How Nigeria contained its Ebola outbreak

While the rapid response to the Ebola outbreak in Nigeria was a significant factor inquelling the spread of the deadlydisease, the countryhad other advantages over Liberia, Sierra Leone and Guineawhere it continues to run rampant.

"There's a series of differencesbetween what happened in Nigeria and what has been happening in other West African countries," said Dr. Aileen Marty, who spent 31 days in Nigeria leading aninternationalteam helping to combat the outbreak.

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Nigeria recorded19 laboratory-confirmed Ebola cases and one probable onein two Nigerian states, andnearly 900 patient contacts were identified and followed since mid-July when the outbreak took off, theAtlanta-basedCenterfor Disease Control (CDC) said in a statement this week. Meanwhile,there have been no new cases since Aug.31, "strongly suggesting the outbreak in Nigeria has been contained," CDC said.

Marty said Nigeria was fortunate in thattheLiberian-American who brought in the disease by plane to Lagos back in July was suspected of having Ebola.

According to the CDC, Nigerian authorities took swift action, putting him into isolation and thendetermining hehad exposed 72 people on commercial aircraft, at an airportand at a hospital. Theyimmediately began tracing those he may have had contact with, and created an incident management centre, which later became the emergency operations centre for the disease.

The disease didn't spread rapidly, in part, because it was mostly limited tothe wealthier population of Nigeria, said Marty, whois alsodirector of the Florida International University'sHealth Travel Medicine Program

"The person who broughtthe infection was a diplomat," Marty said. "He was brought to one of the best hospitals in Nigeria, and the peoplewho were infected were individualswho quickly comprehendedthe importanceof following our recommendations."

Nigeria is also vastly more politically stable and economically affluentthan other West African countries, having not suffered years or decades of civil strife.

"So you have a setting in Liberia and Sierra Leone, which has gone through horrific devastation, and complete depletion of any health-care infrastructure, which means youcan't provide beds, can't adequatelyequipmedical personal and you can'tidentifypatientsand trace contacts," said Dr. Peter Hotez, the founding deanof the National School of Tropical Medicine at Texas' Baylor College of Medicine.

Because of its oil resources, Nigeria is a relatively wealthy country, compared to others in the region, meaning ithad the resources to tackle the outbreak, Hotez added.

As well, Nigeria had established a good health-services infrastructurein October 2012 as part of its emergency plan for the global polio eradication initiative, the CDC said.

But Marty said it was alsoimportant thatNigerian government officials recognizedtheir physicians and first responders had no experience in dealing with Ebola, and so sent out a rapid cry to the international community to come help.

Marty said international teams, in coordination with the Nigerian government, fanned out across the country, employing an effective messaging campaign.

"We made it extremely clear that the sooner you get to us, the better your chances of survival, and the better the chance that yourloved ones wouldn't get sick, that your community wouldn't be affected and this problem wouldn't get worse."

The CDC estimatesthat approximately 26,000 households of persons living near those who have been in contact with Ebola victims had been reached by house-to-house visits.

"The Nigeriangovernment was wholeheartedlyinto theprocess oftrying to solve the problem," Marty said.

Officials alsomade sure tocoverall points of entry air, sea and land while creating a cadre of volunteerswho had at least a college level understanding of science andwho could be trained to be primary screeners, Marty said.

Marty said she helped train Nigerian physicians to become secondary screeners, and to distinguish suspectedcases of Ebola from other diseases.

Thousands of people were screened per day per point of entry, with two or three suspected cases captured per day, and with one every few days taken to the isolation ward, she said.

"So the idea is not to let anybody slip throughwho was either coming or going with this," she said.

"Theway we did the system, which was much morethoroughthanwhat's goingon in Liberia,or Sierra Leone or Guinea, is we had our system so we were capturing peoplein transit. We actually intercepted people who weren't even coming to Nigeria.They were just passing through."

Lots of companies, which benefit greatly from Nigerian oil,also played a major role, donating important supplies like ambulances, stretchers and bleach.

"The enormous fear of it gettinginto the impoverishedareas ofNigeria, and then affecting industry was really high and was a real motivator for industry," she said.