Via The Guardian, a long, fascinating and worrying account: Nigeria fears fourth Ebola frontline after infected man lands in Lagos.
After watching three regional neighbours battle an eight-month-long epidemic, Nigerian officials are scrambling to avoid mistakes that have helped fuel the biggest epidemic in history. In Guinea, Liberia and Sierra Leone, 916 have died, or around half of those who been infected.
Now a potential fourth frontline has opened. A colleague travelling alongside Sawyer and a nurse who treated him have both succumbed to Ebola. Eight others have caught the disease in Lagos, and some 200 are under surveillance.
"There are some unique challenges that have come up," said John Vertefeuille, leading the US Centers for Disease Control and Prevention (CDC) response team in the city.
"The population density is a challenge and it's one we're looking at closely in terms how you do contact tracing. What Lagos has as strengths is there's a really talented workforce to draw on."
Oil giant Nigeria has more resources than most to handle an outbreak but whether the situation spins out of control hinges on the Herculean task of tracing contacts in a crowded, freewheeling city of transients. It took 10 days to trace Sawyer's driver to Port Harcourt, a densely-populated city 600km south of Lagos.
The incident has also highlighted a deeper culture of neglect when it comes to infectious tropical diseases that ravage West Africa each year.
So far, much has come down to chance. As a diplomat, 40-year-old Sawyer was whisked from the airport by a private driver. The company car – in which he was again sick, according to a Nigerian health official – was taken to a diplomatic compound, but wasn't used again because it was a national holiday.
But public health workers were on strike, so Sawyer was taken to a small family clinic. There, the team who tried to save his life didn't initially suspect Ebola, or work with protective gear. At least one other patient at the clinic would later catch Ebola.
"The family hospital Sawyer went to was caught unawares. If it had been a public hospital, we would have had a much better chance of containing it," said John Oladejo, of Nigeria's Public Health Department, which in April sent dozens of doctors on an Ebola training course. Nigeria has one doctor per 2,879 people, compared with one per 10,000 in Guinea or one per 86,275 in Liberia.
"We have a window of opportunity at the moment to contain it but there's no room for letting down your guard," said Chikwe Ihekweazu, an epidemiologist who helped stem an Ebola outbreak in Sudan a decade ago.
"It's not that we don't have the resources. The challenge is that there are things you have to do religiously every time you're dealing with a patient, and we're just not used to that level of diligence in Nigeria."