OLAOLU Years of Daily Discovery

OLAOLU Years of Daily Discovery eBook: Olakunle Solomon Fatoye: Amazon. leondumoulin.nl: Kindle Store.
Table of contents

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• Epidemiological profile of the Ebola virus disease outbreak in Nigeria, July-September 2014
• Introduction

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Learn more about Amazon Prime. Please try your request again later. Olakunle Solomon is an author. He has spent several years as a training instructor and a training co-ordinator, which taught him the importance of structured delivery of ideas. He helps people to tackle problems in the seven most vital areas of life on a one to one and group basis from time to time.

Drawing on many years of experience in administration, customer service, user technical support, data processing and training, Olakunle Solomon now focuses mainly on helping individuals and companies to provide clear cut solutions in the areas of his expertise. He enjoys making friends, listening to music, reading, doing further research, and traveling. To contact Olakunle Solomon, please go to http: Are you an author? Help us improve our Author Pages by updating your bibliography and submitting a new or current image and biography.

Learn more at Author Central. Popularity Popularity Featured Price: Low to High Price: High to Low Avg. Available for download now. Index Of Products On Clickbank: Book of Offers and Promotions Volume As many offers and promotions as can be made available to you for an easy access always Apr 25, The patient however died on the 25th July The team working at the EEOC planned the administrative, consultative and logistic measures.

Visits were made to health facilities and homes to identify contacts of suspected, probable and confirmed cases or deaths where the outbreak occurred or was rumored to have occurred As part of active surveillance and containment measures undertaken, contact tracing and follow up measures were adapted from the WHO guidelines [ 3 , 6 , 10 — 13 ]. All persons meeting the definition of a contact were listed. These contacts were subsequently followed up every day for 21days and observed for symptoms, including development of fever To identify cases or deaths from EVD, we defined a suspected case as any person with acute onset of fever, malaise, myalgia, headache, followed by vomiting, diarrhea, and may or may not be accompanied by any of: A probable case was defined as a deceased suspected case where it has not been possible to collect specimen for laboratory confirmation but has an epidemiological link with a confirmed case Whereas, a confirmed case was defined as a case with clinical illness or a probable case with laboratory confirmation of Ebola virus infection by RT-PCR We established the existence of an outbreak with a single confirmed case.

In the health care facilities, we monitored HCW deaths, illness, or sick leave or unexplained absenteeism. The contact listing form obtained information on name, age, sex, address, contact, and phone numbers. The contact follow-up form obtained information on name, age, sex, address, date of last contact, type of contact, household information, phone numbers and clinical data of contacts.

At the airports, this was termed primary data and captured in registers at P1 stations at arrival and P2 stations at departure. The number of passengers screened daily was calculated by counting the number of screening forms collected at each of these stations. This was collected and collated by a data manager every morning. At the seaport data on number of vessels and travelers under surveillance was collated using the HSFs and simple temperature monitoring charts.

The data was transmitted to the team lead using data enabled mobile phones configured with a data reporting template. Using the line-list, an epidemic curve was plotted with the number of cases and deaths against the date of onset of disease symptoms. The median incubation period was estimated from the curve as the time interval between the arrival of the index case and the date of the peak of occurrence of cases on the epidemic curve.

The serial interval was defined as the time of disease onset in the index case and onset in a person infected by the index case. The characteristics of cases stratified by occupation and the presenting symptoms were presented in tables. Microsoft Excel was used in analyzing the data. Sites for case management: This bed capacity isolation facility has separate sections for suspected and confirmed cases.

The Lagos clinical staff include 15 doctors, 28 nurses and 16 ancillary staff trained on Ebola case management in the isolation facility and they provided hour care alongside the WHO and MSF staff. In Port Harcourt, the State Ministry of Health SMOH a former primary healthcare center was converted into a bed isolation facility with separate sections for suspected and confirmed cases.

