A team of University of Nebraska Medical Center specialists dropped into Lagos, Nigeria, the largest city in sub-Saharan Africa, on Sunday on a mission to bolster that country's capability to prevent and control highly infectious diseases.
Days later, the World Health Organization declared an outbreak of the Ebola virus in the Congo, a public health emergency of international concern.
The year-old Ebola epidemic in the Congo, a country of nearly 92 million, has infected some 2,500 people and killed more than 1,600. This week, the first case of the virus was reported in Goma, a city near the Rwandan border, prompting the declaration from the WHO on Wednesday.
Meanwhile, some 2,800 miles to the west, members of UNMC's Global Center for Health Security have been working closely with Nigerian health care workers on the "Nebraska Method" — the proper procedure when caring for patients carrying highly infectious pathogens.
Dr. James Lawler, an associate professor of medicine in UNMC's Division of Infectious Diseases and the director for international programs and innovation at the Global Center for Health Security, said the Ebola outbreak in West Africa in 2014 and 2015 reached the Nigerian capital with a population of 23 million, but didn't spread widely.
"Many people see that as a major dodged bullet — it could have been catastrophic if Ebola had taken hold in Lagos," Lawler said in an interview by phone from Nigeria.
In the aftermath of that pandemic, which claimed thousands of lives in Guinea, Liberia and Sierra Leone, the Nigerians reached out to the American government for help in preparing to defend against the next outbreak.
The U.S. Department of Defense, in turn, reached out to the experts in Nebraska.
"The Nigerian government recognizes it would benefit from having a patient isolation unit in the city of Lagos, and asked our partners at DOD for help developing that capability," Lawler said.
UNMC's own Biocontainment Patient Care Unit, built in 2003 in response to the SARS epidemic, played a key role in treating several Americans who contracted the Ebola virus during the last major outbreak, as well as monitoring others for signs of the disease.
The lessons learned during that period were later translated into training modules sent to governments and nongovernmental organizations, as well as international missions putting UNMC's specialists on the ground to build up other country's prevention capabilities.
Lawler said the UNMC team of eight, including Shelly Schwedhelm, director of the biocontainment unit, and John Lowe, a co-director for the Global Center for Health Security, previously visited Nigeria in late 2017 to lay the groundwork for their current mission.
Last fall, the center also provided support to nongovernmental organizations working with refugees in Uganda, which has also reported cases of Ebola, on how to recognize the signs and symptoms of the disease, as well as how to manage them.
"We are constantly trying to find opportunities to make an impact in pandemic preparedness and combating emerging infections," Lawler said.
While the one-week mission is unrelated to the current outbreak and was scheduled to support the Nigerian Biopreparedness Initiative, Lawler said all eyes are focused on the worsening situation in the Congo.
He added the WHO's declaration this week is the acknowledgment of a deteriorating situation in the Congo many public health professionals in Africa have been aware of for quite some time.
"We're concerned with what's happening, but hope the World Health Organization declaration can prompt more action within the (Congo) and in the international community to try and contain the outbreak," he said.