KARACHI: A suspected case of deadly viral disease Ebola, the second in the country so far, was detected at Karachi airport on Monday morning and the patient was hurried to the Jinnah Postgraduate Medical Centre (JPMC) after a brief medical assessment, health officials told Dawn.

The officials said the suspected patient was a 47-year-old expatriate who had returned to Karachi after a long travel from Liberia, a country worst hit by the Ebola outbreak with more than 3,000 deaths though the country has of late been seeing a decline in the number of new cases of the deadly disease.

They said the patient identified as Mohammad Haroon worked as a salesperson in Liberia and had relatives in tMalir. He had started his journey on Nov 29 from Monrovia, Liberia’s capital, and had come to Karachi via Doha aboard a Qatar Airways flight, they said.

“Since he had mentioned Liberia as the port of embarkation, it was considered to be appropriate to have his medical examination. He was found to have fever at 103 degrees Fahrenheit at the airport,” said an airport health official.

The health staff and the patient were provided protective clothing for safe transport and the patient was later shifted to the JPMC where an isolation area had recently been set up for treatment of Ebola cases.

“He was examined by Dr Tasnim Ahsan, executive director at the JPMC and senior professor of medicine, and was found to have slight oral temperature (99 degrees Fahrenheit) with no other symptoms such as flu-like signs, nausea, vomiting, diarrhoea or bleeding from any site,” said Dr Seemin Jamali, joint executive director at the JPMC and head of the emergency section.

The patient had informed the JPMC staff that his temperature was checked twice at Monrovia airport and was found to be normal, she added.

“He also said that he had not come into contact with anyone who was ill or who had died of some infection. He was then transported with all due precaution to the isolation area designated in the hospital for treatment of Ebola cases,” she said.

The patient, she said, though appeared in good health was recently diagnosed with diabetes.

Earlier, a 40-year-old man, who had travelled to Pakistan from Togo, a West African country, was suspected of having Ebola. He later died in Faisalabad.

But the officials at the National Health Services, Regulations and Coordination (NHSRC) later declared that the deceased, who hailed from Chiniot, had died of dengue and hepatitis C and not of Ebola.

No facility to test Ebola virus

According to Dr Jamali, currently there is no health facility in Pakistan that can test Ebola. The blood samples to be taken from the patient would be sent abroad for examination, she added.

“A World Health Organisation (WHO) team is arriving today in the evening to take blood samples of the patient. The samples will be sent to the National Institute of Health, Islamabad,” she said, adding the WHO had also provided protective gear to the hospital staff.

The officials at the NIH and the NHSRC could not give a definite reply when asked where the blood samples would be sent for examination. An official at the NHSRC said that a decision would be taken once the blood samples reached the NIH, while the other said the samples would either be sent to Cairo or Germany.

Replying to a question about similarities in the symptoms of dengue, Congo and Ebola diseases (the first two viral infections are endemic in Pakistan), a senior expert on infectious diseases currently working at the Indus Hospital, Dr Nasim Salahuddin, said that all three were caused by different viruses and their initial presentation was the same as in most infections: fever, body pain and headache.

“Dengue is usually mild, occasionally moderate, with fever, muscle pain, rash, low platelets level and positive dengue serology test. Most patients recover. A rare severe one may bleed. Dengue does not need isolation as it is spread by Aedes Egyptii mosquito and not from person to person,” she said.

The Congo Crimean (CCHF) virus, she said, was spread by tick present on cattle’s skin. “Initially, there are non-specific symptoms, then bleeding starts from skin, nose and gastrointestinal tract. The disease has 60pc mortality rate. It could spread from person to person through blood and body secretions and isolation is required,” she said.

According to her, Ebola in West Africa appears to be just like CCHF but is more virulent and highly infectious. It spreads through all body secretions and kills rapidly. It has no definite treatment at the time.

“The only way of preventing the spread of Ebola and CCHF is by isolating the patient and using strict infection control practices. Both are equally serious conditions and likely to spread fast if not controlled in time.

“However, Ebola is more likely to spread as there is no intermediate host, while CCHF is not as common because it spreads through cattle tick and if you are not exposed, chances of acquiring it are less. In West Africa, most of the cases were either in healthcare workers or during burial rituals where the dead is kissed before burial. Cases have increased in number because of lack of awareness,” she said.

Published in Dawn, December 2nd, 2014