Ebola Virus Epidemiology and Evolution in Nigeria

Folarin, Onikepe A.; Ehichioya, Deborah; Schaffner, Stephen F.; Winnicki, Sarah M.; Wohl, Shirlee; Eromon, Philomena; West, Kendra L.; Gladden-Young, Adrianne; Oyejide, Nicholas E.; Matranga, Christian B.; Deme, Awa Bineta; James, Ayorinde; Tomkins-Tinch, Christopher; Onyewurunwa, Kenneth; Ladner, Jason T.; Palacios, Gustavo; Nosamiefan, Iguosadolo; Andersen, Kristian G.; Omilabu, Sunday; Park, Daniel J.; Yozwiak, Nathan L.; Nasidi, Abdusallam; Garry, Robert F.; Tomori, Oyewale; Sabeti, Pardis C.; Happi, Christian T.

All persons who were exposed to the index patient and their contacts were traced, placed under surveillance, and monitored for clinical features of EVD. If contacts exhibited fever or other symptoms, they were admitted into the Ebola treatment center (ETC) as suspected case patients; blood samples were then collected and tested with reverse-transcription (RT) PCR for presence of EBOV at both Lagos University Teaching Hospital and RUN. Patients who tested positive with RT-PCR were moved to the confirmed ward of the ETC. This combination-history of contact with an EVD case patient, presentation with symptoms, and RT-PCR evidence of EBOV infection-defined a confirmed case. Each patient was counseled on the need for ≥4 L of oral rehydration solution daily. Treatment was started with antibiotics because of their immunosuppression and antimalarials because of the endemicity of malaria in Nigeria. Patients were also placed on a regimen of nutritional supplements and vitamins. The only analgesic administered was paracetamol. Injectables and invasive procedures were avoided unless patients were too ill or weak to take oral rehydration solution.