04 Oct 2022 | Abuja – NCDC on Alert Mode Following the Outbreak of Ebola Virus Disease (EVD) Detected in Uganda
The Nigeria Centre for Disease Control and Prevention (NCDC) is aware of the ongoing outbreak of Ebola virus disease (EVD) caused by the Sudan strain of the Ebola virus (EV) in Uganda as declared on 20th September 2022. This outbreak has also been confirmed by the World Health Organization (WHO). The Sudan strain of the Ebola virus is the known cause of EVD having caused previous outbreaks in Uganda, South Sudan, and the Democratic Republic of Congo.
The Uganda Virus Research Institute confirmed the virus in samples collected from a 24-year-old male who exhibited symptoms of the disease and later died as a result in Mubende District in the Central Region about 175km from the capital, Kampala. As of 29th September 2022, the Ugandan Ministry of Health has reported 54 cases (35 confirmed and 19 probable) and 25 deaths (7 confirmed and 18 probable). The Ugandan Ministry of Health with support from WHO is working to effectively respond to and contain the spread of the virus.
The NCDC-led multisectoral National Emerging Viral Haemorrhagic Diseases Technical Working Group (NEVHD TWG) working with partners and stakeholders has conducted a rapid risk assessment to guide in-country preparedness activities. The NEVHD TWG coordinates preparedness efforts for EVD and other emerging viral haemorrhagic diseases.
Based on available data, the overall risk of importation of the Ebola virus and the impact on the health of Nigerians has been assessed as HIGH for the following reasons:
The Sudan Ebola Virus does not currently have an effective drug for treatment or licensed vaccine for prevention.
The extent of the outbreak in Uganda has not yet been ascertained as investigations have shown that some persons may have died with similar symptoms which were not reported to health authorities. In addition, their burials were not conducted safely to prevent transmission.
The case fatality rate of the Sudan virus varied from 41% to 100% in past outbreaks.
The likelihood of importation to Nigeria is high due to the increased air travel between Nigeria and Uganda, especially through Kenya’s Nairobi airport, a regional transport hub, and other neighbouring countries that share a direct border with Uganda.
The likelihood of spread in Nigeria following importation is high due to the gatherings and travel associated with politics, the coming yuletide as well as other religious gatherings and festivals during the last few months of the year.
Despite this risk assessment, Nigeria has the capacity – technical, human (health workforce), and diagnostic - to respond effectively in the event of an outbreak. This is exemplified by our successful response to the Ebola outbreak in 2014, as well as improvements in our capacity for health emergency response during the COVID-19 pandemic. We have the diagnostic capacity to test for the EVD presently at the National Reference Laboratory in Abuja and the Lagos University Teaching Hospital’s Centre for Human and Zoonotic Virology Laboratory. However, diagnostic capacity will be scaled up to other laboratories in cities with important Points of Entry (POE) and others as may be required. An effective response system is in place with the availability of control capacities (trained rapid response teams, and an effective infection prevention and control programme) to limit the risk of spread in the event of a single imported case.
Currently, no case of EVD has been reported in Nigeria. Nonetheless, the Nigerian government through NCDC’s multisectoral NEVHD TWG has put several measures in place to prevent and prepare for immediate control of any outbreak of the disease in-country. These include:
The NCDC Incident Coordination Centre (ICC) is now in alert mode.
Development of an incident action plan for the first few cases of EVD has commenced.
POE surveillance has been heightened using the passenger pre-boarding health declaration and screening form in the Nigeria International Travel Portal (NITP) platform.
Passengers arriving from Uganda and persons who transited in Uganda are being followed up for 21 days of their arrival in Nigeria on their health status.
Trained Rapid Response Teams are on standby to be deployed in the event of an outbreak.
Public Health Emergency Operations Centres (PHEOCs) in States with major POE i.e., Lagos, Kano, Abuja, and Rivers State are on standby.
A medical countermeasures plan is available.
Amplification of risk communication and engagement with states and partners to strengthen preparedness activities which include– a review of risk communication protocols, plans, and messages in the event of an outbreak.
Nigeria has an active infection prevention and control (IPC) programme nationwide with guidelines and training packages developed for health care workers.
About Ebola Virus Disease
Ebola virus disease (EVD) is a severe, often fatal illness affecting humans. The strain responsible for the current outbreak was first reported in southern Sudan in June 1976. Since then, seven outbreaks caused by this strain have been reported (four in Uganda and three in Sudan) with previous outbreaks' fatality ratio ranging from 41% to 100%.
Just like other types of Ebola virus, people infected cannot spread the disease until the development of symptoms. Symptoms include fever, fatigue, muscle pain, headache, and sore throat later followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function. Symptoms may appear anywhere from 2 to 21 days after exposure to the virus, but the average is 8 to 10 days.
Currently, there are no vaccines or therapeutics for the prevention and treatment of this strain of the virus. However, the early initiation of supportive treatment has been shown to significantly reduce deaths.
Recovery from EVD depends on good supportive clinical care, management of co-morbidities, and the patient’s immune response. People who recover from Ebola virus infection develop antibodies that last for at least 10 years.
For further information on the Ebola virus disease, visit the NCDC website via https://www.ncdc.gov.ng/diseases/factsheet/36
Nigerians are urged to adhere strictly to the following preventive measures.
Avoid non-essential travel to locations where the outbreak is reported for the moment.
Avoid direct contact with blood, saliva, vomit, urine, and other bodily fluids of people with suspected or confirmed EVD.
Call 6232 or other dedicated hotlines by State Ministries of Health to ensure all persons with suspected symptoms of EVD described above are promptly taken to designated healthcare facilities by the responsible State Ministry of Health for prompt diagnosis and initiation of supportive treatment
In suspected and/or confirmed EVD cases, direct physical contact should be avoided by ensuring strict isolation, the use of protective gowns, masks, gloves and safe disposal of needles, beddings, and other contaminated materials
Safe burial practices are recommended for all cases of death from unknown causes, suspected to be EVD or other viral haemorrhagic diseases. Guidelines on the safe burial of EVD patients can be accessed via National Guidelines on Infection Prevention and Control for Viral Hemorrhagic Fevers (Chapter Thirteen)
The strict practice of standard infection prevention control practices in the healthcare setting for all suspected patients must be always adhered to.
The Nigeria Centre for Disease Control and Prevention (NCDC) is the country’s national public health institute, with the mandate to lead the preparedness, detection, and response to public health emergencies. The Bill for an Act to establish NCDC was signed into law in November 2018 by President Muhammadu Buhari. The mission of the NCDC is, ‘To protect the health of Nigerians through evidence-based prevention, integrated disease surveillance and response, using a One Health approach, guided by research, and led by a skilled workforce.
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Dr Ifedayo Adetifa
Nigeria Centre for Disease Control and Prevention.