Bundibugyo Ebola: Early detection, isolation key to containing Nigeria’s outbreak – Expert

Nigeria must prioritise early detection, immediate isolation, rigorous contact tracing and quality supportive care to contain the Bundibugyo strain of Ebola virus, a medical scientist has said.

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Adegboro, who is the incoming Chairman of the Rapid Response Committee of the Academy of Medical Sciences, Nigeria, warned that the absence of an approved vaccine or specific treatment does not make the disease uncontrollable, saying Nigeria’s immediate response should be guided by evidence-based public health measures rather than expectations of premature mass vaccination with an experimental vaccine.

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In an interview, he told Vanguard that Nigeria does not need to embark on experimental vaccination at this stage, given the reported single index case and the ongoing monitoring of identified contacts.

Adegboro said the government, through the Federal Ministry of Health and Social Welfare and the Nigeria Centre for Disease Control and Prevention (NCDC), should ensure that suspected cases are identified quickly and tested without delay.

He explained that although a vaccine specifically targeting the Bundibugyo strain remains experimental, patients can still benefit from prompt diagnosis, careful clinical management and measures designed to prevent infection among healthcare workers, caregivers and other contacts.

“Although there is currently no approved vaccine or specific treatment for Bundibugyo virus disease, this does not mean that the disease is untreatable or uncontrollable. Early diagnosis, effective isolation, high quality supportive care and rigorous infection prevention can save lives and limit transmission,” he said.

The expert’s recommendations come amid concerns about Nigeria’s ability to prevent a localised Ebola infection from developing into a wider outbreak in a country characterised by extensive domestic and international travel, densely populated urban centres and substantial movement across land borders.

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He said Nigeria had valuable public health assets, including disease surveillance networks, laboratory expertise and experience coordinating responses to infectious disease outbreaks. However, their effectiveness must be assessed against current operational realities.

On the country’s preparedness to detect, isolate and manage suspected cases, particularly those with major transport links and high population movement, he said Nigeria has important public health assets.

“But we must distinguish between having preparedness structures on paper and demonstrating that they can function effectively under pressure. Nigeria has valuable experience from the 2014 Ebola outbreak, which it successfully contained through case identification, contact tracing, infection prevention and coordinated emergency response.

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“We also have established national and subnational disease surveillance structures, laboratory expertise and experience managing other infectious disease emergencies. These are important advantages.

“However, we should not automatically conclude that Nigeria is fully prepared simply because it contained an earlier outbreak. Our preparedness must be tested against the realities of today’s Nigeria: extensive domestic and international travel, high population density in major cities, substantial informal movement across land borders, uneven healthcare infrastructure and the possibility that patients may initially present to facilities without adequate infection prevention capacity,” he remarked.

On international assistance, Adegboro said Nigeria should work closely with the World Health Organisation, WHO, and the Africa Centres for Disease Control and Prevention to strengthen its technical and operational response.

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He said lessons from previous Bundibugyo outbreaks in Uganda and the Democratic Republic of the Congo reinforced the importance of technical cooperation that would strengthen Nigeria’s domestic capacity rather than create long term dependence on external deployments.

Such support, he indicated, should reinforce surveillance, laboratory diagnosis, infection prevention and control, clinical management and the ability of response teams to trace and monitor contacts.

For Nigeria, he argued, the immediate priority should be to interrupt transmission through rapid identification of suspected cases, safe isolation, laboratory confirmation, contact tracing and strict infection prevention measures.

Ultimately, the expert said, the country’s ability to contain the index case and prevent additional infections will depend on how effectively these measures are implemented across the health system.

“The central challenge is not simply whether Nigeria has the technical capacity to respond, but whether that capacity can be deployed quickly, consistently and effectively enough to stop the virus from spreading,” he stated