Detailed tracking and surveillance is key to Ebola containment: learning from Nigeria

Oct 14, 2014 Letters

DEAR EDITOR,
I read with interest a recent news article about Guyana’s state of Ebola preparedness where Dr. Shamdeo Persaud, the Chief Medical Officer (CMO) of the Guyana Public Hospital Corporation is quoted as saying that port health workers are checking up on persons who have traveled to Guyana from high-risk countries to ensure that none have symptoms of Ebola.
Dr. Persaud further said that “the travelers were given contact numbers which they could call to alert the health ministry if they start to develop any symptoms.”(http://www.stabroeknews.com/2014/news/stories/10/12/health-ministry-ebola-alert/).
While this shows some proactiveness on the part of the Guyanese health authorities, and while any exposed individual would be cleared as healthy once the 21-day incubation period passes without them developing Ebola symptoms, a question still remains, troubling me.
I am wondering if health workers are indeed making visits to travelers’ homes/workplaces to check their state of health for themselves, or whether they are simply waiting for travelers to call and tell them if/when they develop Ebola symptoms. Dr. Persaud’s comment is not clear and it would be great if he could provide clarification for the Guyanese public.
The reason this is important is because how potentially infectious persons are dealt with is key to Ebola prevention. In Nigeria – the most populous country in Africa – detailed tracking and surveillance of those who could have been affected with Ebola was critical to stopping this deadly disease in its tracks. Nigeria got its first Ebola case in July. Three months later, by mid-October, Nigeria is effectively Ebola-free, having suffered a mere 21 cases and only 8 deaths. These low casualty numbers are incredible, especially when compared to the situation in other countries on the African continent.
Aggressive contract tracing, careful monitoring of individuals, and the spread of healthcare workers throughout the capital Lagos and neighboring cities to conduct face-to-face interviews with potentially affected persons, resulted in most Nigerian Ebola patients not infecting anybody else. Without this dedication and careful tracking and surveillance, the death toll from Ebola in Nigeria would have been much higher. As Guyanese healthcare workers struggle to prepare for the Ebola challenge, they would do well to pay attention to the efforts of other countries, like Nigeria, and learn from their strategies.
As the CMO rightly said, preventing this deadly disease from entering our nation should be the priority. However, knowing that Guyana’s borders are extremely porous, we must also prepare for the eventuality of a breach. But if a country like Nigeria, with a population of 174 million, can successfully halt Ebola, Guyana certainly can. All that is needed is careful attention to detail, dedicated and well-trained healthcare workers, and a supportive public health infrastructure. With these things in place, Ebola would be contained should it ever reach our shores (plus the Guyanese people overall would receive better healthcare). I hereby urge the CMO and all other health officials to view this time as an opportunity to prove and improve themselves and the services they offer to the Guyanese public.
Sherlina Nageer, MPH

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