The Ebola virus disease which has been a thing of collective concern across West African region in the past few months could be on the brink of taking a whole new dimension if urgent government steps are not taken in the interest of the collective health security within affected States and Countries.
The Federal Ministry of Health report stated that as at 3rd September 2014, 18 Ebola cases have been confirmed in Nigeria with Lagos having 14 and Port Harcourt 4. This brings Nigeria Ebola Virus Disease statistics to 18 confirmed cases with 7 deaths. Though a number of quarantine and isolation centres have been set up across many States of Nigeria in preparedness for case management of further possible infected cases.
In WHO's latest situation update on Port Harcourt, the agency warns "the outbreak of Ebola virus disease in Port Harcourt has the potential to grow larger and spread faster than the one in Lagos." There are now 3 confirmed cases in Port Harcourt. The first was a close contact of the first case in Nigeria. This person fled quarantine in Lagos, and was treated in a hotel in Port Harcourt from 1 to 3 August. The treating doctor developed symptoms on 11 August but continued to treat patients, including performing operations, until 13 August. He was hospitalised on 16th, died on 22nd and Ebola was confirmed on 27th. He had many contacts with friends and relatives while infectious, and even during hospitalisation, where WHO says "he was attended by the majority of the hospital’s health care staff". There are over 200 contacts under surveillance, of whom about 60 have had high or very high risk exposure.
This WHO’s recent update when placed in juxtaposition with the Nigerian government recent announcement on reversal of resumption date in Nigerian schools from 13th October 2014 to 22nd September 2014, it gives everyone reasons to be concerned on how we intend to control the Ebola Virus Disease when allowed to get into the schools. When the Federal Government of Nigeria earlier with the month of August 2014 announced a shift in the Nigerian schools proposed resumption date from 22nd September to 13th October 2014, a number of Public Health experts saw that decision as very timely and widely adjudged as right in absolute. The recent resumption date change of 22nd September has a huge potential of taking the Ebola Virus Disease infection in Nigeria to a whole new dimension and I personally feel this very decision should be further reviewed by Government in Public Health interest.
I recall the words of a Ugandan I met at Abuja who works with UNAIDS, he told me Uganda has had a number of Ebola Virus Disease outbreaks which has led the country into developing a better capacity to managing successive outbreaks based on lesson learnt in the previous ones. He told me the first thing Government does is to close down all schools and even sometimes the markets, this is just a natural thing to do as a further containment measure to guide against uncontrollable spread.
When we use Port Harcourt as our case study in the context of this presentation, you will realise school resumption could fuel the wild spread of this disease beyond the capacity of the State. Nigeria has done well thus far in the context of how the Government of Lagos State, The Federal Ministry of Health and Centre for Disease Control (CDC)’s combined efforts in ensuring the disease is kept within a controllable limit. We have about 200 contacts recorded in Port Harcourt of whom 60 persons have had high risk exposure as reported by WHO, but we must understand there may be some contacts that escaped unidentified and unreported and these persons live within the society without any form of symptoms because they are still within the widow period of 2 – 21 days and they are not in any way under quarantine of surveillance. These sets of potential Ebola Virus Disease infected escapees may be married with children who may be amongst the children who are bound to resume schools come 22nd September alongside children from different homes, yet the schools are not trained on what to do when they see a school child that complains of illness with high temperature above 37.2 degree centigrade or shows any symptom of illness. We must understand that once a child has contracted this disease, there is a very high likelihood of the child’s parents and siblings getting infected also.
This list could go on and on but I would rather think instead of this hasty resumption date that has just been announced by Government, we should allow the children remain at home until we are clear on the true position of EVD based on the recent development while we monitor the yielded result of the containment measures already deployed. The new resumption date is rather creating panic and further fear in parents amongst who are many that are reluctant to send their children back to schools.
Let’s even look at the children from homes where parents have visited any of the high risk Ebola Virus Disease prevalent countries, no one has this fact neither is anyone sure of the current health conditions of such parents and even if they have the symptoms of EVD their wards will still come to school where they would miss up with other children from different homes. This is going to be too messy and highly difficult for us all to manage and I think the Government needs to clearly review the resumption decision.
Within last week, I had the opportunity of discussing with a couple of parents and I also share in their fear as expressed. One of the parents who works in the bank told me her daughter is still very tender and due to resume crèche but she is so scared and not sure if she wants to allow the child to resume because of this Ebola scare and recent development. I am sure many parents, including school teachers and school proprietors share in this same fear because everyone is involved in this long chain or cycle of possible infection if this disease is allowed to enter our schools.
I by this appeal once more to the Federal Government of Nigeria and other agencies responsible for this recent school resumption date’s decision to please review the inherent risk and consequences this decision has on the safety and security of the health of Nigerian public and ensure a better decision is arrived at in the interest of collective safety of Nigerians.
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