Ebola latest: Another nurse dies !

A nurse, Justina Obi Echelonu, one of the primary contacts who participated in the initial management of the index case, late American-Liberian, Patrick Sawyer, at the First Consultant Hospital, Obalende, Lagos, has died in quarantine.

She is the second nurse and fourth fatality of the Ebola Virus Disease in the country.

Minister of Health, Professor Onyebuchi Chukwu confirmed her death yesterday at a joint press briefing with the Minister of Information, Labaran Maku, in Abuja.

Chukwu, who disclosed that another of the doctors who treated the late Patrick Sawyer tested positive to the deadly virus, said Nigeria has now recorded 10 confirmed cases of Ebola Virus Disease, EVD, of which four have died and six are currently under treatment.

“The total number of persons under surveillance in Lagos is now 169. These are all secondary contacts as all the primary contacts have completed the 21-day incubation period and have been de-listed to resume their normal lives,” the Minister explained.

Earlier, a top medical expert who is part of the medical team of experts managing confirmed cases at the Ebola Ward of the Mainland Hospital, Yaba, Lagos, said the nurse passed away in the early hours of yesterday.

“We lost her in the early hours of today after much effort. She was one of the people that helped Sawyer when he was vomiting and stooling. That was when she contacted it,” he remarked.

Lagos State Commissioner for Health, Dr. Jide Idris, who spoke to our correspondent on phone, said he could not confirm the death of the nurse yet but promised to give details after the Ebola Management Committee meeting scheduled to hold at the hospital later in the evening.

Also confirming news of her death, Abia State Governor, Theodore Orji regretted the demise of the nurse, and commended her for her selfless service to the nation. In a statement issued, yesterday, the governor prayed for the repose of the dead.

“My heart bleeds as I write this. On behalf of my family, the Government and the good people of Abia State, I commiserate with family, friends and colleagues of our dear lady nurse, Justina Echelonu, who died following the contact she had with the American-Liberian, Mr. Patrick Sawyer, in the course of discharging her duty as a nurse. I pray God to give them the fortitude to bear this tragic and irreparable loss. Rest in Peace Ms Justina Echelonu.”

Ms. Echelonu is the fourth person to die of the disease in Nigeria after Mr. Sawyer died on July 25 and was followed by two other nurses.

Justina, 25, previously worked at Otunba Tunwase National Paediatric Centre, Ijebu-Ode in Ogun State before relocating to Lagos to take up appointment with First Consultants Hospital. She hailed from Mbaise in Imo State and graduated from the Department of Nursing Science in Ebonyi State University, Abakaliki.

Justina’s story before she died

“I never contacted his fluids. I checked his vitals, helped him with his food (he was too weak)….I basically touched where his hands touched and that’s the only contact, not directly with his fluids. At a stage, he yanked off his infusion and we had blood everywhere on his bed…but the ward maids took care of that and changed his linen with great precaution.

“Every patient is treated as high risk…if it were airborne, by now wahala for dey. I still thank God.

Friends, up to our uniforms and all linen were burnt off. We are on surveillance and off work till 11th.

“Our samples have long been taken by WHO and so far we have been fine. For me, kudos to my hospital management because we work professionally with every patient considered risk, because that’s the training.

“Had it been it’s a hospital where they manage ordinary gloves like government hospitals and some janjaweed private hospital, …wahala for dey o. I must also thank Lagos Govt…in fact! Even Federal Government sef (sic)…all have been supportive. I’m good and so are the others in the hospital…”

(culled from her Facebook page).

Enugu, Abia, Anambra, Abuja cleared

Further, the Health Minister stated that Enugu State now has six persons under surveillance as 15 after complete evaluation were found not to have had contact with the nurse, a primary contact of the index case who became symptomatic and tested positive and is one of the 10 confirmed cases.

“The nurse who had been placed under surveillance in Lagos disobeyed the Incidence Management Committee and travelled to Enugu. At the time she made the trip, she was yet to show any symptom and did not infect anyone on her way as transmission of the disease is only possible when a carrier of the virus becomes ill.

“However, she has since been brought back to Lagos. Before the return journey, she had become symptomatic and had to be conveyed to Lagos with her spouse in special ambulances. The husband is not symptomatic neither is he positive for Ebola Virus Disease but has been quarantined given the intimate contact with her while in Enugu.

