EBOLA IN NIGERIA.....

ging humans into closer contact with animal populations, where many of the diseases have begun, he said.

At the same time, globalization means that people are mixing more, trading more and handling more farm animals in industrial settings — all of which facilitate the emergence and spread of infectious diseases.

“This ought to force a reflection,” Mr. Sachs said, adding that establishing a basic network of community health workers across the developing world was an urgent priority.

Health officials emphasized that Nigeria still had only a few confirmed Ebola cases and that its government had mobilized substantial forces to try to stop the spread of the disease.

David Daigle, a spokesman for the Centers for Disease Control and Prevention’s effort in Nigeria, said the ministers of health and information were on hand Friday for the opening of an emergency operation center in Lagos, a sign that the government was treating the situation seriously.

“The Nigerians understand the magnitude of the problem here,” said Dr. Frank Mahoney, an epidemiologist who has been leading the C.D.C.’s Ebola response in Lagos. Still, he said, international health officials are undertaking a substantial effort in Nigeria, motivated by what might happen if the disease, which had been confined to remote forests and villages in decades past, starts to spread in one of Africa’s most densely populated countries.
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“We are very worried about this,” Dr. Mahoney said, pointing out that Nigeria’s health care system could easily become overwhelmed. “Lagos is such a huge city with such a mobile population.”

Lagos, a city of nearly 20 million, the most populous in Nigeria, is also home to a large contingent of religious healers, such as Temitope Balogun Joshua, a popular Christian minister and televangelist known as T. B. Joshua. Health experts are concerned that sick people will flock to Lagos to seek his advice.

Dr. Mahoney said health experts were reaching out to such leaders, and Mr. Jonathan called on churches and religious leaders to halt large gatherings that could encourage the spread of the disease.
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A health official checked the temperature of a worker last week at the Murtala Muhammed International Airport in Lagos, Nigeria. Credit Sunday Alamba/Associated Press

Almost all of the suspected Ebola cases involve people who had direct contact with Mr. Sawyer — either in the airport, where he was helped into a car, or in the hospital where he was treated, the First Consultant Medical Center.

Newspapers in Liberia and Nigeria were brimming with accounts of the strange tale of Mr. Sawyer’s sickness, which began in Liberia, where the disease is exploding.

According to a report in The National Chronicle, a Liberian newspaper, Mr. Sawyer’s sister, who died of Ebola in early July, had arrived at a hospital bleeding. But when doctors and nurses tried to put her in isolation, the report said, Mr. Sawyer refused to allow it, demanding that she be given a private ward. He undressed her, put her into a wheelchair and offered the hospital workers cash, the paper said.

And in an account in another Liberian newspaper, The New Dawn, which cited footage from a security camera in the airport in Monrovia, Mr. Sawyer behaved strangely as he waited for his flight out of Liberia. He sat alone, avoiding physical contact with people, including an immigration agent who tried to shake his hand, and even lay flat on his stomach on the floor of a corridor of the airport, the paper reported.

The episode prompted the president of Liberia, Ellen Johnson Sirleaf, to publicly apologize to Nigeria about Mr. Sawyer, who she said had sneaked out of Liberia, where he was being tracked as a potential Ebola case, according to The Daily Independent, a Nigerian newspaper.

The number of suspected cases has continued to tick up slowly. Nigeria’s state oil company announced on Friday that it had closed its clinic in Lagos after a patient suspected of having Ebola was admitted there. The patient had visited the First Consultant Medical Center, which has since been closed.

In a strange twist, a doctors’ strike in Nigeria may have saved lives by reducing the number of medical workers who came into contact with Mr. Sawyer.

“It would have been a disaster,” said Babajide Saheed, a doctor and the secretary of the Lagos State chapter of the Nigerian Medical Association. “At the time, nobody was prepared for it.”

About 70 people are believed to have had contact with Mr. Sawyer, Nigerian health officials said. Dr. Mahoney said teams of people were working to call those people and to try to persuade them to stay at home and watch for symptoms, such as a rising temperature.

Just as concerning was what would happen if the disease began to spread inside the health care system, Dr. Mahoney said.

“The health care system in Nigeria would have a really difficult time responding to a communitywide outbreak,” he said.
Correction: August 10, 2014

An earlier version of this article reversed the given name and surname of the secretary of the Lagos State chapter of the Nigerian Medical Association. He is Babajide Saheed, not Saheed Babajide.

Ben Ezeamalu contributed reporting from Oshogbo, Nigeria.