The growing number of cases in Lagos, a megacity of some 21
million people, comes as authorities acknowledge they did not treat Patrick
Sawyer as an Ebola patient and isolate him for the first 24 hours after his
arrival in Nigeria last month. Sawyer, a 40-year-old American of Liberian
descent with a wife and three young daughters in Minnesota, was traveling on a
business flight to Nigeria when he fell ill.
The death of the unidentified nurse marks the second Ebola
death in Nigeria, and is a very worrisome development since it is the Africa's
most populous country and Lagos, where the deaths occurred, one of its biggest
cities.
Meanwhile, Saudi Arabia's Health Ministry says a man who was
being tested for the Ebola virus and has died. The 40-year-old returned on
Sunday from Sierra Leone, where there has been an Ebola outbreak, and was then
hospitalized in Jiddah after showing symptoms of the viral hemorrhagic fever.
Spain's Defense Ministry said a medically-equipped Airbus
310 is ready to fly to Liberia to repatriate a Spanish missionary priest who
has Ebola. The ministry said Wednesday preparations for the flight are being
finalized but it is not yet known at what time the plane would take off.
The priest, Miguel Pajares, is one of three missionaries
being kept in isolation at the San Jose de Monrovia Hospital in Liberia who has
tested positive for the virus, Spain's San Juan de Dios hospital order, a
Catholic humanitarian group that runs hospitals around the world, said Tuesday.
Ebola, which has no proven vaccine or treatment, has killed
nearly 900 people this year in Sierra Leone, Guinea, Liberia and Nigeria and
health officials in many countries are struggling to halt its spread.
Health experts say those medical workers in Nigeria now
infected from Sawyer would not have been contagious to their neighbors or
family members until they started showing symptoms of their own. The delay in
enforcing infection control measures, though, is another setback in the battle
to stamp out the worst Ebola outbreak in history.
The specter of the virus spreading through Nigeria is
particularly alarming, said David Morse, an epidemiology professor at Columbia
University's Mailman School of Public Health.
"It makes you nervous when so many people are
potentially at risk," he said.
Lagos is a bewildering combination of wealth and abject
poverty, awash in luxury SUVs and decrepit buses alike that carry passengers
through hours of crowded traffic on the bridges linking the city's islands to
the mainland.
Ebola can only be transmitted through direct contact with
the bodily fluids of someone who is sick -- blood, semen, saliva, urine, feces
or sweat. Millions live in cramped conditions without access to flushable
toilets, and signs posted across the megacity tell people not to urinate in public.
Authorities in Liberia said Sawyer's sister had recently
died of Ebola, though Sawyer said he had not had close contact with her while
she was ill.
In announcing his death, Health Minister Onyebuchi Chukwu
maintained that Nigerian officials had been vigilant.
"It was right there (at the airport) that the problem
was noticed because we have maintained our surveillance," he told
reporters. "And immediately, he went into the custody of the port health
services of the federal ministry of health so there was no time for him to
mingle in Lagos. He has not been in touch with any other person again since we
took him from the airport."
On Tuesday, the Lagos state health commissioner said,
however, that they did not suspect Ebola immediately and it was only after
about 24 hours in the hospital that they identified him as a possible Ebola
case.
Lagos state health commissioner Jide Idris said Tuesday that
the nature of his disease "was not known" the first day.
"They went back to the history and they were like 'Oh,
this is Liberia,' and that's why he was put into isolation," he told
reporters. "So even in that window period it was possible that some of
these people got infected."
Sawyer, who had a fever and was vomiting, was coming from
the infected country of Liberia but had a layover in Togo. As a result,
officials may not have initially known his original destination.
Experts say people infected with Ebola can spread the
disease only through their bodily fluids and after they show symptoms. Since the
incubation period can last up to three weeks, some of the Nigerians who treated
Sawyer are only now showing signs of illness that can mimic many common
tropical illnesses -- fever, muscle aches and vomiting.
The national health minister on Wednesday said special tents
would be used to speed up the establishment of isolation wards in all of
Nigeria's states. Authorities also were setting up an emergency center to deal
with Ebola that would be "fully functional" by Thursday.
"We are embarking on recruiting additional health
personnel to strengthen the team who are currently managing the situation in
Lagos," said his statement.
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