“It is therefore important to emphasise that there is no Ebola Virus Disease in Enugu. All cases are still confined to Lagos State. Also, reports of Ebola Virus Disease in Abia, Imo, Akwa Ibom and Anambra States as well as the Federal Capital Territory, Abuja have all been investigated and none of them was found to be Ebola Virus positive,” Chukwu affirmed.

The minister reaffirmed that the last Federal Executive Council, FEC resolved to partner with the World Health Organisation, UNICEF, governors in their respective states and their commissioners for health for adequate co-operation. “We have been in contact with the private sector and Nigerian scientists both home and abroad”.

He announced that an emergency operation centre under the coordination of the Nigeria Centre for Disease Control (NCDC), in collaboration with an inter-ministerial committee headed by the Minister of Information, Labaran Maku, has been set up by President Goodluck Jonathan.

Chukwu affirmed that all the 36 states and the Federal Capital Territory, FCT are well prepared to contain the virus even in the states that the EVD has not been reported aside Lagos, adding that all hands are on deck to prevent its spread within and outside Lagos.

He said President Goodluck Jonathan held an emergency meeting with all states of the Federation and the FCT to review the state of preparedness of each of the states during which each of the states gave a status report on their readiness while the Lagos State Government gave an account of the Ebola experience in the state.

Chukwu said the Federal Government and international health agencies commended the efforts of the Lagos State Government, describing it as adequate and satisfactory from preventing the spread of the virus.

He said most of the states are very well prepared ahead, and added that the World Health Organisation, commended President Jonathan for the leadership provided, especially his personal commitment to ensure that the EVD does not spread further.

He appealed to Nigerians to adhere strictly to health regulations of washing their hands with sanitizers in line with the WHO international health regulations and in keeping with international best practices in order to keep safe and healthy.

Chukwu further stated that health specialists have been positioned in all of the nation’s entry points, and active surveillance has also been stepped up. All government tertiary health institutions have also been equipped to handle any emergency that might arise from the disease.

“In Imo State, the case was that of a corpse returned from Liberia to Abia accompanied by proper medical certificate of death, and added that the deceased was confirmed to have been cleared of Ebola.

“In Anambra, a corpse was also returned from Liberia with medical certificate of death while all the people that accompanied the corpse had no Ebola

“In the case of Garki Hospital, Abuja, a diabetic and HIV patient was taken to the hospital in coma after which the doctors exhausted all necessary tests for Ebola.”

Chukwu said it was deduced that a patient that had two critical diseases, he could as well have had Ebola but the test carried out was negative hence there is no case of Ebola.

The Imo case, he said, was a case of Stephen Johnson’s syndrome, meaning that the patient reacted to a malaria drug which caused her skin to start peeling off and not a case of Ebola.

Fleeing Nurse attended wedding

Enugu state government said yesterday that nobody is quarantined in the state over the deadly Ebola virus. The State Commissioner of Health, Dr George Eze who made this known while speaking with journalists confirmed that about 20 persons were under surveillance following contact they made with the nurse who attended to the late Patrick Sawyer.

Eze stated that the state government  has designated four centres including the Colliery Hospital, the District Hospital in Ikem, General Hospital in Nsukka and Oji River General hospital as isolation centres for victims of the disease.

The government’s clarification  came as the state branch of the Nigeria Medical Association (NMA), expressed displeasure over the poor preparedness and the way in which the state government has responded to the Ebola virus issue.

The association stated that till date, medical workers in the state were still confused on where to send patients with the ailment, stressing that government has paid less attention to procuring protective devices for volunteers and health workers that could enable them attend to the cases.

Eze stated that the nurse that had contact with Sawyer defied medical advice to visit the husband in Enugu, explaining that the government had acted swiftly on receiving the information and ensured that she and the husband were taken back to Lagos.

He stated that the 20 persons placed under surveillance were due to the contact they had with the lady, explaining that they would only be isolated when they begin to manifest symptoms of the virus.

He said: “You do not quarantine somebody who is moving about because it is only when you develop symptoms that you will be able to transmit the virus and that is when you have excess viral load. It was when she came down to Enugu from what we got from her and the husband that she now started having symptoms. It was then that we were informed, we moved in swiftly and provide the wherewithal with support from expatriates that came down from Lagos, we were able to isolate her and decontaminate the house in line with WHO standard and took her back to Lagos.

“Naturally you have to try to track down the contacts anywhere. It is those contacts that have been put under surveillance. They are in their homes and they are placed under surveillance by Centre for Disease Control in Lagos”.

He stated that the panic being expressed over the development was unnecessary, stressing that the disease can only be transmitted by those who have manifested the symptoms which will unlikely be walking about the streets.

