Nigeria’s experience with the Ebola outbreak in 2014 remains an important reminder of the dangers posed by the deadly virus and the importance of early detection in preventing its spread.
One of the defining moments of the outbreak was the decision by late Dr Ameyo Stella Adadevoh to insist on isolating Patrick Sawyer at a Lagos hospital in July 2014, despite the pressure surrounding his treatment.
Her clinical judgement helped alert health authorities and trigger the emergency response that eventually contained the outbreak.
Adadevoh contracted the virus and died on August 19, 2014. Nigeria recorded 20 confirmed cases and eight deaths before the World Health Organisation declared the country free of Ebola transmission on October 20, 2014.
More than a decade later, the disease remains a public health concern following the reported confirmation on October 20, 2026, of an imported case of Bundibugyo virus disease in a woman who travelled from Uganda and was admitted to a private hospital in Abuja.
Why Ebola remains dangerous
Despite improvements in medical research, disease surveillance and emergency response, Ebola continues to threaten public health systems across the world.
Factors contributing to its continued spread include its biological characteristics, limited treatment options for certain virus species, exposure to infected wildlife, international travel and weaknesses in healthcare systems.
Fear, misinformation and a lack of public trust can also make outbreak management more difficult.
Family physician and public health expert, Dr Rotimi Adesanya, explained that Ebola is particularly dangerous because of its ability to cause severe damage to the human body within a short period.
He described Ebola Virus Disease as one of the most dangerous infectious diseases because it can overwhelm the body’s immune system and affect several vital organs.
The early signs of infection include fever, headaches, weakness, muscle and joint pain, sore throat and fatigue.
As the disease progresses, patients may develop more severe symptoms such as vomiting, diarrhoea and abdominal pain.
These symptoms can easily be confused with malaria, typhoid and other common illnesses, making it important for healthcare professionals to consider a patient’s travel history and possible exposure to the virus.
Symptoms typically develop between two and 21 days after exposure.
According to the Nigeria Centre for Disease Control and Prevention (NCDC), Ebola is transmitted through direct contact with the blood or other bodily fluids of infected persons, deceased patients, infected animals or contaminated objects.
The agency identifies early detection, laboratory testing, isolation, contact tracing and strict infection prevention measures as essential components of outbreak control.
Adesanya also cautioned against the widespread assumption that every Ebola patient must experience visible bleeding.
He explained that severe dehydration, shock and multiple organ failure are among the major causes of death associated with the disease.
According to him, vomiting and diarrhoea can lead to significant loss of body fluids and electrolytes, causing dehydration, reduced blood pressure and shock. The infection may also damage vital organs, including the liver and kidneys.
The importance of early detection
Adesanya stressed that waiting for advanced symptoms before suspecting Ebola could put more lives at risk.
He explained that patients may require urgent medical attention before severe complications develop, while people who have been exposed must be identified and monitored.
He noted that early diagnosis protects both the infected individual and others who could potentially contract the virus.
The experience of Dr Adadevoh, he said, demonstrates why medical professionals must look beyond familiar symptoms and consider possible exposure risks when assessing patients.
However, this does not mean every fever should automatically be treated as Ebola. Rather, suspected cases should be assessed promptly through appropriate medical and public health procedures.
Why Ebola outbreaks continue to occur
Containing an outbreak does not mean the virus has been completely eliminated.
Ebola is a zoonotic disease, meaning it can spread from animals to humans. As long as the virus continues circulating in its natural environment, there remains a possibility of transmission to human populations.
Adesanya explained that certain species of fruit bats are considered likely natural reservoirs of some Ebola viruses, although the exact ecological patterns and transmission pathways are not fully understood.
Human infections can occur through contact with infected wildlife or their bodily fluids.
Once the virus enters the human population, it can spread through direct contact with the blood and other bodily fluids of infected people, including those who have died from the disease.
In an interview with Vanguard, Adesanya identified weak disease surveillance, limited laboratory facilities and inadequate healthcare access in remote communities as some of the factors that make outbreaks difficult to control.
He also highlighted how conflict and population displacement can disrupt medical services, while poverty may prevent people from accessing treatment facilities.
Distrust of government authorities can further discourage communities from reporting suspected infections or cooperating with health workers.
