Nigeria’s efforts to contain the deadly Ebola virus have suffered a major setback with the news that another medical doctor has been killed by the disease in Port Harcourt, Rivers State. The news was announced by the Minister of Health, Prof Onyebuchi Chukwu, at a news conference in Abuja on Thursday.
The doctor’s passage on Friday, the first outside Lagos, caused panic in Rivers State and worry among health personnel and other stakeholders battling to stamp out the disease in the country. Although Chukwu did not give the identity of the doctor, the Rivers State Government said he is Iyke Enemuo.
Enemuo was said to have contracted the virus from an Economic Community of West African States diplomat while allegedly treating him of Ebola symptoms in a hotel in Port Harcourt. It was gathered that Enemuo, before he took ill on Tuesday “operated on a woman on Monday presumably after treating the diplomat.”
A resident of the city said on her Facebook page that the doctor’s widow, who was quarantined alongside the diplomat, had a three-month-old baby. The ECOWAS official whose name was also not given by Chukwu, was said to have had contact with the index case in Nigeria (Patrick Sawyer).
He was placed under surveillance in Lagos but he escaped to Port Harcourt where he checked into a hotel and contacted Enemuo for treatment. The official recovered from the ailment and returned to Lagos. Health workers were said to have tested him when he allegedly came for a clearance certificate and gave him a clean bill of health.
The minister said following a test conducted on the corpse of Enemuo which showed that he died of the EVD, Health ministry officials placed 70 people who came into contact with him either when he was sick or touched his corpse, under surveillance. But the Rivers State Government said “about 100 contacts from a hotel, patients of Dr. Enemuo and patients of the hospital where Enemuo was treated until his demise have been identified and restricted.’’
Chukwu told journalists that Enemuo’s death had increased the number of deaths recorded as a result of the EVD to six. He explained that even though the ECOWAS official did not presently have the EVD, further laboratory tests indicated that he had suffered the deadly disease before travelling to the oil-rich city.
Chukwu said, “This case (ECOWAS official) would have been of no further interest since he had completed the 21 days of surveillance without any other issue, but for the fact that the doctor who treated him died last Friday, August 22, 2014. “Following the report of this death by the doctor’s widow the next day, the case had been thoroughly investigated and laboratory analysis showed that this doctor died from EVD.
“As a result, several contacts have now been traced, registered and placed under surveillance. However, because the widow is now symptomatic, she has been quarantined pending the outcome of laboratory tests on her.” The minister added that the Incident Management Committee had already deployed a very strong team in Port Harcourt to work with the Rivers State’s health authorities.
He assured Nigerians that “just like the situation has effectively been managed in Lagos and Enugu, the situation in Port Harcourt will also similarly be effectively managed and we have begun to do so.’’ He said, “The doctor’s blood sample tested positive after death. Also, 70 persons have been placed under surveillance in Port Harcourt.
“I want to charge the residents of Port Harcourt not to panic over this situation as the experience we have gathered from Lagos and Enugu respectively indicate that there is no cause for alarm when you have the government fully in control of the situation.
“Once again, we appeal to all contacts under surveillance to abide by the advice given to them by the Incident Management Committee. “With regard to Enugu, all secondary contacts will be followed up till tomorrow (Friday) when they are all expected to be discharged from our surveillance.
He maintained that the total number of cases treated at the isolation ward in Lagos stood at 13 while the total number of those discharged was seven. The minister added that the only person currently under treatment at the isolation ward was stable and improving clinically.
Also at the news conference, the Minister of Information, Mr. Labaran Maku, appealed to Nigerians under surveillance to respect the advice of medical personnel pending when they would receive a clean bill of health to travel. But in Port Hourcourt where some residents feared that many people who came into contact with Enemuo and the ECOWAS official might have gone underground, the state government said it acted proactively by placing about 100 persons under surveillance.
A statement by the Rivers State’s Commissioner for Health, Dr. Sampson Parker, quoted Governor Rotimi Amaechi as urging “every Rivers State citizen and resident to remain calm and go about their normal business.” The statement read in part, “it is with a heavy heart that I announce to you that the Ebola virus has claimed its first victim in Rivers State. Dr. Iyke Sam Enemuo died last week Friday, August 22, 2014 as a result of what was suspected to be EVD.
The Rivers State Ministry of Health on becoming aware of the conditions of his death, immediately commenced investigations and contact tracing. “As of today (Thursday), about 100 contacts from a hotel, patients of Dr. Enemuo and patients of the hospital where the Enemuo was treated until his demise have been identified and restricted in Rivers State. The locations are being decontaminated.
