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      Epidemiological profile of the Ebola virus disease outbreak in Nigeria, July-September 2014

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          Abstract

          Introduction

          In July 2014, Nigeria experienced an outbreak of Ebola virus disease following the introduction of the disease by an ill Liberian Traveler. The Government of Nigeria with the support of Technical and Development Partners responded quickly and effectively to contain the outbreak. The epidemiological profile of the outbreak that majorly affected two States in the country in terms of person, place and time characteristics of the cases identified is hereby described.

          Methods

          Using field investigation technique, all confirmed and probable cases were identified, line-listed and analysed using Microsoft Excel 2007 by persons, time and place.

          Results

          A total of 20 confirmed and probable cases; 16 in Lagos (including the index case from Liberia) and 4 in Port Harcourt were identified. The mean age was 39.5 ± 12.4 years with over 40% within the age group 30-39 years. The most frequent exposure type was direct physical contact in 70% of all cases and 73% among health care workers. The total case-fatality was 40%; higher among healthcare workers (46%) compared with non-healthcare workers (22%). The epidemic curve initially shows a typical common source outbreak, followed by a propagated pattern.

          Conclusion

          Investigation revealed the size and spread of the outbreak and provided information on the characteristics of persons, time and place. Enhanced surveillance measures, including contact tracing and follow- up proved very useful in early case detection and containment of the outbreak.

          Most cited references15

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          Ebola hemorrhagic fever outbreaks in Gabon, 1994-1997: epidemiologic and health control issues.

          From the end of 1994 to the beginning of 1995, 49 patients with hemorrhagic symptoms were hospitalized in the Makokou General Hospital in northeastern Gabon. Yellow fever (YF) virus was first diagnosed in serum by use of polymerase chain reaction followed by blotting, and a vaccination campaign was immediately instituted. The epidemic, known as the fall 1994 epidemic, ended 6 weeks later. However, some aspects of this epidemic were atypical of YF infection, so a retrospective check for other etiologic agents was undertaken. Ebola (EBO) virus was found to be present concomitantly with YF virus in the epidemic. Two other epidemics (spring and fall 1996) occurred in the same province. GP and L genes of EBO virus isolates from all three epidemics were partially sequenced, which showed a difference of <0.1% in the base pairs. Sequencing also showed that all isolates were very similar to subtype Zaire EBO virus isolates from the Democratic Republic of the Congo.
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            Ebola outbreak in Kikwit, Democratic Republic of the Congo: discovery and control measures.

            The Ebola epidemic in Kikwit, Democratic Republic of the Congo, was recognized because of a nosocomial outbreak in Kikwit General Hospital. Initially, a diagnosis of shigella infection was suspected because many patients presented with bloody diarrhea. On 4 May 1995, blood samples from 14 acutely ill patients were sent to the Centers for Disease Control and Prevention (Atlanta), and on 9 May, a diagnosis of Ebola hemorrhagic fever was confirmed. The major disease control measures that were undertaken were the isolation of patients in a quarantine ward at Kikwit General Hospital, the distribution of protective equipment to health care workers and family members caring for Ebola patients, the use of barrier nursing techniques, the distribution of health education material, active and passive case finding, and the burying of the deceased in plastic bags by a trained team of Red Cross volunteers who wore gloves and protective clothing.
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              Outbreak of Ebola hemorrhagic fever Uganda, August 2000-January 2001.

              (2001)
              On October 8, 2000, an outbreak of an unusual febrile illness with occasional hemorrhage and significant mortality was reported to the Ministry of Health (MoH) in Kampala by the superintendent of St. Mary's Hospital in Lacor, and the District Director of Health Services in the Gulu District. A preliminary assessment conducted by MoH found additional cases in Gulu District and in Gulu Hospital, the regional referral hospital. On October 15, suspicion of Ebola hemorrhagic fever (EHF) was confirmed when the National Institute of Virology (NIV), Johannesburg, South Africa, identified Ebola virus infection among specimens from patients, including health-care workers at St. Mary's Hospital. This report describes surveillance and control activities related to the EHF outbreak and presents preliminary clinical and epidemiologic findings.
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                31 August 2015
                2015
                : 21
                : 331
                Affiliations
                [1 ]World Health Organization, Country Office, Abuja, Nigeria
                [2 ]Nigeria Field Epidemiology and Laboratory Training programme, Abuja
                [3 ]World Health Organization, Department of Communicable Diseases, Kampala District, Uganda
                [4 ]Department of Community Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
                [5 ]World Health Organisation, Field Office, State Ministry of Health, Akure, Ondo State, Nigeria
                [6 ]Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
                [7 ]Federal Ministry of Health, Abuja, Nigeria
                [8 ]Lagos State Primary Health Care Board, Lagos, Nigeria
                [9 ]Rivers State Ministry of Health, Port Harcourt, Nigeria
                [10 ]Nigeria Center for Disease Control, Abuja, Nigeria
                Author notes
                [& ]Corresponding author: Emmanuel Onunche Musa; World Health Organization, Country Office, Abuja, Nigeria
                Article
                PAMJ-21-331
                10.11604/pamj.2015.21.331.5834
                4633745
                3e5f8ba5-a9fd-44d2-be4b-7abec43861fc
                © Emmanuel Onunche Musa et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 November 2014
                : 14 April 2015
                Categories
                Research

                Medicine
                epidemiological profile,ebola virus disease outbreak,nigeria
                Medicine
                epidemiological profile, ebola virus disease outbreak, nigeria

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