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The clinical team included MSF and SMOH doctors 12 , nurses 24 and support staff 24 who were all trained on Ebola case management and appropriate infection prevention and control in the isolation facility. Description of the index case: He was reported to have been ill while on board a flight from Monrovia to Lagos and remained very ill on arrival at the airport. He was admitted at a private facility with fever, vomiting and diarrhea.

While fully conscious, he reported no history of contact with anyone suspected or confirmed to be suffering from EVD in Liberia. Later he was discovered to have visited and cared for a sibling in Liberia who died of EVD with his symptoms starting 17th of July Outcome of contact tracing and identification of cases: As of September 30, , the total numbers of passengers screened at the points of entry were , in Lagos and , in Port Harcourt, with no EVD case detected. The epidemic curve Figure 1 initially shows a typical common source outbreak, followed by a propagated pattern; though atypical.

The total length of epidemics was 43 days. The median incubation period was 11days and serial interval for the first wave of infection was 11days. Arising from the primary chain of transmission were secondary and tertiary generations of cases Figure 2. With a total of twenty cases the size of the current outbreak in the country is small compared to the concurrent outbreak in Guinea, Sierra Leone and Liberia [ 2 , 3 , 5 ].

However, in terms of spread, cases were identified in two major urban cities that are geographically far from each other. This contrasts with the current outbreaks reported in Guinea, Liberia and Sierra Leone where contiguous districts and communities were affected [ 5 ].

In addition, the length of the outbreak in Nigeria was 43 days; shorter than most outbreaks previously and currently reported [ 5 , 10 , 11 — 14 ]. This suggests efficient containment. The case fatality in Nigeria was far less than the This pattern of lower case fatality was also observed among health workers, who are the high-risk group in all the other EVD outbreaks reported including the concurrent outbreaks in other West African countries suggesting an effective response [ 1 , 5 ]. As observed in previously reported outbreaks from other African countries, including the concurrent outbreak in West Africa sub region, females were the most affected [ 3 — 5 , 7 , 12 — 15 ].

This may be explained by the role that the female gender plays in care-giving and nursing in our society, thereby exposing them to infection. Majority of the cases reported direct physical contact with an infected person. This is more obvious among the health workers. Other factors may include the lack of consideration given to potential body fluids which were not overtly visible. A clearer understanding of the role of direct physical contact in the absence of visible bodily fluid is needed through further research as this has implications for the containment of the disease.

The concurrent outbreak in the West Africa sub region similar to our study also indicated that the most productive middle-aged groups are affected [ 5 ].

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Fever, fatigue, vomiting and diarrhoea were the most commonly reported symptoms at presentation. Only very few presented with any form of bleeding diathesis. These are consistent with clinical symptoms being reported from the concurrent epidemics in other countries within the sub region [ 5 , 11 — 14 ]. The epidemic curve initially shows a typical common source pattern, followed by a propagated; though atypical.

This is in contrast with the epidemic curve described in the outbreak in Gabon with a typical propagated pattern [ 10 ]. The timely containment measures and the multiple strategies used might have contributed to the atypical pattern observed. The median incubation period we obtained is consistent with the known incubation. Apart from the primary wave of infection there were two other waves; secondary and tertiary in the current outbreak. The serial interval for the first wave was 11days.

We were not able to explore the data further to generate the reproductive rate due to the small number of cases.

Introduction

We recognize the challenges that the field investigation may have imposed on our findings. Firstly, the outbreak locations were in two geographical areas that are wide apart.

This could have imposed coordination difficulties and standardization of procedures and observations, but same protocols and SOPs were used in the 2states and all data were sent to the same server. Secondly, the teams of public health workers used in the response had no previous experience in response to EVD outbreaks although they were highly skilled health professionals. However, misclassification bias was minimized by using a standard case definition during case identification.

Ascertainment of the accuracy of the data was performed at every stage of the data collection process. Enhanced surveillance measures, including contact tracing and follow-up, effective case management and social mobilization efforts with effective coordination of government and partner agencies proved very useful in containment of this outbreak. National Center for Biotechnology Information , U.