How Nigeria contained its Ebola outbreak

While the rapid response to the Ebola outbreak in Nigeria was a significant factor in quelling the spread of the deadly disease, the country had other advantages over Liberia, Sierra Leone and Guinea where it continues to run rampant.

Rapid response was key, so was reaching out for international help

A Nigerian port health official uses a thermometer to screen Muslim pilgrims for Ebola at the Hajj camp before boarding a plane for Saudi Arabia at the Murtala Muhammed International Airport in Lagos. Thousands of people were screened per day per point of entry. (Sunday Alamba/Associated Press)

While the rapid response to the Ebola outbreak in Nigeria was a significant factor in quelling the spread of the deadly disease, the country had other advantages over Liberia, Sierra Leone and Guinea where it continues to run rampant. 

"There's a series of differences between what happened in Nigeria and what has been happening in other West African countries," said Dr. Aileen Marty, who spent 31 days in Nigeria leading an international team helping to combat the outbreak.

Nigeria recorded 19 laboratory-confirmed Ebola cases and one probable one in two Nigerian states, and nearly 900 patient contacts were identified and followed since mid-July when the outbreak took off, the Atlanta-based Center for Disease Control (CDC) said in a statement this week. Meanwhile, there have been no new cases since Aug. 31, "strongly suggesting the outbreak in Nigeria has been contained," CDC said.

Marty said Nigeria was fortunate in that the Liberian-American who brought in the disease by plane to Lagos back in July was suspected of having Ebola.

According to the CDC, Nigerian authorities took swift action, putting him into isolation and then determining he had exposed 72 people on commercial aircraft, at an airport and at a hospital. They immediately began tracing those he may have had contact with, and created an incident management centre, which later became the emergency operations centre for the disease.

The disease didn't spread rapidly, in part, because it was mostly limited to the wealthier population of Nigeria, said Marty, who is also director of the Florida International University's Health Travel Medicine Program

"The person who brought the infection was a diplomat," Marty said. "He was brought to one of the best hospitals in Nigeria, and the people who were infected were individuals who quickly comprehended the importance of following our recommendations."

Nigeria health official display a leaflet explaining Ebola at the arrival hall of Murtala Muhammed International Airport in Lagos, Nigeria. (Sunday Alamba/Associated Press)

Nigeria is also vastly more politically stable and economically affluent than other West African countries, having not suffered years or decades of civil strife.

"So you have a setting in Liberia and Sierra Leone, which has gone through horrific devastation, and complete depletion of any health-care infrastructure, which means you can't provide beds, can't adequately equip medical personal and you can't identify patients and trace contacts," said Dr. Peter Hotez, the founding dean of the National School of Tropical Medicine at Texas' Baylor College of Medicine.

Because of its oil resources, Nigeria is a relatively wealthy country, compared to others in the region, meaning it had the resources to tackle the outbreak, Hotez added.

As well, Nigeria had established a good health-services infrastructure in October 2012 as part of its emergency plan for the global polio eradication initiative, the CDC said.

But Marty said it was also important that Nigerian government officials recognized their physicians and first responders had no experience in dealing with Ebola, and so sent out a rapid cry to the international community to come help.

Marty said international teams, in coordination with the Nigerian government, fanned out across the country, employing an effective messaging campaign.

"We made it extremely clear that the sooner you get to us, the better your chances of survival, and the better the chance that your loved ones wouldn't get sick, that your community wouldn't be affected and this problem wouldn't get worse."

The CDC estimates that approximately 26,000 households of persons living near those who have been in contact with Ebola victims had been reached by house-to-house visits.

"The Nigerian government was wholeheartedly into the process of trying to solve the problem," Marty said.

Officials also made sure to cover all points of entry — air, sea and land — while creating a cadre of volunteers who had at least a college level understanding of science and who could be trained to be primary screeners, Marty said.

Marty said she helped train Nigerian physicians to become secondary screeners, and to distinguish suspected cases of Ebola from other diseases.

Thousands of people were screened per day per point of entry, with two or three suspected cases captured per day, and with one every few days taken to the isolation ward, she said.

"So the idea is not to let anybody slip through who was either coming or going with this," she said.

"The way we did the system, which was much more thorough than what's going on in Liberia, or Sierra Leone or Guinea, is we had our system so we were capturing people in transit. We actually intercepted people who weren't even coming to Nigeria. They were just passing through."

Lots of companies, which benefit greatly from Nigerian oil, also played a major role, donating important supplies like ambulances, stretchers and bleach. 

"The enormous fear of it getting into the impoverished areas of Nigeria, and then affecting industry was really high and was a real motivator for industry," she said. 

With files from The Associated Press