On the provision of protective gear and other materials for personnel, he said the state like others have requested for the facilities from the federal government and would ensure that the materials were not fake.

On the information that the lady in question had attended a wedding in Enugu, he said: “If somebody is well enough to attend and enjoy himself in a wedding, it is not going to transmit the virus. It is only when the person has become ill and developed symptoms”.

On why it has taken so long for the Ministry to brief the people of the state on the situation of things regarding the disease, he said that he wanted to ensure that the public were given the right information.

He said the centres earmarked have been provided with facilities such as bed among others, adding that Centre for Disease Control would soon start training volunteers.

Waivers for corpses from Ghana, India

The Health Minister said waivers were granted to corpses brought in from Ghana and India because they were not Ebola cases. He explained that the one from India died from cancer of the rectum adding that both were proper certified.

Concerns over quarantined victims

Meanwhile, fears heightened yesterday over the health of 198 Nigerians in quarantine, following reports that they are critically ill.
Although plans are underway by the Federal Government to provide Personal Protective Equipment, isolation tents and relevant facilities to halt the spread in the country, concerned Nigerians have called for technical support and expertise from the United States of America and the international community to help contain the spread of the disease in Nigeria
Speaking in Lagos, Managing Director, Premium Health, HMO, Dr. Ladi Okuboyejo, disclosed that. while a few victims have passed on as a result of infection with the virus, there is need for international intervention to halt the likely spread of the disease as the situation is beyond what the country can deal with presently.
Okuboyejo commended the chief consultant and other health workers at the First Consultants Hospital, Obalende, for promptly reporting the case to the appropriate health authorities after the late Patrick Sawyer, failed to respond to treatment. However, he pointed out that a lot more needed to be done to address the situation so that it does not get out of control in the country.
”We have been following closely and know some of the individuals that are being quarantined and it is beyond what we can deal with right now.
“This disease is new to us in the country and we have never been involved in containing this kind of outbreak. There is need for the international community to come and assist Nigeria in helping to halt the likely spread of the disease. As we speak, those quarantined are critically ill.
”I know that the Federal Government is trying its best but there is a lot more we can do to address this situation. Nigeria is too big to be ignored. This disease is new to us in Nigeria and there are experts
globally that have experience in treating Ebola globally. We need to tap into their expertise in-country. It is a learning curve for everyone. It is beyond our capacity to handle. If this gets out of control, the consequences, you know,” Okuboyejo disclosed.

Relatives of infected doctor send SOS to US, others

Okuboyejo, who led a group of relatives and concerned friends of the quarantined Senior Consultant Physician and Endocrinologist, Dr. Ameyo Stella Adadevoh, of the First Consultants Medical Centre, at a media briefing in Lagos yesterday, sent an SOS to the United States and international community.

“When you turn on your television now the first news item you hear about is Ebola. A few victims have passed on and the question is what is the state of things in our nation right now. We have been following it very closely because a couple of us happen to know a number of people who have been quarantined and it is obvious to all of us that are concerned that are sitting down here that it is beyond what we can deal with. We would not want to paint what is black white but it is beyond what we can deal with right now and therefore we feel that there is a need for us to make this urgent cry for help for the international community to come to our aid and our assistance.
“I think that it is important that we reflect back and try and see how things happened. I am a medical doctor and I am surprised that they made the diagnosis in the first instance because this is a man that could have gone somewhere else and could have been treated for malaria and he could have died and spread the thing like wild fire. However, the chief consultant that attended to these patients who is also being quarantined right now felt it was very necessary for them to send the blood sample for screening after which it was confirmed and she insisted he must not leave the Hospital.
“So I think we must get the facts right and really come out. We are particularly concerned that if someone could be so patriotic as to save millions of Nigerians from the hardship of this pestilence, the least we can do is to make an appeal to the international community for assistance.
“Two Americans were flown to Atlanta for help. The chap who brought this thing to Nigeria was an American. Our question is that what is the international community doing for us? What are they doing to help the situation because as we speak this is beyond what we can cope with. For example the patients that are there under quarantine, do they even have water? Do we have the facilities to cope with this? It is a big question mark.

“We know that the government is trying but certainly there is a lot more we can do to improve the situation. This why we are making this passionate cry and appeal to the international community to come to our aid so that this doesn’t get out of control. Nigeria is the most populous country in Africa and God forbid if this runs out of control. The consequences you all know. So we have to call you to make this passionate appeal to you.”