By Iroyin Yoruba Television
Nigeria has strengthened its public-health surveillance for international travellers following the continuing Ebola outbreak in the Democratic Republic of the Congo, with passengers arriving from countries affected by Ebola transmission required to complete health declarations and undergo screening.
The measures are being maintained as health authorities in the region confront a serious outbreak that has expanded geographically in eastern Democratic Republic of the Congo, placing additional pressure on already stretched healthcare facilities.
Nigeria has not been identified as having an Ebola outbreak in the latest health information available. Instead, the country's current measures are focused on preventing the virus from being imported and ensuring that potentially exposed travellers can be identified and monitored quickly.
Travellers arriving in Nigeria from countries with relevant Ebola transmission are required to complete the Nigeria Health Declaration Form and provide information including travel history, health status and contact details. Public-health authorities can then use the information for follow-up monitoring where necessary.
The monitoring period can extend to 21 days after arrival, reflecting the importance of observing travellers who may have been exposed to the virus during the incubation period.
The renewed attention to Ebola follows a significant deterioration in the situation in the Democratic Republic of the Congo, where health facilities in North Kivu have reported a sharp increase in patients.
In Butembo, one of the major cities in North Kivu, the Kitatumba Ebola treatment centre had reached full capacity, with all 29 beds occupied during the week ending September 25. Medical workers have been dealing with severely ill patients while continuing efforts to identify new infections and prevent further transmission.
The situation is particularly challenging because North Kivu is densely populated and has experienced years of armed conflict.
Insecurity can make it difficult for health workers to reach affected communities, conduct investigations, trace contacts and ensure that patients receive treatment early.
The outbreak has also spread beyond the areas initially associated with the resurgence, creating concern that infections may continue appearing in locations where health authorities have less capacity to respond.
The current situation demonstrates why countries that do not have confirmed cases can still need to strengthen surveillance.
International travel means that an infected person can potentially move between countries before symptoms become obvious. Health screening therefore provides an additional layer of protection, particularly when travellers arrive from areas where transmission is occurring.
However, screening at airports and other entry points is only one component of outbreak preparedness.
Effective disease control also depends on laboratories, trained health workers, contact tracing, infection prevention, isolation facilities, public communication and the ability to rapidly investigate unusual illness.
Nigeria has experience dealing with infectious-disease emergencies, including its response to the 2014 Ebola outbreak.
That experience established systems for emergency coordination, surveillance and contact tracing that have subsequently been used during other public-health emergencies.
The lessons from previous outbreaks remain relevant because Ebola requires rapid action once a suspected case is identified.
The disease can initially resemble other illnesses, meaning health workers need appropriate training and diagnostic capacity to distinguish suspected Ebola cases from malaria, typhoid, respiratory infections and other conditions that can produce fever and related symptoms.
This makes early reporting particularly important.
People who have travelled from affected areas and subsequently develop symptoms should disclose their travel history to healthcare professionals. Providing accurate information can help doctors and public-health authorities determine whether additional testing or monitoring is required.
The same principle applies to people who have had close contact with individuals who may have been exposed.
The purpose of Nigeria's health declaration system is therefore not simply to collect information at the airport.
It provides authorities with a mechanism for identifying people who may require follow-up during the period after their arrival.
Such systems can become particularly valuable when an outbreak is occurring in a country with substantial international travel connections.
Nigeria is one of Africa's largest aviation markets, with major international gateways including Murtala Muhammed International Airport in Lagos and Nnamdi Azikiwe International Airport in Abuja.
Large numbers of passengers move through these airports every day, connecting Nigeria with other African countries, Europe, the Middle East, Asia and North America.
The volume of international travel means that disease surveillance at points of entry remains an important part of the country's health-security system.
At the same time, health officials must balance surveillance with the need to avoid unnecessary disruption to legitimate travel.
The objective is not to prevent people from travelling simply because they are from a particular country. Rather, public-health authorities need to identify people who may have been exposed and ensure that appropriate monitoring is available.
This distinction is important because Ebola is not transmitted simply because a person has travelled from a particular country.
Transmission generally requires exposure to infected bodily fluids, particularly when a patient is symptomatic. Close contact with an infected person or contaminated materials can increase the risk.
Consequently, travel history is an important screening factor but does not by itself establish that someone has Ebola.
