Clinical profile and containment of the Ebola virus disease outbreak in two large West African cities, Nigeria, July-September 2014.

Journal: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

Volume: 53

Issue: 

Year of Publication: 2017

Affiliated Institutions:  African Field Epidemiology Network, Kampala, Uganda; Department of Medicine, Morehouse School of Medicine, West View Drive SW, Atlanta, GA , USA. Electronic address: cohuabunwo@msm.edu. Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria. College of Medicine, University of Lagos, Lagos, Nigeria. Lagos State University Teaching Hospital, Ikeja, Nigeria. Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria; College of Medicine, Ahmadu Bello University, Zaria, Nigeria. Lagos State Mainland Hospital, Yaba, Lagos, Nigeria. World Health Organization, Geneva, Switzerland. Médecins Sans Frontières, Operational Base, Madrid, Spain. World Health Organization Country Office, Abuja, Nigeria. African Field Epidemiology Network, Kampala, Uganda; Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria. Nigeria Centre for Disease Control, Abuja, Nigeria. Nigeria Institute of Medical Research, Yaba, Lagos, Nigeria. Lagos State Primary Health Care Board, Yaba, Lagos, Nigeria. UNICEF Country Office, Abuja, Nigeria. Lagos State Ministry of Health, Ikeja, Lagos, Nigeria. Department of Psychiatry, University of Lagos, Lagos, Nigeria. Rivers State Ministry of Health, Port Harcourt, Nigeria.

Abstract summary 

The Ebola virus disease (EVD) outbreak in Nigeria began when an infected diplomat from Liberia arrived in Lagos, the most populous city in Africa, with subsequent transmission to another large city.First-, second-, and third-generation contacts were traced, monitored, and classified. Symptomatic contacts were managed at Ebola treatment centers as suspected, probable, and confirmed EVD cases using standard operating procedures adapted from the World Health Organization EVD guidelines. Reverse transcription PCR tests confirmed EVD. Socio-demographic, clinical, hospitalization, and outcome data of the July-September 2014 Nigeria EVD cohort were analyzed.The median age of the 20 EVD cases was 33 years (interquartile range 26-62 years). More females (55%), health workers (65%), and persons <40 years old (60%) were infected than males, non-health workers, and persons aged ≥40 years. No EVD case management worker contracted the disease. Presenting symptoms were fever (85%), fatigue (70%), and diarrhea (65%). Clinical syndromes were gastroenteritis (45%), hemorrhage (30%), and encephalopathy (15%). The case-fatality rate was 40% and there was one mental health complication. The average duration from symptom onset to presentation was 3±2 days among survivors and 5±2 days for non-survivors. The mean duration from symptom onset to discharge was 15±5 days for survivors and 11±2 days for non-survivors. Mortality was higher in the older age group, males, and those presenting late.The EVD outbreak in Nigeria was characterized by the severe febrile gastroenteritis syndrome typical of the West African outbreak, better outcomes, rapid containment, and no infection among EVD care-providers. Early case detection, an effective incident management system, and prompt case management with on-site mobilization and training of local professionals were key to the outcome.

Authors & Co-authors:  Ohuabunwo Ameh Oduyebo Ahumibe Mutiu Olayinka Gbadamosi Garcia Nanclares Famiyesin Mohammed Nguku Koko Obasanya Adebayo Gbadegesin Idigbe Oguntimehin Nyanti Nzuki Abdus-Salam Adeyemi Onyekwere Musa Brett-Major Shuaib Nasidi

Study Outcome 

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Statistics
Citations : 
Authors :  27
Identifiers
Doi : 10.1016/j.ijid.2016.08.011
SSN : 1878-3511
Study Population
Females
Mesh Terms
Adult
Other Terms
Clinical profile;Ebola virus disease;Gastroenteritis;Hemorrhagic fever;Nigeria;Outbreak containment
Study Design
Study Approach
Country of Study
Niger
Publication Country
Canada