Nigeria’s Ebola Case: Experts, Africa CDC Worry Over Late Detection, Contact Tracing

BY JONATHAN NDA-ISAIAH AND PATIENCE IVIE IHEJIRIKA

Nigeria’s response to an imported case of Ebola Bundibugyo virus disease in the Federal Capital Territory (FCT) has raised concerns over delays in diagnosis, the adequacy of contact tracing and the preparedness of healthcare facilities to detect rare but deadly infections.

Although the federal government says the patient is recovering and emergency response measures are in place, the time taken to diagnose the infection and the number of contacts identified have drawn attention to gaps that could complicate efforts to prevent further transmission.

The government confirmed the case on October 20, 2026, involving a woman who arrived in Nigeria from Uganda on October 3. The Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, said laboratory results showed significant improvement in her condition.

“Today I spoke to the clinicians, and I understand that lab results are showing great improvement and there’s a possibility that she will recover from this. But we cannot hold our breath,” Pate said.

However, the Africa Centres for Disease Control and Prevention (Africa CDC) has raised concerns about the patient’s movements through several health facilities in Abuja before she was tested for Ebola.

According to the Africa CDC director-general, Dr Jean Kaseya, the woman arrived in Nigeria on October 3, fell ill three days after her arrival but initially suspected malaria and sought treatment at different facilities before being tested on October 19.

The interval between the onset of symptoms and diagnosis has raised questions about whether healthcare workers adequately assessed her travel history and considered the possibility of Ebola.

Ebola is a severe disease that can be transmitted through direct contact with the blood or bodily fluids of an infected person or contaminated materials. Early detection, prompt isolation and effective contact tracing are essential to containing an outbreak.

Warning about the risks posed by infectious disease outbreaks, Kaseya said: “No one is safe today.”

Prominent virologist Prof. Oyewale Tomori also questioned the diagnostic delay, warning that the 44 contacts identified by health authorities might not represent everyone potentially exposed to the patient.

The concerns have renewed calls for stronger surveillance, improved screening and better training of frontline healthcare workers to identify suspected cases promptly

Tomori Questions Diagnostic Delay

Tomori told LEADERSHIP Friday that the patient arrived in Nigeria on October 3, developed symptoms on October 7 and was admitted to a hospital on October 11 before her Ebola diagnosis around October 19.

He described the delay as concerning, arguing that a more thorough assessment of her travel history might have prompted healthcare workers to suspect Ebola earlier.

“It’s a bit slow,” he said.

Tomori said healthcare workers should have asked about her recent travels, particularly if treatment for a common illness such as malaria failed to produce the expected improvement.

“If the people at the first office had actually asked enough good questions about her travel history, then they probably would not have been treating for just malaria,” he said.

He added that subsequent healthcare providers should also have investigated her travel history and possible exposure to areas affected by Ebola.

Tomori stressed the need to establish the patient’s movements during the 21 days before the onset of symptoms, noting that Ebola’s incubation period ranges from two to 21 days.

He said determining where she had travelled and whom she had encountered was essential to understanding the possible source of infection and identifying those at risk.

He cautioned against drawing conclusions about where she contracted the virus until the relevant details had been established.

44 Contacts May Not Tell The Full Story

Tomori expressed concern that the 44 contacts identified by health authorities might not account for everyone the patient encountered while ill.

He said investigators needed to establish her movements at home, in hospitals and at other locations before the diagnosis.

“She was within our health system for at least 11 days or 12 days. So, for 12 days, she was sick, then definitely she would have had contact with many, many people,” he said.

He, however, said the adequacy of the contact list could not be determined without knowing the patient’s movements and the scope of the investigation.

Tomori urged health authorities to monitor identified contacts throughout the incubation period and promptly isolate anyone who developed symptoms.

He recommended regular temperature checks and immediate isolation of anyone showing possible symptoms pending further investigation.

“Immediately they show temperature, I think you put them straight in isolation until it is proven that they don’t have these diseases,” he said.

Tomori urged Nigerians not to panic, stressing that preparedness and effective monitoring were more important than fear.

“People shouldn’t fear unnecessarily, no panic. The important thing is preparedness, not panic,” he said.

