EBOLA: FIRST CONSULTANTS CLEARED, CONCERN MOUNTS OVER SCHOOLS’ RESUMPTION DATE

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• One new case confirmed in Lagos, Enemuo’s sister discharged 
• Chukwu warns of more infections
After six weeks of forced closure, First Consultants Medical Centre, the hospital in Lagos which treated the index case, Patrick Sawyer, who imported the Ebola virus into the country from Liberia, has finally been issued a Certification of Decontamination by the federal government and given the green light to reopen for business.
This is just as the federal government yesterday revealed that the fiancé of one of the primary contacts of Sawyer, who died of the Ebola virus in Lagos, also contracted the disease but had recovered, increasing the number of confirmed cases in Nigeria to 19.
Concerns have also mounted over the decision by the federal government to review the resumption date for private and public schools in the country to September 22, with a group, Africa Health, Human & Social Development Information Service (Afri-Dev. Info), warning that the reope
ning of schools, involving 80 million children, adolescents, students and teachers is a high-risk strategy.
In two letters from the Nigeria Centre for Disease Control (NCDC) through its Ebola Emergency Operations Centre in Lagos and the Lagos State Commissioner for Health, Dr. Jide Idris, which were exclusively obtained by THISDAY, both parties notified First Consultants that it had been cleared to reopen for business, having undergone three rounds of state-certified decontamination processes.
The Lagos State Government also commiserated with the hospital over the loss of its medical personnel, “who died in the line of duty” and expressed its appreciation for the altruistic role it played in containing and managing the Ebola virus, “thus preventing an epidemic”.
In the first letter dated August 29, 2014, which was addressed to the Lagos State Commissioner for Health and signed by Dr. Faisal Shuaib, Incident Manager at the Ebola EOC, NCDC stated: “On behalf of the Honourable Minister of Health, Prof. Onyebuchi Chukwu, I write to inform you that First Consultants Hospital has now had three rounds of state-certified decontamination process and as a result, the hospital is now cleared to reopen for business.”
Having been informed of the state-certified decontamination, Idris, in his letter dated September 3, 2014, wrote to the Managing Director, First Consultants Hospital, Mr. Benjamin Ohiaeri, stating: “The Ministry is in receipt of a letter dated August 29, 2014, from the Nigeria Centre for Disease Control, Ebola Emergency Centre, Lagos, informing that your facility has had three rounds of state-certified decontamination process.
“The Ministry acknowledges the role your facility played in alerting the State Government of the index case of the Ebola Virus Disease (EVD) and appreciates your altruistic gestures in containing and managing this dealy virus, thus preventing an epidemic.
“We also commiserate with you on your members of staff who died in the line of duty.
“First Consultants has now been cleared to reopen for business. We hope that with this reopening, your facility will continue to maintain its high quality of standards.”
First Consultants was shut down and quarantined by the federal government on July 26 in line with the World Health Organisation’s (WHO) protocol on the virus, following the death of Sawyer at the hospital on July 25.
The hospital, which lost a number of its health care workers to the Ebola outbreak, including its Senior Consultant Physician and Endocrinologist, Dr. A. S. Adadevoh, had responded rapidly to Sawyer’s case when he was taken to the hospital for medical care after he arrived sick at the Murtala Muhammed International Airport in Lagos on July 20.
Sawyer had arrived in Lagos for an ECOWAS conference as a senior-level diplomat, but denied that he had the Ebola virus when he was questioned by the medical workers who attended to him at First Consultants.
Having been treated for malaria with no significant improvement, the management carried out tests for possible infectious haemorrhagic diseases, especially Ebola, based on the fact that he had flown in from Liberia, which was already reeling from the impact of the disease.
Once the hospital established that Sawyer was indeed Ebola-positive, it immediately notified the Lagos State Ministry of Health, which in conjunction with the federal government, swung into action to contain the spread of the disease.
New Case in Lagos
Meanwhile, the federal government yesterday revealed that the fiancé of one of the primary contacts of Sawyer, who died of the Ebola virus in Lagos, also contracted the disease but had recovered, increasing the number of confirmed cases in Nigeria to 19.
The Minister of Health said this yesterday in Abuja, stating: “It has been 50 days since the Ebola virus was imported into Nigeria through Lagos, and 38 days since it was introduced into Port Harcourt.
“So far, all the cases that have been confirmed in Nigeria are traceable to the index case, the Liberian-American, Mr. Patrick Sawyer.
As of this morning, the total number of confirmed cases of EVD in Nigeria is 19, 15 in Lagos and four in Port Harcourt.”
He explained that “the 19th case is the fiancé of one of the primary contacts of Mr. Sawyer’s who died of the disease. The test results were equivocal but further tests established the disease.
