TY - JOUR
T1 - Clinical profile and containment of the Ebola virus disease outbreak in two large West African cities, Nigeria, July–September 2014
AU - Ohuabunwo, Chima
AU - Ameh, Celestine
AU - Oduyebo, Oyin
AU - Ahumibe, Anthony
AU - Mutiu, Bamidele
AU - Olayinka, Adebola
AU - Gbadamosi, Wasiu
AU - Garcia, Erika
AU - Nanclares, Carolina
AU - Famiyesin, Wale
AU - Mohammed, Abdulaziz
AU - Nguku, Patrick
AU - Koko, Richard I.
AU - Obasanya, Joshua
AU - Adebayo, Durojaye
AU - Gbadegesin, Yemi
AU - Idigbe, Oni
AU - Oguntimehin, Olukayode
AU - Nyanti, Sara
AU - Nzuki, Charles
AU - Abdus-Salam, Ismail
AU - Adeyemi, Joseph
AU - Onyekwere, Nnanna
AU - Musa, Emmanuel
AU - Brett-Major, David
AU - Shuaib, Faisal
AU - Nasidi, Abdulsalami
N1 - Funding Information:
Funding: There was no funding for the study, but financial and material support for the outbreak response was provided by the Government of Nigeria, Lagos State Government, Rivers State Government, WHO, MSF, UNICEF, US-CDC, African Field Epidemiology Network, and the organized Private Sector.
Publisher Copyright:
© 2016
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Introduction 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. Methods 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. Results 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. Conclusion 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.
AB - Introduction 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. Methods 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. Results 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. Conclusion 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.
KW - Clinical profile
KW - Ebola virus disease
KW - Gastroenteritis
KW - Hemorrhagic fever
KW - Nigeria
KW - Outbreak containment
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U2 - 10.1016/j.ijid.2016.08.011
DO - 10.1016/j.ijid.2016.08.011
M3 - Article
C2 - 27575939
AN - SCOPUS:84995813029
SN - 1201-9712
VL - 53
SP - 23
EP - 29
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -