NCDC Issues High Alert to States Amid Risk of Ebola Importation

The Nigeria Centre for Disease Control and Prevention (NCDC) has placed several states on heightened Ebola preparedness following a fresh risk assessment that classified Nigeria’s risk of importing the deadly virus as high due to ongoing regional outbreaks.

NCDC Director-General, Dr. Jide Idris, announced this in a statement on Thursday, emphasizing that while Nigeria has not yet recorded any confirmed Ebola Virus Disease (EVD) cases linked to the current outbreak, the situation demands urgent attention.

He explained that the World Health Organization’s declaration of a Public Health Emergency of International Concern, alongside rising Ebola cases in the Democratic Republic of Congo (DRC) and Uganda, necessitates intensified surveillance and preparedness measures across Nigeria.

According to Dr. Idris, the NCDC’s dynamic risk assessment determined that Nigeria faces a heightened risk of Ebola importation due to international travel and regional population movement. He also noted that the similarity between Ebola symptoms and those of endemic diseases like malaria and Lassa fever could delay detection.

Preparedness Classification and High-Risk States

All states and the Federal Capital Territory (FCT) must maintain Ebola preparedness, Dr. Idris said, but readiness efforts should be tailored based on the NCDC’s new risk classification system. The agency has designated Lagos, FCT, Rivers, Kano, Enugu, Borno, Akwa Ibom, Cross River, Taraba, and Adamawa as high-risk states, citing factors such as international airports, porous borders, and active trade and travel routes.

Ogun, Nasarawa, Kaduna, Plateau, Kogi, Niger, Jigawa, Katsina, Bauchi, Ebonyi, Abia, and Bayelsa are categorized as moderate-risk, requiring sustained vigilance against possible Ebola importation and transmission.

Dr. Idris stressed that the WHO alert highlights the seriousness of the regional threat and underscores the need for Nigeria to strengthen its preparedness before any suspected cases emerge. The national strategy aims to ensure all states and the FCT can swiftly detect, contain, and respond to suspected Ebola cases while protecting healthcare workers and maintaining essential health services.

Ongoing Outbreaks and Global Response

He noted that health authorities in the DRC and Uganda have reported 1,077 suspected Ebola cases and 247 deaths, with people aged 14 to 45 years most affected. The outbreak’s case fatality rate stands at 24.6 percent, with both regional and national risks remaining high due to ongoing transmission and the lack of approved vaccines for the current outbreak strain.

No approved vaccines or specific treatments currently exist for Bundibugyo Ebola virus disease, Dr. Idris added, making rapid public health interventions critical to containing the outbreak and preventing widespread transmission, especially among vulnerable communities.

He emphasized that effective outbreak control depends on early detection, prompt isolation, strict infection prevention, efficient contact tracing, safe burials, community engagement, and robust national surveillance systems.

Dr. Idris also disclosed that suspected Ebola cases have been reported in India, and Canada has suspended travel applications from residents of the DRC, Uganda, and South Sudan. Meanwhile, Uganda has implemented border closure measures. He warned that Nigeria faces significant risks as the current Bundibugyo Ebola outbreak lacks licensed vaccines or approved targeted treatments.

Current Ebola vaccines and monoclonal antibody therapies target the Zaire ebolavirus strain and should not be relied upon against the Bundibugyo strain affecting neighboring countries.

Transmission, Symptoms, and Clinical Management

Dr. Idris clarified that Ebola is not an airborne disease; transmission occurs through direct contact with blood, bodily fluids, contaminated materials, or infected animals, primarily from symptomatic or deceased individuals.

The Ebola incubation period ranges from two to 21 days, making recent travel and exposure history within the preceding three weeks a critical factor in assessing suspected cases. Early symptoms are non-specific and include fever, fatigue, muscle pain, headache, sore throat, vomiting, diarrhea, abdominal pain, rash, hiccups, unexplained bleeding or bruising, and signs of shock.

He cautioned health workers not to wait for bleeding before suspecting Ebola in patients who present with compatible symptoms and relevant travel or exposure histories linked to affected countries.

In the absence of strain-specific vaccines and approved therapeutics for Bundibugyo Ebola, Dr. Idris said, prompt and optimized supportive care is essential for improving patient outcomes. Clinical management should involve rapid assessment, fluid and electrolyte management, glucose monitoring, treatment of malaria or bacterial co-infections, symptom control, shock management, and humane care in isolation facilities.

National Response and State-Level Actions

The NCDC has activated its national Emergency Operations Centre, now operating in alert mode and coordinating preparedness activities with federal and state agencies to strengthen response capacity.

State governments and Commissioners for Health, he noted, must ensure immediate operational readiness across public and private health systems to manage suspected Ebola cases and prevent community transmission. Preparedness should prioritize early detection, immediate isolation, supportive care, infection prevention and control, safe sample handling, contact tracing, functional referral systems, workforce protection, and adequate medical supplies.

Dr. Idris urged Commissioners to provide leadership for coordinated Ebola readiness in their states and the FCT, assuring continued technical guidance and national coordination from the NCDC.

He also called on states to activate public health coordination structures, conduct rapid risk assessments focused on population movement and high-density settings, and engage both public and private healthcare providers to ensure early suspicion, safe separation, immediate reporting, and identification of suitable isolation facilities.

Facility readiness for screening, infection prevention, ambulance transfers, safe sample movement, decontamination, and waste management must be strengthened, he said, with frontline workers receiving adequate protection and psychosocial support.

States with airports, seaports, transport hubs, land borders, and migrant corridors should intensify traveler monitoring and surveillance. Dr. Idris encouraged clear public communication to discourage stigma and promote the sharing of verified information.

He directed states to maintain essential health services without disruption and submit preparedness updates within 72 hours, as well as to immediately report any suspected cases, high-risk exposures, unusual clusters of fever, or major gaps in readiness.

(NAN)