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Nigeria�?¢�?�?��?�?�s Ebola Outbreak Response: Lessons for Future Epidemic Preparedness

Emmanuel Musa, Abdulsalam Nasidi, Faisal Shuaib, Patrick M Nguku, Rui Gama Vaz

Introduction: An extra-ordinary outbreak of Ebola which started in Guinea in December 2013 rapidly spread to Liberia and Sierra Leone in 2014 affecting at least eight countries, and culminated in the introduction of Ebola into Nigeria in July 2014 by an ill Liberian traveler to Lagos. The outbreak spread in two large densely populated cities of Lagos and Port Harcourt with a combined population of 25 million. This paper describes the key activities of the response, highlights the key achievements and presents the major lessons learned including the implications for future epidemic preparedness.

Methods: An Ebola Emergency Operations Centre (EEOC) and incident management system was activated to effectively coordinate the response. Resources were rapidly mobilized. The approach used was a coordinated, and integrated rapid implementation of EVD control measures using multidisciplinary teams. Five response teams were set up to mount an effective and high quality response. Data was collected, analyzed and daily situation reports of the response activities were disseminated to all stakeholders.

Results: Overall, a total of 20 cases and 8 deaths were recorded. A total of 892 contacts were listed and completed the daily follow-up for 21 days. A total of 117 alerts and rumors were reported and investigated between August and September, 2014. All alerts and rumors were investigated within 24 hours. 13 confirmed cases were isolated in the Ebola Treatment Center (ETC). 9 were discharged and 5 died. Our response was effective and successful in rapidly controlling the outbreak because of available laboratory capacity and local human resources and infrastructure that were rapidly mobilized with effective results. Strong government leadership and commitment, country ownership of response activities, effective community awareness and engagement, strong coordination of partners and harmonization of resources and the unprecedented support from the private sector, media organizations and professional bodies contributed to the success.

Conclusions: The key lessons learned reinforce the importance of country ownership of epidemic preparedness and response activities and building local capacity for the critical improvements that are still needed to strengthen early warning systems and improve rapid response capabilities in preparation for any future outbreaks.