“He had only mild symptoms and he has since recovered from the illness. He was quarantined but because of the equivocal test result he was not placed on active treatment.
“The total number of deaths from EVD in Nigeria stands at seven, five of them died in Lagos – one in a private hospital, the index case Mr. Sawyer, and the other four in the isolation ward in Lagos State.
“While two of the seven died in Port Harcourt – the medical doctor (Ike Enemuo), who died in a private hospital and the contact, a patient in the hospital at the time the doctor was also on admission – died in the isolation ward in Rivers State.”
On the total number of patients who had been successfully managed and discharged, the minister said the number had risen to nine, the latest being the sister, Chinyere, of the Port Harcourt doctor who was discharged from the isolation ward in Rivers State yesterday.
The nine patients successfully managed and discharged are among the 11 survivors of EVD in Nigeria, he added.
He further disclosed that at the moment, only one person, the wife of the late Enemuo, was undergoing treatment in the isolation ward in Lagos, adding, “She no longer has any symptoms and is undergoing a series of tests, preparatory to her discharge from the isolation ward this week.”
Regarding the contacts currently under surveillance, the minister said Lagos has 27 under watch, while a total of 339 contacts who were previously under surveillance had been given the all clear signal, having completed 21 days of observation.
“Port Harcourt has 477 contacts under surveillance. It is a mixed group consisting of tertiary and quaternary contacts of Mr. Sawyer’s. Five contacts have already been discharged from surveillance in Port Harcourt, having completed 21 days of observation,” he explained.
On suspected cases of Ebola outbreak in some states, Chukwu said: “In the last one week, a number of rumours have been investigated and all the cases have turned out to be Ebola-negative. Specifically, the rumours in Kebbi, Kaduna, Lagos, Oyo, Ebonyi, Delta and Sokoto States, as well as the Federal Capital Territory have all been debunked.”
It was also revealed that both the minister and other officials from his ministry inspected facilities for the management of Ebola in Rivers State at the weekend, where they met with experts working at the Emergency Operations Centre (EOC) in the state.
They were accompanied during the tour by the state’s Commissioner for Health, Dr. Samson Parker.
Speaking on the inspection, Chukwu said he was happy to note that the facilities at the Rivers State treatment centre, laboratory and EOC were satisfactory and met world standards.
“The case management team had enough medical and nursing personnel and the morale of the personnel was high,” he added.
The ministry, he said, also commenced the distribution of ambulances, utility vehicles and motorcycles to the Port Health Services at the international airports, seaports and land crossings.
Chukwu also appealed to other countries against profiling Nigerians, saying: “We continue to appeal to countries and individuals not to profile or stigmatise anyone on account of EVD. In particular, we have observed that some countries have continued to selectively quarantine Nigerian travellers without any health or scientific basis.
“For the record, let me state clearly that while any individual from any country of the world could be a carrier of the EVD and transmit same to others, no single Nigerian as of now has introduced EVD to any country.
“Nigeria shall continue to support protocols approved by the World Health Organisation (WHO), which do not support the closure of borders, do not restrict travel, and do not stigmatise anyone on the basis of the passport that one carries.”
He maintained that the federal government would continue to remain vigilant and strengthen screening at the country’s ports of entry and exit.
“As long as there is a single case of EVD anywhere in the world, every nation, every individual remains at risk and Nigeria and Nigerians are not exempted,” he said.
Chukwu Warns of New Cases
Also, the minister warned that there was the possibility of an increase of Ebola cases in the country.
He stated that though Nigeria was in control of the situation, there was need for vigilance.
“There is that possibility of having other cases as long as you have contacts under surveillance, there is the possibility of having other cases. We are not saying that we cannot have new cases from the current contacts that are under surveillance, what I am saying is that the government is in full control.
“We know what to expect, we have learnt from the experience of what we did in Port Harcourt and Lagos. We also learnt from the experience of other countries. We have the experts who came initially through the World Health Organisation and we also have Nigerian experts who have learnt since the time Ebola came into Nigeria,” Chukwu added.
The minister said the confidence in Nigeria stemmed from the fact that, “we know what we are doing when it comes to Ebola, we are in control and we have contained the situation. Ebola is not in any street in Nigeria.
“However, what we are saying is that even if there is no single case today in Nigeria, as long as there is one case anywhere in the world, Nigeria will still be at risk, so we must remain vigilant. I must stress this that until the very last case in every country is treated, everybody in the world remains at risk.”