The current outbreak in the Democratic Republic of the Congo has also demonstrated the importance of early detection.
Health authorities have reported that delays in diagnosis and access to appropriate treatment can contribute to preventable deaths.
In some parts of North Kivu, the outbreak has been difficult to control because new infections have appeared without clear links to previously identified patients.
That makes traditional contact-tracing approaches more difficult because investigators may not immediately know where transmission began or how an infected person became exposed.
The challenge is compounded by the movement of people between communities.
Conflict and displacement can force families to relocate, sometimes moving through areas where health services are limited. People may also hesitate to seek treatment if they fear stigma, isolation or disruption to their families.
For public-health authorities, building trust with communities is therefore as important as deploying medical equipment.
Health workers need communities to report suspected cases and cooperate with contact-tracing activities.
When people hide symptoms or avoid treatment because of fear, infections can continue undetected for longer periods.
The Nigerian response therefore has a wider lesson: disease preparedness depends on public cooperation as well as government systems.
Health declarations, airport screening and monitoring procedures can help identify risks, but individuals also have a role in reporting relevant symptoms and providing accurate travel and contact information.
The current situation has also placed renewed attention on the importance of regional cooperation.
Diseases do not respect national borders, particularly in regions where people regularly cross borders for work, trade, family reasons and humanitarian needs.
An outbreak in one African country can therefore quickly become a concern for neighbouring and connected countries.
For this reason, surveillance information needs to move rapidly between national health authorities and regional institutions.
Nigeria's participation in continental disease-surveillance networks provides an important mechanism for receiving alerts about emerging threats.
The World Health Organization has continued to coordinate international support for the Democratic Republic of the Congo, while African health institutions are monitoring the spread and supporting affected countries.
The current crisis also highlights the relationship between health security and humanitarian conditions.
North Kivu has been affected by armed violence for years, making it difficult to establish consistent healthcare access in some communities.
A disease outbreak occurring in an insecure environment can be considerably harder to contain than one occurring in a stable area.
Medical teams may require security escorts to reach patients. Ambulances can face delays. Contact tracers may not be able to enter certain communities. Health facilities may also struggle to maintain adequate staffing.
These conditions can increase the likelihood that patients arrive for treatment late.
Nigeria's own experience with infectious diseases has demonstrated the importance of maintaining preparedness even when a particular threat appears distant.
The country's large population and international connections mean that public-health authorities must continuously monitor developments beyond its borders.
The current Ebola situation is therefore another test of the country's health-security infrastructure.
One important component is laboratory preparedness.
When a suspected case is identified, confirmation must be obtained quickly because Ebola treatment and infection-control procedures differ significantly from those used for many other illnesses.
Rapid diagnosis also allows health authorities to begin contact tracing and other interventions sooner.
Isolation capacity is equally important.
If a suspected patient can be safely separated while diagnostic testing is carried out, the risk of potential exposure to healthcare workers, family members and other patients can be reduced.
Healthcare workers themselves are among the groups requiring particular protection.
During Ebola outbreaks, medical staff can face significant exposure risks if appropriate infection-prevention procedures are not followed.
Protective equipment, training, waste management and safe handling of patients are therefore essential.
Nigeria's public-health preparedness must consequently extend beyond airport screening to hospitals and clinics across the country.
A traveller who develops symptoms after arrival may not necessarily present at an airport. They may visit a private clinic, pharmacy or public hospital.
Healthcare workers across different levels of the health system therefore need to know how to identify a possible high-risk case and where to report it.
Public awareness also has an important role.
People should understand that Ebola is a serious disease but avoid unnecessary panic or misinformation.
Rumours can create stigma against travellers or entire nationalities and can interfere with legitimate public-health measures.
Accurate information should instead focus on symptoms, exposure risks, travel history and appropriate steps for seeking medical assistance.
This is particularly important in an era when false health information can spread rapidly through social media.
A person experiencing a fever after international travel should not automatically assume they have Ebola. Many common illnesses can cause similar symptoms.
However, where there has been possible exposure to an Ebola-affected area, the person's travel and contact history should be communicated to healthcare professionals.
The same principle applies to people who have been in close contact with someone who later develops a suspected or confirmed infection.
The current outbreak also illustrates the importance of international funding for epidemic response.
