ABUJA, Nigeria — Water laced with salt and sugar, and gallons of the nasty-tasting stuff.
Doctors who survived Ebola in Nigeria credited heavy doses of fluids with saving their lives as the World Health Organization declared the country Ebola-free Monday, a rare victory in the battle against the disease that is ravaging West Africa.
In the end, Nigeria — the most populous country in Africa, with 160 million people — had just 20 cases, including eight deaths, a lower death rate than the 70 percent seen elsewhere across the stricken region.
Officials are crediting strong tracking and isolation of people exposed to the virus, and aggressive rehydration of infected patients to counter the effects of vomiting, diarrhea and other symptoms.
Nigeria’s containment of Ebola is a “spectacular success story,” said Rui Gama Vaz, WHO director for Nigeria.
Dr. Adaora Igonoh, a survivor, said the treatment is not easy. It entails drinking, as she did, at least 1.3 gallons of the solution every day for five or six days when you have mouth sores and a sore throat and feel depressed.
“You don’t want to drink anything. You’re too weak, and with the sore throat it’s difficult to swallow, but you know when you have just vomited, you need it,” she told The Associated Press.
Some 9,000 people have been infected with Ebola, and about 4,500 have died, mostly in hard-hit Sierra Leone, Guinea and Liberia, with the number of cases expected to increase exponentially in the coming weeks.
Dr. Simon Mardel, one of the world’s leading experts on viral hemorrhagic fevers, said the number of deaths could be cut in half if infected people were taught to properly hydrate themselves and do not take anti-inflammatory drugs, which can actually harm Ebola victims.
Mardel, of Britain’s University Hospital of South Manchester, called rehydration a low-tech approach that has been neglected by a medical system focused on groundbreaking research.
Nigeria’s outbreak started in July when Patrick Sawyer, an American of Liberian descent, traveled by air from Liberia to Lagos, the country’s biggest city, starting a chain of infection that spread the disease to 19 other people and resulted in eight deaths.
Sawyer died five days after arriving, but the disease spread to Port Harcourt, Nigeria’s oil industry hub, after a close contact of Sawyer’s flew there for treatment, adding to fears that Nigeria faced what could become West Africa’s worst epidemic.
Nigeria’s success in averting that outcome started with the action of Ameyo Stella Adadevoh, a doctor at First Consultant Hospital in Lagos who diagnosed the Ebola virus in Sawyer and later died of the disease. Together with Benjamin Ohiaeri, the hospital director, Adadevoh had insisted on keeping Sawyer isolated despite threats of legal action by Liberian officials demanding his release.
Many feared the worst in a city with large numbers of people living in crowded and unsanitary conditions in slums.
Instead, with swift coordination among health officials, the WHO and the U.S. Centers for Disease Control and Prevention, and with ample financial and material resources from Nigeria’s government, isolation wards were constructed and Ebola treatment centers designated.
Health workers tracked down nearly all of those who had contact with the infected, paying 18,500 visits to 894 people.
The eight deaths included two doctors and a nurse.
Monday’s announcement came 42 days, twice the incubation period, since the last case in Nigeria tested negative.
Still, Nigeria, like Senegal, which was declared free of Ebola on Friday, is susceptible to new cases by virtue of its proximity to the West African epicenter, health authorities warn.
There is no licensed treatment for Ebola, so doctors focus on hydration and supportive care, even in developed countries. In some cases, doctors have been surprised that keeping patients hydrated has been enough to save them.
To improve survival rates, Mardel said, it is time to designate packaged rehydration solutions as part of the cure. He said more needs to be done to make the fluids palatable, such as making the solutions weaker or flavoring them.
Igonoh said she sometimes added orange juice.
The Associated Press,
The New York Times
