ABUJA, Nigeria -- A Nigerian nurse who treated a man with Ebola is now dead and five other people are sick with one of the world's most virulent diseases after coming into contact with him, the country's health minister said Wednesday.
The growing number of cases in Lagos, a megacity of some 21 million people, comes as authorities acknowledge they did not treat Patrick Sawyer as an Ebola patient and isolate him for the first 24 hours after his arrival in Nigeria last month. Sawyer, a 40-year-old American of Liberian descent with a wife and three young daughters in Minnesota, was traveling on a business flight to Nigeria when he fell ill.
The death of the unidentified nurse marks the second Ebola death in Nigeria, and is a very worrisome development since it is the Africa's most populous country and Lagos, where the deaths occurred, one of its biggest cities.
Meanwhile, Saudi Arabia's Health Ministry says a man who was being tested for the Ebola virus has died. The 40-year-old returned on Sunday from Sierra Leone, where there has been an Ebola outbreak, and was then hospitalized in Jiddah after showing symptoms of the viral hemorrhagic fever.
Spain's Defense Ministry said a medically-equipped Airbus 310 is ready to fly to Liberia to repatriate a Spanish missionary priest who has Ebola. The ministry said Wednesday preparations for the flight are being finalized but it is not yet known at what time the plane would take off.
The priest, Miguel Pajares, is one of three missionaries being kept in isolation at the San Jose de Monrovia Hospital in Liberia who has tested positive for the virus, Spain's San Juan de Dios hospital order, a Catholic humanitarian group that runs hospitals around the world, said Tuesday.
Ebola, which has a mortality rate between 60 and 96 percent, is a systemic virus, meaning it impacts all organs that control various functions in the body. But before it attacks the gastrointestinal, respiratory, vascular, muscular, neurological and immune systems, Ebola starts off looking a lot like the flu.
At its onset, a patient may experience fatigue, fever, headache, sore throat and pain in the joints and muscles. The initial symptoms are so common that the Centers for Disease Control and Prevention says cases are often misdiagnosed.
Ebola, which has no proven vaccine or treatment, has killed nearly 900 people this year in Sierra Leone, Guinea, Liberia and Nigeria and health officials in many countries are struggling to halt its spread.
Health experts say those medical workers in Nigeria now infected from Sawyer would not have been contagious to their neighbors or family members until they started showing symptoms of their own. The delay in enforcing infection control measures, though, is another setback in the battle to stamp out the worst Ebola outbreak in history.
The specter of the virus spreading through Nigeria is particularly alarming, said David Morse, an epidemiology professor at Columbia University's Mailman School of Public Health.
"It makes you nervous when so many people are potentially at risk," he said.
Lagos is a bewildering combination of wealth and abject poverty, awash in luxury SUVs and decrepit buses alike that carry passengers through hours of crowded traffic on the bridges linking the city's islands to the mainland.
Ebola can only be transmitted through direct contact with the bodily fluids of someone who is sick - blood, semen, saliva, urine, feces or sweat. Millions live in cramped conditions without access to flushable toilets, and signs posted across the megacity tell people not to urinate in public.
Authorities in Liberia said Sawyer's sister had recently died of Ebola, though Sawyer said he had not had close contact with her while she was ill.
In announcing his death, Health Minister Onyebuchi Chukwu maintained that Nigerian officials had been vigilant.
"It was right there (at the airport) that the problem was noticed because we have maintained our surveillance," he told reporters. "And immediately, he went into the custody of the port health services of the federal ministry of health so there was no time for him to mingle in Lagos. He has not been in touch with any other person again since we took him from the airport."
On Tuesday, the Lagos state health commissioner said, however, that they did not suspect Ebola immediately and it was only after about 24 hours in the hospital that they identified him as a possible Ebola case.
Lagos state health commissioner Jide Idris said Tuesday that the nature of his disease "was not known" the first day.
"They went back to the history and they were like 'Oh, this is Liberia,' and that's why he was put into isolation," he told reporters. "So even in that window period it was possible that some of these people got infected."
Sawyer, who had a fever and was vomiting, was coming from the infected country of Liberia but had a layover in Togo. As a result, officials may not have initially known his original destination.
Experts say people infected with Ebola can spread the disease only through their bodily fluids and after they show symptoms. Since the incubation period can last up to three weeks, some of the Nigerians who treated Sawyer are only now showing signs of illness that can mimic many common tropical illnesses - fever, muscle aches and vomiting.
The national health minister on Wednesday said special tents would be used to speed up the establishment of isolation wards in all of Nigeria's states. Authorities also were setting up an emergency center to deal with Ebola that would be "fully functional" by Thursday.
"We are embarking on recruiting additional health personnel to strengthen the team who are currently managing the situation in Lagos," said his statement.