Nigeria has 500 epidemiologists, govt should let them lead Ebola response, expert says

A senior field epidemiologist, Peter Adewuyi, has called on the Nigerian government to put the country’s trained epidemiologists at the forefront of efforts to contain the confirmed Ebola case, saying Nigeria has about 500 specialists capable of supporting the response.

Mr Adewuyi, who led contact tracing during Nigeria’s 2014 Ebola outbreak, said the country should rely on its existing public health expertise rather than depend on foreign epidemiologists to manage the outbreak.

“We have about 500 epidemiologists in the country and the government should just allow them to do their work,” he said during an interview on ARISE TV Morning Show on Thursday.

His comments came two days after Nigeria confirmed an imported Ebola case in a woman in the Federal Capital Territory, raising concerns about the risk of further transmission and the capacity of the country’s surveillance system to detect infections early.

The World Health Organisation said the patient’s symptoms began on 7 October, four days after her arrival in Nigeria. She sought treatment at a private health facility in Abuja on 11 October, and laboratory tests confirmed the infection on 20 October.

The patient is receiving treatment in isolation, while health authorities have identified 44 contacts and are monitoring them for possible symptoms.

Mr Adewuyi said the response to the case had begun early but stressed that the time taken to detect the infection was a concern.

He cited the “717” surveillance performance indicator, which he said requires suspected cases to be detected within seven days, reported within one day and followed by a response within seven days.

“We are supposed to detect within seven days, report within a day and then respond within seven days. Response is okay, reporting is okay, but the detection took about eight to nine days and that is the fear as far as the response that we are given right now,” he said.

‘Local expertise should lead response’

Mr Adewuyi said Nigeria did not need foreign epidemiologists to lead its response, pointing to the pool of trained professionals already available in the country. “Nigeria does not need people to come from outside,” he said.

He cited the African Field Epidemiology Network, which he said was supporting the Nigeria Centre for Disease Control and Prevention to deploy more epidemiologists to the field.

He also pointed to the Nigeria’s Integrated Disease Surveillance and Response system, which is designed to track diseases from health facilities and local government areas through state authorities to the national level.

He said the system provides a structure for identifying and reporting infections and coordinating responses across the country.

Contact tracing

The epidemiologist stressed that contact tracing must cover everyone who may have been exposed to the infected woman before her diagnosis, including health workers and other people who entered the facilities where she received treatment.

“So in this case, all the people that treated this person from day one till the time she was diagnosed, all of these people are contacts. Whether the person that came to sweep the room, whether the person that came to make the bed, every one of them,” he said.

He warned that the number of identified contacts could increase as investigations progressed, calling on anyone who might have been exposed to provide accurate information to health authorities.

Contact tracing is a critical part of Ebola containment because it enables health officials to identify potentially exposed people, monitor them for symptoms and isolate suspected cases promptly.

Nigeria’s 2014 experience

Nigeria successfully contained its 2014 Ebola outbreak after an infected traveller from Liberia arrived in Lagos. The country recorded 19 laboratory-confirmed cases and one probable case, with eight deaths.

The WHO declared Nigeria free of Ebola transmission on 20 October 2014, after 42 days without a new case.

PREMIUM TIMES reported that the federal government had strengthened its Ebola preparedness before the latest case was confirmed, following outbreaks in the Democratic Republic of the Congo and other African countries.

The latest case is as a result of the ongoing regional outbreak of Ebola Bundibugyo virus disease, a strain for which no licensed vaccine has been approved specifically.

The federal government has activated its response arrangements, while the WHO and other partners are supporting efforts to contain the infection and prevent further transmission.