18-month-old Admitted in Rivers
Also, during his briefing yesterday, the Rivers State Commissioner for Health, while confirming the discharge of Chinyere, Enemuo’s sister, disclosed that another suspect, who had been admitted because she showed symptoms of the disease, had also been treated and discharged as tests showed it was not Ebola.
He however said another child had been admitted into the treatment centre for symptoms of the disease.
“Right now, we have another admission, a child of 18 months. He was just admitted but not yet tested. When we test, we will be able to state his status,” he said.
Parker said this week would be very critical to the state, considering the gestation period of the virus, adding that his ministry was sensitising the people to ensure the containment of the disease.
“We need to go to the nooks and crannies of Rivers State so that we don’t miss out anything. We all need to be on bended knees this week and next week, and we will be coasting home. You know Ebola is a 21-day disease. So if we are not flooded this week and next week, then we will be coasting home. All hands need to be on deck to make sure that we are prepared for any eventuality,” he said.
He also disclosed that the state had achieved 94 per cent contact-tracing of 479 contacts, and expressed optimism that all contacts would be covered before the end of the day.
The commissioner also dismissed reports that foreigners were fleeing the state because of the disease, saying there was no need to cause panic as the disease was under control.
He said: “I don’t see any foreigner running away. In fact, these days they even come in more than they are going out. So please let us not publish anything that will cause panic in the society. We have always said that this disease can be controlled. We have controlled it in Lagos State, you can also see that it is under control in Rivers State. So we should not cause any panic anywhere again.”
On the resumption of schools in the state, Parker said even though the federal government had announced a resumption date, the state government would review the situation.
“Even the federal government has said they would have another meeting to review the situation. We are at the peak of the battle, we cannot readily say we will go with the federal government. We will review our situation. It can still be the same date or another date,” he said.
Concern over Schools’ Resumption Date
Parker’s statement of the resumption of schools in Rivers State was re-echoed yesterday by a group, Afri-Dev.Info, which expressed concern over the decision to bring forward schools’ resumption date from October 13 to September 22.
Shortly after the outbreak of Ebola in the country, the Federal Ministry of Education had held a meeting with the 36 state Ministries of Education and the Federal Capital Territory (FCT).
At the meeting, it was decided that schools should remain closed during the summer holiday till October 13, when the government might have been certain that the virus had been contained.
Last week, however, the federal government changed its mind, stating that schools would be allowed to resume on September 22.
However, Afri-Dev.Info has queried the rationale for the decision, warning that 80 million children, adolescents, students and teachers could be put at risk.
It wondered why the government had changed its mind on the “42-day no Ebola case” had been discarded by the authorities.
It said the global standard for declaring an Ebola outbreak over in a particular location is two full incubation periods (21 days x 2/ 42 days) without a case.
Afri-Dev.Info further warned that in a country with weak health systems, Nigeria would not be able to cope if the strategy backfires.
It added that teachers cannot be converted to emergency health workers based on three weeks training only and Ebola can still be transmitted in semen weeks after recovery.
It reminded the federal government that the Liberia epidemic was worsened by premature relaxation of vigilance, adding that even without Ebola, a review of some annual and cumulative health indicators for children, adolescents and young adults in Nigeria demonstrates the country’s health care system is already inadequate, with successive Ministers of Health struggling to perform miracles with insufficient resources.
The group said it would be much safer to wait for some time after the outcomes of the minimum 21-day incubation period covering the last batch of persons placed under surveillance before reviewing the date for schools’ resumption?
No Saudi Ban for Nigerians
In another development, Saudi Arabia, which has barred pilgrims from Sierra Leone, Liberia and Guinea from the Hajj due to Ebola concerns, will allow Nigerians to attend, an official was reported yesterday as saying, suggesting the smaller outbreak there was less worrying.
Guinea, Liberia and Sierra Leone have been worst hit by an outbreak of the disease in West Africa, with a combined death toll in those three countries since March of 2,097, as at September 5, WHO said.
The Arab News daily quoted Mohammed Al-Khasheem, deputy health minister for planning and development, as saying there was no need to worry about Nigerians coming on pilgrimage.
“We have not stopped issuing Hajj visas to Nigerians and we know that about 70,000 pilgrims come from the African country every year,” he was quoted as saying.
“The WHO knows the situation in Mina and Arafat during the Hajj season and there is no need to worry about a few Ebola cases that have occurred in Nigeria,” he said, referring to holy Hajj sites in Saudi Arabia.
“We have taken precautionary measures to prevent an Ebola outbreak in the Kingdom during the Hajj season,” Al-Khasheem said. “We have made early preparations for the annual pilgrimage.”
He said the ministry’s department for preventive medicine is in constant contact with the WHO on the latest developments on Ebola and other infectious diseases.
Source: Thisday

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