Ebola:Threat Forced Lagos to Scramble.
A nurse Thursday places an information sign about Ebola on
a wall of a public-health center in Monrovia, Liberia, which announced
school closures.
Agence France-Presse/Getty Images.
Doctors in Lagos, Nigeria, were on
strike July 20, the day a man infected with Ebola landed at a packed
airport in Africa's biggest city.
In a
few days a Muslim holiday would send health workers on a break and
millions of ordinary people crowding into buses and planes. The city's
health commission was out of thermometers, said Health Commissioner Jide
Idris.
In a press conference Friday, President Obama said the
CDC and other U.S. health agencies are working with the World Health
Organization to send a surge of resources to Africa to contain the Ebola
outbreak.
It could have been a nightmare, but a
chaotic overpopulated city showed how some organization and creative
hustle can tamp down the threat of one of the world's deadliest viruses.
While
nearby nations Liberia, Guinea and Sierra Leone have been struggling to
tame an Ebola outbreak that has killed 729 people this year, Nigerian
officials crash-trained lab technicians and civil servants on how to
enter a house and check for the virus. In four days, they turned an
abandoned government building into an isolation unit. In a week they
managed to find and cold-call scores of people from blue-collar workers
to diplomats who may have touched
Patrick Sawyer,
the Liberian-American passenger whose landing in Lagos could have
sparked an outbreak in a city of as many as 21 million people.
Lagos
also got lucky: Mr. Sawyer, a consultant at the Liberian Finance
Ministry, collapsed on arrival in the city and was put in isolation at a
hospital. Had he spent even a few hours outside the airport, he might
have spread his illness to exponentially more people, many of them
impossible to trace in the city's endless sprawl of tin-roof shacks and
walk-up apartments.
More than 1,323
people have been sickened, about 60% of them fatally, in West Africa
since Ebola erupted from the forested interior of Guinea, according to
the World Health Organization. The hundreds dead include a top Sierra
Leonean doctor and another from Liberia, while two U.S. health-care
workers are ill.
The Centers for Disease Control and Prevention is part
of a new international effort to help bring the ebola outbreak in Africa
under control, as at least one American ebola patient is flown to
Atlanta for care. WSJ's Betsy McKay discusses on Lunch Break.
On Friday, Guinea, Sierra Leone and
Liberia agreed to quarantine the area where their countries share a
border, said Liberian Information Minister
Lewis Brown.
Also on Friday, WHO
Director-General
Margaret Chan
said the outbreak is spreading faster than health workers can
control it, yet it can be stopped with a well-managed response. She will
lead an international response coordinated by the WHO, which on
Thursday said it is launching a $100 million effort with its member
states to bring the outbreak under control.
Dr.
Chan put her finger on the problem that has allowed Ebola to spin out
of control in West Africa, despite efforts by experts who have been able
to tame outbreaks of the same disease for some 40 years elsewhere:
"This is not just a medical or public-health problem," she said. "It is a
social problem. Deep-seated beliefs and cultural practices are a
significant cause of further spread and a significant barrier to rapid
and effective containment."
Health
workers have been up against doubts about Western medicine compounded by
belief systems that encourage family members to care personally for
their infected loved ones and to follow burial rites that have them
handling still-contagious corpses. Mobs of angry and suspicious citizens
have attacked teams of health workers. Families have hidden suspected
cases, preferring to keep them at home rather than allow them to be
taken to a treatment center and isolated.
A
few weeks ago, staff members at one Ebola treatment center thought they
had gotten through the worst when they were down to one convalescing
patient, said
Pierre Rollin,
a veteran Ebola expert at the U.S. Centers for Disease Control
and Prevention, who is currently in Guinea. Then one family that hadn't
brought its sick for treatment sparked a resurgence, he said. The
treatment center now has as many as 17 patients.
"Chains
of transmission have moved underground. They are invisible. They are
not being reported," Dr. Chan said. "Because of the high fatality rate,
many people in affected areas associate isolation wards with a sure
death sentence, and prefer to care for loved ones in homes or seek
assistance from traditional healers."
At
the same time, Ebola is so rare a disease that no more than 300
professionals globally have worked on outbreaks before, Dr. Rollin said:
"We need more people."
Lagos,
meanwhile, might not be out of the storm yet. There are still a small
number of people who were on the flight with Mr. Sawyer that health
workers haven't found, said Oluwakayode Oguntimehin, a permanent
secretary on the Lagos State Primary Healthcare Board, who helped to
lead the response. The next three days are a critical period when the
virus is likely to flare and become contagious if those people have it.
What is clear, though is that hundreds more lives could have been saved if more West African governments acted as Lagos did.
When
the government received the passenger list for Mr. Sawyer's flight, it
was missing contact information for 18 of the flight's 48 passengers.
All officials had to go by were names and their nationality—in a part of
the world where phone books don't exist.
Liberian soldiers move through streets to prevent panic as
fears of the deadly Ebola virus spread in the city of Monrovia,
Liberia, on Friday.
Associated Press
The airline tracked down some
passengers by calling the ticket agents that booked the flight, and
Nigeria's government found others by contacting local embassies. Again,
they were lucky: The plane was full of government workers on their way
to a conference, passengers who were easy for diplomats to track.
A
crew of health workers set about cold-calling people with the
terrifying news they might have Ebola. "Are you feeling feverish," was
their opening question, said Dr. Oguntimehin. "You're trying to reassure
them."
They sent nurses, lab
technicians and civil servants into homes to deliver forms that
potential carriers now fill out twice daily, asking about muscle aches,
fever or nausea. By Friday, only two had developed a fever—the handlers
who helped Mr. Sawyer into a wheelchair. Their blood tested negative,
and they are still under close watch.