Adesanya added that Ebola viruses may persist in certain bodily fluids of survivors after recovery, occasionally creating opportunities for further transmission.
He also identified international travel and migration as additional challenges, as infected individuals may cross national borders before their conditions are detected.
He maintained that controlling Ebola requires a comprehensive One Health approach that brings together human health, animal health and environmental surveillance.
Such an approach involves cooperation among public health authorities, veterinary professionals, wildlife experts and environmental agencies to identify possible threats before they develop into outbreaks.
Treatment options and medical challenges
Although Ebola is a serious disease, infection does not automatically result in death. Survival depends on the virus species, the patient’s condition and how quickly appropriate medical care is provided.
However, treatments developed for one Ebola virus species cannot automatically be used to treat another.
According to Adesanya, there are currently no approved virus-specific treatments or vaccines for Bundibugyo virus disease.
Treatment therefore focuses on supportive medical care, including intravenous fluids, correction of electrolyte imbalances, oxygen support where necessary, blood pressure management, nutritional support and close monitoring of organ functions.
For infections caused by the Zaire ebolavirus species, specific medical interventions are available.
These include monoclonal antibody treatments such as Inmazeb and Ebanga, as well as the Ervebo vaccine for prevention.
However, these treatments and vaccines should not be assumed to be effective or approved for Bundibugyo virus disease.
The NCDC has also stated in its public health advisories that there are no approved specific treatments or licensed vaccines for Bundibugyo virus disease, explaining that existing Ebola vaccines and monoclonal antibody therapies are primarily directed against the Zaire ebolavirus species.
Beyond the availability of medicines, effective treatment requires functional isolation centres, diagnostic laboratories, adequate medical supplies and properly trained healthcare personnel.
Medical workers must also have access to appropriate protective equipment and safe working conditions to reduce the risk of infection.
The death of Dr Adadevoh remains a reminder of the risks faced by frontline health workers and the importance of strengthening Nigeria’s emergency healthcare infrastructure.
Wildlife exposure and the risk of infection
Scientists continue to investigate how Ebola viruses circulate in wildlife and the conditions that allow them to enter human populations.
Although fruit bats belonging to the Pteropodidae family are suspected natural hosts of some Ebola viruses, a natural reservoir has not been conclusively established for every species.
Chimpanzees, gorillas, monkeys and forest antelopes, including duikers, can also become infected.
However, these animals are susceptible hosts rather than confirmed natural reservoirs in every case. Some can develop the disease and expose humans who handle their bodies.
Environmental changes, including deforestation, agricultural expansion and human encroachment into forest areas, may increase contact between people and wildlife, creating opportunities for infections to cross species barriers.
This makes environmental monitoring and wildlife surveillance important components of Ebola prevention.
Bush meat and possible exposure
Bush meat remains part of the diet and trading activities of some communities across Africa, with hunting and wildlife trading also providing livelihoods for certain households.
However, public health experts warn that handling potentially infected animals can expose people to Ebola.
The risk is not restricted to eating bush meat. Infection may occur during hunting, killing, transporting, skinning or butchering an infected animal when blood or other bodily fluids come into contact with broken skin or the eyes, nose and mouth.
Eating raw or inadequately cooked meat from an infected animal may also pose a risk, although thorough cooking inactivates the Ebola virus in food.
Adesanya’s explanation highlights the importance of educating communities about safe wildlife handling and the risks associated with contact with infected animals.
Public health campaigns must also consider the economic realities of communities that depend on wildlife for food and income.
He emphasised the need for cooperation between health authorities, veterinary services, environmental agencies, wildlife experts and communities living close to forest habitats.
Monitoring unusual animal deaths, strengthening laboratory services and improving information sharing could help authorities identify possible outbreaks earlier.
International travel and cross-border transmission
The movement of people across international borders presents another challenge in controlling Ebola.
An infected individual may travel to another country before symptoms become apparent or before the infection is identified.
Adesanya explained that transmission occurs through direct contact with the blood or other bodily fluids of an infected person who is ill or has died, as well as contaminated materials. He stressed that Ebola does not spread through the air in the same way as measles.
Public health expert and Financial Secretary of the Medical Guild, Dr Ope Osunyomi, also stressed the need for Nigeria to maintain vigilance because infections can be imported from countries experiencing outbreaks.
Source: Vanguard
