Patrick Oliver Sawyer ( - 24 July 2014) was a Liberian-American lawyer who was notable for being the

index case The index case or patient zero is the first documented patient in a disease epidemic within a population, or the first documented patient included in an epidemiological study. It can also refer to the first case of a condition or syndrome (not n ...

for the introduction of Ebola virus disease into Nigeria during the

West African Ebola epidemic The 2013–2016 epidemic of Ebola virus disease, centered in Western Africa, was the most widespread outbreak of the disease in history. It caused major loss of life and socioeconomic disruption in the region, mainly in Guinea, Liberia an ...

in 2014. Sawyer was a naturalized U.S. citizen who lived in

Coon Rapids, Minnesota Coon Rapids is a northern suburb of Minneapolis, and is the largest city in Anoka County, Minnesota, United States. The population was 63,599 at the 2020 census, making it the fifteenth largest city in Minnesota and the seventh largest Twin Ci ...

. He has been variously described as working for the Liberian Ministry of Finance and for the mining company

ArcelorMittal ArcelorMittal S.A. is a Luxembourgian multinational steel manufacturing corporation headquartered in Luxembourg City. It was formed in 2006 from the takeover and merger of Arcelor by Indian-owned Mittal Steel. ArcelorMittal is the second la ...

as their national manager for public health. He was aged 40 at the time of his death.

Ebola infection and death

On 9 July 2014, Sawyer informed

management at the Buchanan office that he had been exposed to the

Ebola virus ''Zaire ebolavirus'', more commonly known as Ebola virus (; EBOV), is one of six known species within the genus '' Ebolavirus''. Four of the six known ebolaviruses, including EBOV, cause a severe and often fatal hemorrhagic fever in humans and o ...

. They referred his case to the Liberian Ministry of Health for observation. However, Sawyer utilized an upcoming conference in

Calabar Calabar (also referred to as Callabar, Calabari, Calbari and Kalabar) is the capital city of Cross River State, Nigeria. It was originally named Akwa Akpa, in the Efik language. The city is adjacent to the Calabar and Great Kwa rivers and c ...

Cross River State ) , image_map = Nigeria - Cross River.svg , map_alt = , map_caption = Location of Cross River State in Nigeria , coordinates = , coor_pinpoint ...

, Nigeria to petition the Liberian Finance Ministry to attend as an "ambassador". His departure was approved. The Liberian government has apologized for the lack of communication between offices and for not listing Sawyer's name at the airport. On 20 July 2014, Sawyer flew via

ASKY Airlines ASKY Airlines is a private multinational passenger airline serving West and Central Africa, with its head office in Lomé, Togo and its hub at Gnassingbé Eyadéma International Airport. The airline is a strategic partner of Ethiopian Airlines ...

from James Spriggs Payne Airport in

Monrovia Monrovia () is the capital city of the West African country of Liberia. Founded in 1822, it is located on Cape Mesurado on the Atlantic coast and as of the 2008 census had 1,010,970 residents, home to 29% of Liberia’s total population. As th ...

, Liberia to

Murtala Muhammed International Airport Murtala Muhammed International Airport (MMIA) ( yo, Pápá Ọkọ̀ Òfurufú Káríayé Múrítàlá Mùhammẹ̀d) is an international airport located in Ikeja, Lagos State, Nigeria, and is the major airport serving the entire state. The ai ...

Lagos Lagos (Nigerian English: ; ) is the largest city in Nigeria and the second most populous city in Africa, with a population of 15.4 million as of 2015 within the city proper. Lagos was the national capital of Nigeria until December 1991 fo ...

, Nigeria, with a stopover at

Lomé Lomé is the capital and largest city of Togo. It has an urban population of 837,437

Togo Togo (), officially the Togolese Republic (french: République togolaise), is a country in West Africa. It is bordered by Ghana to the west, Benin to the east and Burkina Faso to the north. It extends south to the Gulf of Guinea, where its c ...

. He was subsequently described as having appeared to be "terribly ill" when he left Monrovia. He collapsed upon arriving at

Ikeja Ikeja is the capital city of Lagos State in southwestern Nigeria. Its population, as of the 2006 census, is 313,196. Prior to the emergence of military rule in the early 1980s, Ikeja was a well planned, clean and quiet residential and commercia ...

. A protocol officer of

Economic Community of West African States The Economic Community of West African States (ECOWAS; also known as in French and Portuguese) is a regional political and economic union of fifteen countries located in West Africa. Collectively, these countries comprise an area of , and in ...

(ECOWAS) was there to greet him. The officer drove Sawyer in an ECOWAS pool car to

First Consultant Hospital First Consultant Hospital (also known as First Consultant Medical Centre) is a private hospital in Lagos. It is located on St. Gregory's College Road in Obalende, a neighborhood of Lagos Island, in Lagos. The hospital came to worldwide attentio ...

Obalende Obálendé, an adulteration of the Yoruba saying ''Ibi ti Oba le wa de'', meaning "Where the king chased us to", is a neighbourhood of Lagos, Nigeria, located in Eti-Osa LGA, close to Lagos Island. Eti-Osa was split by the Lagos State Government i ...

, Lagos, where he later died on 24 July. In response, the Nigerian government observed all of Sawyer's contacts for signs of infection and increased surveillance at all entry points to the country. On 6 August, the Nigerian health minister told reporters, "Yesterday the first known Nigerian to die of Ebola was recorded. This was one of the nurses that attended to the Liberian. The other five ewly confirmedcases are being treated at an isolation ward." It was later reported that at that time he flew, Sawyer was already under surveillance for Ebola infection, but had been cleared by the Finance Ministry of the Liberian government to leave for the ECOWAS conference in Calabar. On 19 August, it was reported that the doctor who treated Sawyer,

Ameyo Adadevoh Ameyo Stella Adadevoh (27 October 1956 – 19 August 2014) was a Nigerian physician. She is credited with having curbed a wider spread of the Western African Ebola virus epidemic in Nigeria by placing the patient zero, Patrick Sawyer, in ...

, had also died of Ebola. Adadevoh was posthumously praised for preventing Sawyer from leaving the hospital at the time of diagnosis, thereby playing a key role in curbing the spread of the virus in Nigeria.

Aftermath

The infection brought into the country by Sawyer resulted in 19 confirmed cases of Ebola infection and eight deaths. As of October 2014 the Nigerian Ebola outbreak was regarded as having been contained. On October 20, 2014, Nigeria was announced as Ebola-free by the WHO, following two incubation periods without any further reports of infection. Sawyer's travel to Nigeria provoked anger there towards the Liberian authorities who allowed him to fly out of Liberia despite being unwell. First Consultant Hospital leadership described Sawyer's behavior in ward as a "deceptive" and "intentional" attempt to spread the infection as widely as possible — Sawyer denied any exposure to Ebola and mobilized diplomatic pressure on the hospital to discharge him from the hospital in spite of showing severe symptoms. There was also suspicion towards American authorities as Sawyer was a United States citizen. Some believed his arrival was not an accident, but a deliberate attempt to infect the Nigerian population. Especially when direct requests came from the Liberian authorities to release him from quarantine in hospital despite him clearly being ill. Sawyer's case and the successful containment of the outbreak by Adadevoh and other medical staff form the basis of the 2016 Nigerian drama thriller film '' 93 Days''.

References

{{DEFAULTSORT:Sawyer, Patrick 1970s births 2014 deaths Index cases Deaths from Ebola Liberian emigrants to the United States People from Coon Rapids, Minnesota Infectious disease deaths in Nigeria Naturalized citizens of the United States 20th-century American lawyers