The first cluster emerged in July, when an infected Liberian-American man named Patrick Sawyer flew into Lagos. Sawyer died within days of arriving and Nigerian officials tried to prevent an outbreak by quarantining his close contacts. But Nigeria’s Federal Ministry of Health has confirmed that a diplomat with the Economic Community of West African States ignored that quarantine and traveled from Lagos to Port Harcourt after developing symptoms of the deadly disease.
The diplomat was treated at a hotel in Port Harcourt between Aug. 1 and Aug. 3, according to the World Health Organization. A doctor who treated him developed symptoms of the infection roughly 10 days later but continued to interact with family, friends and patients for two days, the agency said.
As his symptoms progressed, the doctor rested at home, where he was visited by friends and relatives to celebrate the birth of a baby. He was hospitalized on Aug. 16 but continued to be seen by dozens of community members, including church members who performed a “laying on of hands,” according to WHO. He was also visited by a majority of the hospital’s medical staff before he died on Aug. 22.
Officials with WHO and the Nigerian government are now monitoring more than 200 people that had contact with the doctor. At least 60 of those people are considered to have had high risk or very high risk exposure, including two patients that he operated on. The doctor’s wife and another patient at the hospital where he was treated have already tested positive for the disease, according to WHO.
The diplomat survived and returned to Lagos, where he remains in quarantine to ensure he’s no longer contagious, according to the country’s Federal Ministry of Health. Local reports suggest he could face manslaughter charges for evading quarantine and exposing others to Ebola.
Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical School, said the new cluster could represent a major setback in the fight to stop the outbreak.
“You’ll never be successful unless the population [understands,] unless they’re collaborating with the public health effort,” he said. “This is exactly the kind of thing that everyone is on tenterhooks about.”
Schaffner said this kind of cluster makes it more likely the virus will continue to spread throughout the region.
“The greatest concern is [not only] that this outbreak is going to continue in the three major countries already affected, but that the longer it goes on, the likelier [they are to] export the disease,” he said.
The virus has already killed at least 1,841 and infected a total of 3,685 people in West Africa, according to the latest numbers from WHO. Nearly all of those infected were in Liberia, Guinea and Sierra Leone.