The Nigeria Centre for Disease Control and Prevention has placed travellers arriving from countries experiencing Ebola outbreaks under intensified surveillance, directing health workers nationwide to closely monitor individuals who develop symptoms within 21 days of travel.
The agency, in updated surveillance guidelines issued to health facilities and disease surveillance officers, said any person who develops a sudden fever and other symptoms associated with Ebola within 21 days of travelling to affected countries should be treated as a suspected case and immediately investigated.
The directive comes as Nigeria remains on heightened alert over ongoing Ebola outbreaks in parts of Africa, particularly countries such as the Democratic Republic of Congo and Uganda, where health authorities have continued efforts to contain periodic outbreaks of the deadly viral disease.
According to the NCDC guidelines, any person with a sudden onset of fever and at least three symptoms, including headaches, lethargy, loss of appetite, muscle or joint pain, stomach pain, difficulty swallowing, vomiting, difficulty breathing, diarrhoea or hiccups, who has travelled to a country reporting suspected or confirmed Ebola cases within the previous 21 days, should be considered a suspected Ebola case.
The agency also identified unexplained bleeding in individuals who recently travelled to affected countries as a major red flag requiring urgent public health attention.
“Any person with a sudden onset of fever and at least three of the following symptoms—headaches, lethargy, anorexia, aching muscles or joints, stomach pain, difficulty swallowing, vomiting, difficulty breathing, diarrhoea or hiccups—and travel history to countries reporting suspected or confirmed Ebola cases within the last 21 days,” should be treated as a suspected case, the NCDC guidelines stated.
The public health agency further warned that persons who have had contact with a confirmed or probable Ebola patient within the previous 21 days and subsequently develop fever, with or without other symptoms, should also be investigated immediately.
The guidelines noted that the 21-day period is critical because it corresponds with the known incubation period of the Ebola virus, during which an exposed person may begin to develop symptoms.
Beyond international travel, the NCDC said individuals exposed to wildlife or bushmeat within the previous 21 days and who develop persistent fever that does not respond to routine treatment should also be regarded as suspected cases.
The agency explained that exposure to sick or dead animals, bushmeat, or animal body fluids remains a recognised pathway for transmission of Ebola from animals to humans.
According to the guidelines, healthcare workers should be particularly vigilant when evaluating patients with unexplained fever who have epidemiological links to confirmed cases or high-risk exposures.
The NCDC defined a probable case as “any suspected case with an epidemiological link to a confirmed case for whom laboratory confirmation could not be obtained.”
The agency added that confirmation of Ebola infection can only be made through laboratory testing.
“Laboratory confirmed cases must test positive for the virus antigen either through detection of virus RNA by reverse transcriptase-polymerase chain reaction (RT-PCR) or through detection of IgM antibodies directed against Ebola,” the guidelines stated.
As part of efforts to strengthen early detection, the NCDC also expanded surveillance at the community level, urging residents to report unusual illnesses and unexplained deaths promptly.
Under the agency’s community-based surveillance framework, any person with persistent fever that fails to respond to treatment, bleeding symptoms, bloody diarrhoea, blood in urine, or any sudden unexplained death should be reported immediately to health authorities.
“Any sudden or unexplained death should be considered a priority event for investigation,” the guidelines stated.
Public health experts say community reporting remains one of the most effective tools for detecting outbreaks before they spread widely.
The renewed emphasis on the 21-day monitoring period reflects lessons learned from previous Ebola outbreaks across Africa, where delays in identifying exposed individuals often contributed to the spread of the disease.
Ebola Virus Disease is a severe and often fatal illness caused by viruses of the genus Ebolavirus.
