Equatorial Guinea, a country just south of Cameroon in West-Central Africa, is hosting the one million people gathered for the 30th Africa Cup of Nations after Morocco refused due to the largest Ebola Virus Disease (EVD) outbreak in history in West Africa.

Soccer ball/flomar (public domain)
Soccer ball/flomar (public domain)

Much preparation was required to make the sporting event as safe as possible, with efforts from Equatorial Guinea’s Ministry of Health, FIFA and the World Health Organization (WHO).

What does it take to prevent, identify and respond to potential Ebola virus transmission at such a large mass gathering? WHO discussed it in an feature article.

“Large mass gatherings like the FIFA World Cup, the Olympic Games or the Africa Cup of Nations are highly visible events and offer the occasion to promote long lasting health legacies,” says Dr Maurizio Barbeschi, WHO scientist and team leader for the WHO preparedness and mass gatherings team.

“Mass gatherings require extensive preparation,” adds Nicolas Isla, WHO technical officer within the same team, now deployed in Equatorial Guinea for AFCON. “Coordinated surveillance and alert systems have to be installed in each point of entry, stadium and hospital. Rapid response teams, dedicated health-care facilities and labs must be developed and ready to handle any potential cases. Health authorities must ensure that local and visitor populations are educated about early symptoms of Ebola and how to protect themselves. Hand washing areas, mobile toilets, isolation areas and personal protective equipment must be placed in strategic areas. This is no small feat.”

The unique nature of Ebola preparation is in addition to other preparedness required to include food and waterborne illness, injuries and the ever present risk of terrorism.

Some of the preparation was taken from previous events in Nigeria last summer.

In Equatorial Guinea, this work included supporting the Ministry of Health to develop Standard Operating Procedures for the Ebola response and establishing epidemic surveillance and response systems for Ebola virus disease, involving airports, stadiums, and select healthcare centres across the country.

Image/CDC
Image/CDC

The team also trained healthcare workers in infection prevention and control and provided advice on the finalization of three Ebola Treatment Centres being built.

“We were encouraged by how much had been already done in Equatorial Guinea, especially given the amount of work that is needed to prepare for an event like the Africa Cup of Nations. We really worked hand in hand to establish and implement protocols for preparing, detecting and managing suspect and confirmed cases,” says Nicolas Isla, WHO technical officer.

“The country has done a tremendous amount of social mobilization around Ebola and is carrying out temperature screening at airports and stadiums. At stadiums they are also disinfecting spectators’ hands with hand sanitizing gel as they enter – people are very receptive to this.”