Nigeria CDC: The overall risk of importation of the Ebola virus and the impact on the health of Nigerians has been assessed as HIGH

October 7, 2022

Africa

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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.

The NCDC-led multisectoral National Emerging Viral Hemorrhagic 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 hemorrhagic 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 neighboring 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.

Uganda reports two additional confirmed Ebola cases, Bunyangabu becomes the 4th district with a case

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 program) 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.

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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) program nationwide with guidelines and training packages developed for health care workers.