The Democratic Republic of the Congo has required additional medical supplies, treatment capacity and trained personnel as the outbreak has expanded.
Earlier reports indicated that shortages of trained staff, operational partners and funding were creating bottlenecks in efforts to expand the response.
These constraints matter to countries outside the immediate outbreak zone because the longer transmission continues unchecked, the greater the opportunity for the virus to reach additional communities.
International disease control therefore depends on helping affected countries contain outbreaks at their source.
Nigeria's continued screening measures are part of a wider continental effort to prevent cross-border transmission.
The country is also involved in broader health-security initiatives aimed at strengthening surveillance and preparedness for infectious diseases.
In September, the World Health Organization announced a new regional health-campaign digitisation initiative intended to improve the planning and delivery of public-health campaigns across Africa.
Digital systems can become particularly useful during outbreaks because authorities need to collect, analyse and share information quickly.
Accurate information about suspected cases, contacts, vaccination campaigns, laboratory results and health-facility capacity can help officials identify patterns and direct resources.
Nigeria's experience with digital health systems is expanding in several areas, including surveillance and disease-control campaigns.
The country's current Ebola preparedness therefore comes at a time when African health authorities are increasingly attempting to combine traditional public-health systems with digital technology.
Another important development is the strengthening of regional cooperation around other infectious diseases.
The WHO and the King Salman Humanitarian Aid and Relief Centre recently signed an agreement worth more than $5.3 million to support cholera preparedness and response across the Lake Chad Basin, including Nigeria, Cameroon, Chad, Mali and Niger. The programme includes water and sanitation measures, disease surveillance and medical supplies.
Although cholera and Ebola are different diseases, the response demonstrates the same principle: public-health threats that cross borders require coordinated surveillance and preparedness.
For Nigeria, maintaining this preparedness is particularly important because the country shares land borders with several countries and has extensive air links with the rest of Africa.
The country's public-health system must therefore be prepared for threats originating both within and outside its borders.
The current Ebola situation is also a reminder that outbreak preparedness cannot be treated as a temporary activity that begins only after cases appear.
Surveillance systems, laboratory capacity, infection-control training and emergency coordination need to remain operational between outbreaks.
This reduces the time required to respond when a new threat emerges.
For travellers, the immediate message is straightforward: people arriving from areas affected by Ebola transmission should comply with Nigeria's health-screening requirements and provide accurate information to health authorities.
Anyone who develops concerning symptoms after possible exposure should seek medical attention and clearly disclose relevant travel and contact history.
For healthcare workers, vigilance remains essential.
A suspected case does not mean a confirmed case, but unusual illness combined with relevant exposure history should trigger appropriate public-health procedures.
For the government, the challenge is maintaining strong surveillance without creating unnecessary fear or disruption.
The latest developments in the Democratic Republic of the Congo show how quickly an infectious disease outbreak can put pressure on hospitals, especially when insecurity and limited resources restrict access to patients.
Nigeria's preventive approach is therefore significant.
The country has not been identified as experiencing the current Ebola outbreak, but it is maintaining safeguards designed to detect potential imported cases early.
That distinction should remain clear.
Preparedness is not evidence that an outbreak is occurring in Nigeria. It is evidence that authorities are attempting to reduce the risk of one occurring.
As the situation in the Democratic Republic of the Congo develops, Nigerian health authorities will need to continue monitoring international travel patterns and epidemiological information while keeping the public informed.
The effectiveness of the country's response will depend on how quickly potential risks are identified, how accurately information is shared and how effectively health workers can respond if a suspected case appears.
The continuing Ebola outbreak has therefore placed renewed attention on Nigeria's health-security system.
For ordinary Nigerians, the most important measures remain awareness, accurate information and prompt communication with health professionals when there is a genuine exposure concern.
For travellers, compliance with health declarations and monitoring requirements remains an important part of the country's prevention strategy.
And for health authorities, the priority is to ensure that surveillance systems remain strong enough to detect a threat before it can establish local transmission.
The experience of the Democratic Republic of the Congo shows the consequences of delayed detection and limited access to treatment. Nigeria's current measures are intended to avoid facing the same challenge at home.
With international travel continuing and the Ebola outbreak still active in parts of Central Africa, maintaining vigilance remains an important part of protecting Nigeria's population.