He explained that people infected with Ebola were not considered contagious before symptoms appeared, making close monitoring of exposed individuals essential.

He added that Nigeria should remain vigilant in the coming weeks, as any additional cases among contacts would require an appropriate response.

Expert Calls For Stronger Surveillance

An associate professor of Infectious Diseases, Pathogen Genomics and Molecular Epidemiology at Adeleke University’s Department of Microbiology, Dr Oladipo Elijah Kolawole, has called for stronger surveillance, improved screening and continuous training of frontline healthcare workers to improve early Ebola detection.

Kolawole, who is also the founder of Helix Biogen Institute, said the confirmed case underscored the need to strengthen risk-based screening and reporting across healthcare facilities.

He told LEADERSHIP Friday that Ebola could be difficult to recognise in its early stages because symptoms such as fever, headache, fatigue, muscle pain, vomiting and diarrhoea often resemble those of malaria, typhoid fever and other infections.

He said testing every patient with a fever for Ebola would be impractical and costly because most fever cases were caused by more common illnesses.

Instead, he advocated surveillance systems that identify unusual symptoms, patterns of illness and epidemiological risk factors that could indicate a dangerous infection.

Kolawole said healthcare workers should routinely ask patients about recent travel to areas experiencing outbreaks, contact with seriously ill people or suspected cases of haemorrhagic diseases, and whether their symptoms were worsening unusually.

He added that clusters of similar illnesses should trigger further investigation.

To improve early detection, he recommended enhanced triage and screening, routine questions about travel and exposure history, and electronic alerts to flag patients who meet specific risk criteria.

He also called for risk-based testing, under which patients with relevant symptoms and epidemiological risk factors would be prioritised rather than testing indiscriminately for every case of fever.

Kolawole stressed the need for continuous training to help clinicians recognise when to suspect viral haemorrhagic fevers, even when patients initially present with symptoms commonly associated with other illnesses.

He also advocated stronger laboratory networks for rapid specimen transportation and testing, alongside better coordination among hospitals, laboratories, state health authorities and the Nigeria Centre for Disease Control and Prevention (NCDC).

On whether the latest case indicated a failure of Nigeria’s surveillance system, Kolawole cautioned against reaching a conclusion without examining how the case was handled.

He said visiting several healthcare facilities before diagnosis did not automatically indicate surveillance failure because rare diseases could initially resemble common illnesses, even in countries with advanced health systems.

The key questions, he said, were whether the case was reported promptly once Ebola became a realistic possibility, whether testing was conducted without unnecessary delays, and whether contact tracing and infection prevention measures were activated quickly.

He also called for an assessment of whether exposed healthcare workers had been identified and monitored appropriately.

Kolawole warned that delayed recognition of a potentially fatal disease in a densely populated city could increase the number of people exposed and complicate containment.

He urged health authorities to strengthen risk-based detection, improve clinicians’ awareness and establish rapid reporting mechanisms to distinguish unusual infections from routine illnesses.

Index Case Recovering As FG Quarantines High-Risk Contacts

Pate said the patient was recovering, with laboratory results indicating significant improvement, although her survival was not guaranteed.

Speaking at a press briefing on Thursday, he said clinicians treating her had reported encouraging developments and urged Nigerians to remain vigilant while containment efforts continued.

He said the patient was asymptomatic when she arrived in Nigeria but developed symptoms a few days later.

According to the minister, contact tracing began after confirmation of the infection. Health authorities identified contacts at the hospital where she received treatment, a private clinic she had previously visited and among her domestic contacts.

The contacts were categorised according to their exposure risks. High-risk contacts were quarantined at a designated facility, while others were isolated and monitored in line with public health guidelines.

Pate said the measures were intended to prevent the virus from spreading into the wider community.

He added that the NCDC was coordinating the response with FCT authorities and other relevant agencies.

The government had also initiated plans to sequence the virus’s genome to improve understanding of the pathogen. Pate said Professor Christian Happi, a genomics expert at Redeemer’s University, had been invited to support the NCDC’s work.

He said additional resources had been mobilised, including funds released to the NCDC, while states had been urged to strengthen their preparedness plans.

