Wrong Diagnosis Rears Its Head


Posted on: Wed 27-08-2014

Since the first case of Ebola Virus Disease was announced in the country on July 20, the Federal Ministry of Health has toiled to give the correct figure of confirmed cases and deaths. The first case of a misdiagnosis last week in Lagos has however introduced a new dimension to the outbreak. Findings by our correspondent showed that the case was a man in Lagos.
On Monday, however, the ministry, through the Special Assistant on Media and Communication to the Minister, Mr. Dan Nwomeh, said contrary to the figure announced earlier, the number of confirmed Ebola cases in the country was 13.
In a press statement, Nwomeh said, “Total number of confirmed cases including the index case is now 13. (Explanation: The 14th case initially announced as positive turned out to be a false positive).
Speaking to our correspondent on the phone, the Minister for Health, Prof. Onyebuchi Chukwu, said cases of misdiagnosis has not been uncommon in any human system. He added that the misdiagnosed case, which was the first in the country, was found to be a false positive through two other subsequent tests.
“The case announced as positive was a false positive. It was a spouse of one of the primary contacts in Lagos. For each case, we double check in our laboratory in Lagos. The case was a man. We had to the test the second and third time to confirm the result. All the positive cases so far are from Lagos and this is the first case of misdiagnosis. In any human system, there is a likelihood of getting a false result. In science, when we say this drug can cure malaria, we know that there may be one or two cases where the outcome may be different. That is why we do confirmatory tests even in HIV cases,’’ he said.
The development has however not unnoticed by stakeholders who have expressed concerns. A Consultant Gynecologist, Olabisi Onabanjo University, Ago-Iwoye, Ogun State, Dr. Femi Oloyede, urged health authorities to direct laboratory officials to be more watchful when handling blood samples to avoid false results.
Oloyede added that even if confirmatory tests show otherwise, an individual who has earlier been said to be positive risks stigmatisation from the society.
“People will not even believe that the person is not Ebola positive. The public outcry that has trailed Ebola has shown that it is a highly feared disease. You may say the person is not known to the public but as time goes on, the person will be known. That person must have left his place of work, he must have been separated from his normal routine. When you now say the person is no longer positive, it is taken with a pinch of salt.
“There are two ways to prevent misdiagnosis. We need to be very careful not to raise too much alarm about this disease. Now, every individual that has a high temperature is labelled as an Ebola patient even by medical personnel. Labelling people as Ebola patients simply because of a high temperature is wrong. Fortunately, we have dedicated laboratories for this virus but even at that, laboratory officials need to be careful so that samples don’t get mixed up. Human errors, though negligible, has been documented in science. So, it is important that samples are well labelled and verified before making any announcement,’’ he said.
Meanwhile survivors in Guinea are telling incredible stories. The number of people who have contracted the Ebola virus in Guinea, according to the World Health Organization, has risen to 208 – and 136 of them have died. About half of these cases have been confirmed in a laboratory – earlier cases were not tested.
There is no cure for Ebola but with early medical support some people’s bodies are able to develop antibodies to fight it off.
One survivor, who asked not to be named, told the BBC his story.
None of us could sleep — we thought we would never make it to the morning”
The first doctor I saw at a village health centre said it was malaria – it was only when I was brought to a special unit at the hospital in [the capital] Conakry that I was told I had the Ebola virus.
I felt really depressed — I had heard about Ebola so when the doctors told me, I was very scared.
I tried to be positive — I was thinking about death, but deep inside I thought my time had not come yet and I would get over it. That’s how I overcame the pain and the fear.
Doctors from the charity Medecins Sans Frontiers (MSF) were here to comfort me and give their moral support. I tried to stay positive although I was scared when I saw my relatives dying in front of me.
There was a moment when I thought I might die when I lost two of my uncles and their bodies were taken away.
On that night none of us could sleep — we thought we would never make it to the morning.
Some doctors from MSF came to collect and wrap the bodies and sterilise the area. It all happened in front of us.
People moving the bodies of those killed by Ebola wear protective clothing
A short while after I was admitted to the hospital for treatment I started feeling better, step by step.
‘Shook my hands’
At first I was scared to eat as I thought I would be sick but after a while I took a few drops of water and realised it was OK and the diarrhoea gradually stopped as well. Symptoms include high fever, bleeding and central nervous system damage
The doctors would come to see me and ask questions and one day nearly all my answers were “no” – the doctors were pleased and I realised that I would make it.
That was a very powerful feeling for me.
It was a great feeling when I walked out of the hospital.
We had a little celebration with the doctors, all the nurses and the people who had been waiting for me.
They took pictures of me, they shook my hands — I saw that they felt safe touching me and I realised I was better. I was really happy on that day. Now I feel good although I sometimes get some pain in my joints.
I prefer not be identified in the media — many people are aware that I had the disease but many others are not.
We have been through difficult times — people were afraid of us.
You know about African solidarity — usually when someone dies people visit you but when we lost one and then two, three, four members of our family, nobody came to visit us and we realised we were being kept at bay because of fear.
It gets even worse if everybody hears about your condition on the radio and television. People in Guinea are poorly informed about the virus
Even people close to us, neighbours and relatives, are met with suspicion when they mention they know us.
Immediately the other person takes two or three steps back for fear of contracting the virus. People are very poorly informed about the disease.
Nine people in my family had the virus in total. My wife and my cousin survived too, so it is the three of us out of nine.
We were very affected by the deaths of our relatives but we were also relieved that not all of us had died.
It would have been such a catastrophe if we had all passed away.
This was a lesson on a spiritual level and it has changed the way I look at life.
The short time we spent in hospital has really transformed us. I feel lucky. I feel very happy to be alive.