Ebola virus disease (EVD) outbreak in Dallas, USA: tips from Nigeria’s response

Background: The recognition that a case of Ebola Virus Disease (EVD) constitutes an epidemic is perhaps the first step in planning an effective response to the outbreak. The grave impact of EVD in West Africa may indeed spread to become a global issue if appropriate measures are not taken correctly and timely. This brings to bare the need for key stakeholders especially health workers and indeed the general public to know what constitutes the case definition of EVD.

Case Definition for Ebola Virus Disease (EVD)

Illness in a person who has both consistent symptoms and risk factors as follows:


1) Fever of greater than 38.6 degrees Celsius and additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage;


2) Epidemiologic risk factors within the past 3 weeks before the onset of symptoms, such as contact with blood or other body fluids of a patient known to have or suspected to have EVD; residence in—or travel to—an area where EVD transmission is active; or direct handling of bats, rodents, or primates from disease-endemic areas.

Pls note : Malaria diagnostics should also be a part of initial testing because it is a common cause of febrile illness in persons with a travel history to the affected countries.

For more information please visit:  http://www.cdc.gov/vhf/ebola/hcp/case-definition.html

Health workers: The place of health workers is bi-facetted, as they are the most at risk group as well as the front line solders in the fight against the EVD. A high index of suspicion is key to selecting eligible suspects, confirming cases of EVD and quarantining contacts. It should however be noted that a missed case of EVD can be potentially catastrophic. Standard operating protocols and guidelines should be developed as part of preparedness plans. These protocols should highlight areas such as; patient screening and triage, transportation of patients, isolation guidelines and case management etc. It is recommended that an isolated but centrally located treatment centre be established and full equipped with necessary equipment and infection control consumables.

Contact tracing and quarantine: All contacts should be identified and closely monitored in preferably a quarantine facility with self contained apartments. However practiced in Nigeria, quarantining patients at home was practiced with some success, but not without its attendant limitation of inadequately monitoring contact’s movements. When practiced, contacts are visited daily and clinically monitored for health changes baring in mind the natural history of EVD.

Surveillance: Close scrutiny and continuous watchfulness disease patterns and cause of deaths should be monitored. An efficient reporting system is key an effective surveillance.

Health education and Advocacy: Educating the general public on signs and symptoms of EVD, infection control (hand hygiene) and prevention practises cannot be over emphasized. Empowering the public with correct information prevents panic reactions as many health conditions mimic EVD. Finally, political will remains the driving force to an effective response.

“Lets act fast to prevent Ebola Virus Disease”

Dr. Victor A. Aduayi MBChB, MPH, FWACP (Comm.H)

Dept of Epidemiology and Community Health,

Ekiti State University, Ekiti state, Nigeria.

email; [email protected]

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