/impermeable gown, and eye protection. In certain situations involving copious body fluids, additional equipment may be needed (for example, double gloving, disposable shoe coverings, and leg coverings). CDC has posted detailed infection prevention and control recommendations.
Going forward, President Obama’s FY 2015 budget requests $45 million for CDC to build global health security capacity by helping other nations prevent, detect, and stop disease outbreaks.