Ebola, one of the world’s most fatal diseases, has surfaced in Africa’s most populous country.
Nigerian health officials have announced 10 confirmed cases and two deaths in the country from the Ebola outbreak that is sweeping West Africa – including a nurse and a man from Liberia whom the nurse had been caring for.
The man, Patrick Sawyer, a naturalized U.S. citizen, had flown to Nigeria in late July and died soon after. He had infected at least seven other people, including the nurse, who died Aug. 5, officials said.
By Friday, President Goodluck Jonathan had declared a state of emergency, officially adding Nigeria, home to more than 160 million people, to the list of nations struggling to control one of the largest public-health emergencies in recent history. More than 900 people have died.
The story of Sawyer, who according to Nigerian newspaper accounts was aware that he was sick when he left Liberia, demonstrates just how difficult containing the disease will be in the modern age of rapid travel and growing urbanization. Nigeria has Africa’s largest economy and is deeply connected to the outside world, a fact that could magnify the consequences if the outbreak is not contained.
“Rapid epidemic transmission has been with us a long time, but my guess is that it’s accelerating, with the number of people on the move and intensity of air travel, global trade, and the numbers of displaced people we have globally,” said Jeffrey D. Sachs, an economist and the director of the Earth Institute at Columbia University.
Climate change, population growth and an increase in displaced populations means that people are pushing into previously uninhabited places, creating new vulnerabilities and bringing humans into closer contact with animal populations, where many of the diseases have begun, he said.
At the same time, globalization means that people are mixing more, trading more and handling more farm animals in industrial settings – all of which facilitate the emergence and spread of infectious diseases.
“This ought to force a reflection,” Sachs said, adding that establishing a basic network of community health workers across the developing world was an urgent priority.
Health officials emphasized that Nigeria still had only a few confirmed Ebola cases – 10 as of Sunday, with two deaths – and that its government had mobilized substantial forces to try to stop the spread of the disease.
David Daigle, a spokesman for the Centers for Disease Control and Prevention’s effort in Nigeria, said the ministers of health and information were on hand Friday for the opening of an emergency operation center in Lagos, a sign that the government was treating the situation seriously.
“The Nigerians understand the magnitude of the problem here,” said Dr. Frank Mahoney, an epidemiologist who has been leading the CDC’s Ebola response in Lagos.
Still, he said, international health officials are undertaking a substantial effort in Nigeria, motivated by what might happen if the disease, which had been confined to remote forests and villages in decades past, starts to spread in one of Africa’s most densely populated countries.
“We are very worried about this,” Mahoney said, pointing out that Nigeria’s health care system could easily become overwhelmed. “Lagos is such a huge city with such a mobile population.”
Lagos, a city of nearly 20 million, the most populous in Nigeria, is also home to a large contingent of religious healers, such as Temitope Balogun Joshua, a popular Christian minister and televangelist known as T.B. Joshua. Health experts are concerned that sick people will flock to Lagos to seek his advice.
Mahoney said health experts were reaching out to such leaders, and Jonathan called on churches and religious leaders to halt large gatherings that could encourage the spread of the disease.