The federal government was also working with development partners, the World Health Organisation and the Africa CDC to coordinate the response.

Pate said the government had briefed the Presidential Task Force on Ebola preparedness, the Nigeria Governors’ Forum and the National Economic Council (NEC) to secure political commitment at the highest levels.

He added that a meeting with state commissioners for health and information was planned to improve coordination and ensure consistent public communication.

FG Rules Out Immediate Restrictions on Public Gatherings

Pate said the government was not considering restrictions on planned public gatherings, including political campaigns and conferences, because the case remained contained and there was no evidence of wider community transmission.

He, however, said the authorities would review their recommendations if new evidence or changing circumstances warranted further measures.

“It’s a contained single case, and we are diligently working to ensure that it remains so. At this moment, there is no indication that requires us to alter the course of large gatherings that have been planned,” he said.

The minister stressed that decisions on public gatherings would be guided by scientific evidence and public health considerations.

He also urged political leaders not to politicise the outbreak, describing health as an issue that should unite Nigerians across political, religious and ethnic divides.

Pate said surveillance at the country’s points of entry had been strengthened, with additional capacity planned to improve traveller screening and risk assessment.

He said Nigeria had gone five months without an imported case despite significant international travel, adding that the government would intensify efforts to prevent further importation and transmission.

FG Warns Against Misinformation

Pate expressed concern about misinformation and public distrust surrounding the outbreak, insisting that the patient had tested positive three times.

He urged Nigerians to rely on verified information from public health authorities, warning that misinformation could undermine containment efforts if people refused to comply with isolation, quarantine and other public health directives.

He also appealed to the media to verify information and avoid spreading rumours, adding that the Ministry of Health and Social Welfare and the NCDC would continue to provide updates.

The minister said Ebola was transmitted through direct contact with the blood or bodily fluids of an infected person or contaminated materials, not through the air.

He advised Nigerians to practise regular handwashing, avoid contact with other people’s bodily fluids and promptly inform health authorities if they developed symptoms after possible exposure.

Pate said hospitals had been directed to prepare isolation beds and strengthen infection prevention and control measures to protect healthcare workers and patients.

He urged private healthcare providers to remain vigilant, noting that the patient had initially sought treatment at a private facility.

The minister expressed confidence that Nigeria’s experience in containing the 2014 Ebola outbreak, together with its public health capacity and international partnerships, would support the current response.

He urged those identified through contact tracing to cooperate with health authorities as efforts continued to prevent further transmission.

** FG Urges 15 States to Strengthen Preparedness Measures**

The Federal Government has urged 15 states to strengthen their preparedness and response mechanisms following the confirmation of an imported Ebola case in the FCT.

Pate made the call while briefing the NEC on the country’s response to the outbreak.

According to a statement issued on Thursday by Stanley Nkwocha, Senior Special Assistant to the President on Media and Communications in the Office of the Vice President, 21 states had updated their response plans, while the remaining 15 were urged to expedite the establishment of appropriate preparedness and response mechanisms.

Pate gave the update at the 161st NEC meeting, chaired virtually by Vice President Kashim Shettima.

He assured council members that Nigeria had the institutional capacity to contain the situation, adding that the Federal Ministry of Health and Social Welfare was working with relevant stakeholders to operationalise a coordinated national response.

He identified coordination and governance, screening at points of entry, laboratory testing, logistics for essential supplies and personal protective equipment, and strategic communication as critical components of the response.

The briefing highlighted the need for coordinated action by federal and state governments to strengthen preparedness and ensure that appropriate response systems were in place.

Meanwhile, the council received a report from its Ad Hoc Committee on Polio Eradication, chaired by Gombe State Governor Muhammadu Inuwa Yahaya.

The council resolved to direct states to conduct post-campaign reviews, particularly in areas where children were missed during immunisation exercises and communities affected by insecurity.

It also stressed the need for timely release of counterpart funds, stronger routine immunisation, improved coordination with security agencies and closer cooperation among states to improve coverage in subsequent campaigns.

The council said sustained commitment from governors, traditional rulers and security agencies remained critical to eradicating polio in Nigeria.