“From our investigations, some facts have emerged. A member of staff of ECOWAS on the team that received the late Patrick Sawyer, the Liberian-American diplomat, who died of Ebola in Lagos, made a trip to Port Harcourt where he checked into a hotel and met with Dr. Enemuo. “About a week after his departure, Enemuo took ill and was rushed to a hospital where he presented with symptoms of fever, diarrhea and vomiting.
“In the course of treatment, the managing physician became suspicious and took samples for investigation. A few days after, Enemuo died on August 22, 2014. His body was deposited in a mortuary in Port Harcourt. “Enemuo’s widow, who is also a medical doctor and who cared for him during his illness, has taken ill. She is being quarantined.
‘‘A few hours ago, results of the test carried out on samples taken from Dr. Enemuo came back and was positive of EVD.” A resident of Port Harcourt, said in her Facebook post, that the latest development was a calamity. “It’s quite a calamity unfolding in Port Harcourt. Unfortunately, the city’s health facilities are not quite ready to contain Ebola at the moment,” she lamented.
The resident said Enemuo, before he took ill on Tuesday, “operated on a woman on Monday presumably after treating the diplomat.” She wrote, “He (Enemuo) fell ill next day Tuesday and died last Friday. No one knew about the hotel angle which was a very big risk he took…and unethical thing to do.
“He was ill for three days and then started vomiting blood. He was first rushed to one hospital where he was rejected and then taken to Good Heart Hospital whose owner is a Cardiologist and a consultant physician with the University of Port Harcourt Teaching Hospital. He died there. “The doctor that died practises in East West Road, Rumuokoro…Sam Steel clinic. The wife, also a doctor, has a three-month-old baby.
“As it is, there may have been well over 200 contacts of this devilish diplomat who lured his young doctor friend to treat him secretly and went back to Lagos. We have to look at the health workers in the Good Heart Hospital, Sam Steel Clinic, the members of staff of the hotel and its guests, those who travelled with the diplomat in the same vehicle(s) or aircraft from Lagos to Port Harcourt, the late doctor’s family members. The list goes on and on.”
The resident ,who is an educationist, added that what played out in this latest development was what she called the “Ostrich mentality of our people.” She said, “My own take is what is with the foolishness of people who suspect they have Ebola not wanting to subject themselves to straight testing. Don’t they know quick detection could save their lives and those of others?”
Another resident said she was particularly worried that Ebola had reached Port Harcourt, a city where according to her, social and economic activities are very high. He said, “Look, I am troubled that this virus in here with us. I am disturbed because I know this state cannot easily trace people who came into contact with the so-called diplomat and the doctor that died.
“I fear that many of the contacts must have travelled to neighbouring states like Abia, Akwa Ibom, Bayelsa, Delta and even Cross River State.” Sahara Reporters said on Thursday that Good Heart Hospital, and the hotel where the ECOWAS diplomat allegedly received treatment in Port Harcourt, had been shut down.
However, a member of the Emergency Operation Centre for Ebola in Lagos, Prof. Oyewale Tomori, has argued that the Federal Government and the Lagos State government should not be blamed for the death of the medical doctor in Port Harcourt.
Tomori told one of our correspondents on Thursday that some of the people who had had primary contact with Sawyer, did not cooperate with the monitoring and surveillance committee by evading surveillance.
He said, “Initially many people who came into contact with Sawyer were not forthcoming with the truth. It was difficult to trace some contacts who did not leave any address. They could not trace the ECOWAS diplomat for days. Surveillance is the duty of everyone. And we must follow international guidelines and regulation. If we take your temperature and say we will be back tomorrow by 8am to take another, we expect that you should cooperate, but that was not the case.
“Some even travelled, and their people were also not ready to disclose where they went. Some even denied the degree of contact that they had with Sawyer.” Tomori who is also a professor of virology noted that though there were no sanctions yet for those who evade surveillance, such individuals pose great health risk to the nation.
To further contain the outbreak, Tomori advised doctors to treat every case of high fever, vomiting and stooling as a suspected case of Ebola. He added, “I will say with the new dimension, doctors should assume the worst when they see patients with high fever who are vomiting and stooling. Those with three symptoms of the disease must be put under observation and isolated, while waiting for a test result.
“It is important that we get laboratories where test results can be out within two or three hours. That way you can quickly isolate and begin taking necessary precautions to contain it within the health facility.”