Nigeria May Have Halted Ebola's Advance as Doctor is Discharged

 Health Minister, Prof Onyebuchi Chukwu

• Abandoned by husband after first diagnosis of  Ebola, Dr. Ada's antibodies offer hope to victims as Nano Silver is ruled out

By Paul Obi and Busayo Adekoya 

A major milestone was reached at the weekend in Nigeria’s ongoing efforts to tackle the Ebola Virus Disease (EVD) as a female medical doctor who contracted the virus was certified fully recovered and was discharged from the isolation ward of the Infectious Diseases Hospital (IDH) after meeting all the checks and protocols. Dr. Ada, a 26-year-old medical officer in the First Consultants Hospital, Obalende, Lagos, was one of the first responders to Liberian-American Patrick Sawyer who brought EVD to Nigeria and died five days later after infecting the medical personnel who treated him, and the protocol officer who received him into Nigeria. Two nurses and the protocol officer at Sawyer’s place of work, the Economic Community of West African States (ECOWAS), died last week.

The recovery of newly wed Dr. Ada, who was immediately abandoned by her husband when she became one of the first Nigerians to test positive to the virus after Sawyer’s death, now offers hope to other victims as the antibodies present in her blood system, which successfully fought off the Ebola virus, could now be used in the treatment of others.

Dr. Ada was the first person that saw Sawyer when he arrived the hospital. Sawyer told her he had Malaria and never told her he was coming from Liberia where he had been in contact with his sister who died of Ebola.

On the second day when Sawyer did not show sign of recovery from malaria despite the aggressive treatment, Dr. Ada and others at First Consultants became concerned. She then invited her boss, Dr. Ameyo Adadevoh, the senior consultant at the hospital, who immediately suspected Ebola and ordered for test.

In one of the several incidents with the deteriorating Sawyer within 24 hours, he became restive and dropped his drip bag on the floor and called for assistance. And when the nurse came, he told her that he wanted to see the doctor and not the nurse. When the doctor arrived, she found the drip bag on the floor. She then assisted him to reset the drip without gloves and protective clothing. That may have been the moment of contact with Sawyer’s fluid.

The female doctor’s recovery is seen as a giant step towards providing a deeper understanding of how to manage Ebola patients for Nigerian doctors and the US Centre for Disease Control's personnel assisting them. Her recovery, THISDAY gathered, was because of her strong immune system, which was boosted by supportive drugs, that is a cocktail of antibiotics and immune boosting drugs.

The cheery news of Ada’s recovery was announced yesterday by the Minister of Health, Professor Onyebuchi Chukwu, at a press briefing held at Yaba Psychiatry, Lagos. Chukwu also said that at present, five of the other confirmed cases of EVD in Nigeria had almost fully recovered.

The minister said the current statistics of confirmed cases of EVD in Nigeria had risen to 12, while the number of deaths due to EVD remained four – comprising the index case, two health workers and a protocol officer working with ECOWAS. He noted that the number of persons under surveillance in Lagos was now 189 and the number of persons under surveillance in Enugu was six.

“The patients under treatment have now been moved to the new 40-bed capacity isolation ward provided by the Lagos State Government and at present five of the confirmed cases of EVD have almost fully recovered,” Chukwu disclosed.

All hopes that Nano Silver, an experimental drug, offered by a Nigerian in the Diaspora, would be deployed in the treatment of the Ebola patients in Nigeria was dashed as it failed to get the nod of the National Health Research Committee.

Chukwu said, “It is with great regret that I inform you that the drug did not meet the requirements of the National Health Research Ethic code. Accordingly, approval of its use has been withheld by the National Health Research Ethics Committee.”

It would be recalled that last Thursday, the federal government announced that it was ready to deploy an experimental drug named Nano Silver, if it was cleared by the National Health Research Committee. Although the drug had since last Thursday been made available to the Emergency Operations Centre in Lagos, it had not been administered to any patient because it was awaiting clearance from the National Research Ethics Committee.

Noting that all hope was not lost as other candidate drugs were currently being evaluated by the Treatment Research Group for EVD, the minister said, “As soon as any of the experimental drugs is cleared by the National Health Research Ethics Committee and is made available, we shall include it in the treatment regimen subject to the informed consent of the patient.”

While Nano Silver is seen in the medical community as "alternative medicine”, untested Z-Mapp is being used for the treatment of two American doctors recovering from Ebola at Emory Hospital in Atlanta. Z-Mapp is said to offer the best hope and promising future of an Ebola vaccine so far. Ii is made from several antibodies capable of neutralising the EVD. It is those same naturally occurring antibodies that have helped Dr. Ada defeat EVD and offer a "treatment" to Nigerian Health Authorities and caregivers.
Chukwu also seized the opportunity to debunk allegations of inadequate care of EVD patients from the government and health workers.

According to him, “The federal government has heard their complaints and I can assure you we are doing everything necessary so that their complaints would be met. It is only natural for them (family and friends) to be anxious and agitated. No one prays to lose a loved one.

"Now that the Lagos State has provided a better isolation unit of a brand new 40-bed ward, it would be more conductive and care and services would be better. The health workers that have come out to volunteer in this crisis are to be commended for their effort. Words cannot emphasise how much effort and energy they have put in the quick recovery of patients as well as monitoring the leads of Ebola crisis. They are really working hard.”

According to CDC experts, if Nigeria is able to contain the EVD spread to only Sawyer contacts and aggressively monitor them, the days of EVD in Nigeria may be numbered. According to the New York Times, "Health workers have fought the Ebola outbreak to a tentative standstill in Nigeria, Africa’s most populous nation, offering at least a chance to eradicate the disease there before it spins out of control, as it has in Guinea, Liberia and Sierra Leone, where a sluggish response failed to halt it early.... Dr. Thomas R. Frieden, the director of the Centers for Disease Control and Prevention, said health officials were watching Nigeria with intense interest, because of its huge population and because it is much more of a crossroads than the other three countries, in much closer touch with the rest of Africa. Ebola arrived in Nigeria on July 20, carried by Patrick Sawyer, a native Liberian and naturalised American citizen. He contracted the disease in Liberia, flew to Lagos while he was ill and died on July 25. Health officials say he was vomiting during the flight. Every case in Nigeria has been traced to him. Some victims had helped him when he arrived at the airport, and others were health workers who had treated him."

The leadership of the federal government and the efficiency of the Lagos State health system have helped halt the spread of EVD in Nigeria, THISDAY checks reveal. Lagos government has recruited a group of young aggressive contact tracers who, using the emergency declaration by President Goodluck Jonathan, are following, with policemen, the 195 persons under surveillance, checking and questioning every contact and monitoring their body temperatures every day and reporting to a central command.

On the sack of resident doctors, Chukwu confirmed that the suspension was temporary as government continued to mull how to better improve the health care sector.

“I believe the suspension is only temporary, the government is looking at how the health care system can be improved. But please, note that the suspension is just for only federal-owned hospitals, it is not extended to other state hospital.”  On the claim by doctors that the health insurance scheme the federal government promised had not been provided, as no volunteer health worker had been issued any health insurance policy from the federal government, Chukwu said the federal government had not started to provide the insurance policy but the Lagos State government had started issuing theirs.

“We are still working on the paper works. When it is ready we would definitely give it out. But we still need more volunteers, as health workers are little and they can't handle the job alone," he said.

The dreaded Ebola virus was brought to Nigeria last month by a Liberian-American, Patrick Sawyer. Sawyer, who had contracted the disease in Liberia, flew into Nigeria aboard the Asky flight and was rushed to a Lagos hospital. He died on July 25.