A man wearing face mask walks at the Yaba Mainland hospital where an Italian citizen who entered Nigeria on Tuesday from Milan on a business trip, the first case of the COVID-19 virus is being treated in Lagos Nigeria Friday, Feb. 28, 2020. Nigeria's health authorities have reported the country's first case of a new coronavirus in Lagos, the first confirmed appearance of the disease in sub-Saharan Africa. (AP Photo/ Sunday Alamba)

A man wearing face mask walks at the Yaba Mainland hospital where an Italian citizen who entered Nigeria on Tuesday from Milan on a business trip, the first case of the COVID-19 virus is being treated in Lagos Nigeria Friday, Feb. 28, 2020. Nigeria's health authorities have reported the country's first case of a new coronavirus in Lagos, the first confirmed appearance of the disease in sub-Saharan Africa. (AP Photo/ Sunday Alamba)

ABUJA, Nigeria (AP) — Nigerian authorities on Friday confirmed the first case of the new coronavirus in sub-Saharan Africa as the outbreak spread to a region with some of the world’s weakest health systems.

The health commissioner for Lagos, Africa’s largest city with more than 20 million people, said an Italian citizen who entered Nigeria on Tuesday from Milan on a business trip fell ill the next day. Commissioner Akin Abayomi said the man was clinically stable with no serious symptoms.

Abayomi said officials were working to identify all of the man’s contacts in Nigeria. The Italian had traveled on Turkish Airlines to Istanbul and then to Lagos, according to health authorities. Lagos state early this month advised people arriving from virus-affected areas to observe 14 days of self-quarantine.

“I have seen him this morning, he is in high spirits,” said Dr. Bowale Abimbola, medical director of the hospital where the 44-year-old Italian was brought with body aches and fever. “He is doing well and we expect that he will continue to do well.”

Nigerian health authorities urged Lagos residents to take measures such as keeping their distance from people who cough and washing their hands regularly.

Cases of the virus also were confirmed in Egypt and Algeria in north Africa in recent days. Until then, some global health experts had expressed surprise that no cases had been reported in Africa.

Concerns about the virus spreading to countries with weaker health systems led the World Health Organization to declare the outbreak a global health emergency last month. WHO officials in Africa have warned that health systems could be overwhelmed.

Nigeria is one of 13 African countries classified by the WHO as high priority in this outbreak because of direct links to China or a high number of visitors from there.

That Nigeria’s first case came from overseas and wasn’t person-to-person transmission inside Africa “shows that the Nigerian government had the right systems in place to detect and confirm this case,” Trudie Lang, director of The Global Health Network at the Nuffield Department of Medicine and the University of Oxford, said in a statement.

But detection of further cases in Africa will be challenging as more inexpensive testing kits are needed for on-the-spot diagnosis, Lang added.

The Africa Centers for Disease Control and Prevention has hurried to train its 54 member countries in testing for the virus. Just two countries had the capability at the beginning of this month. Now more than two dozen have it, including Nigeria.

Africa Centers for Disease Control has deployed an epidemiologist to Nigeria and shipped 1,000 additional testing kits, according to Africa CDC director Dr. John Nkengasong.

“Nigeria is well capacitated to respond to the outbreak,” he said. “Africa CDC had anticipated that COVID-19 outbreak would inevitably impact Africa and has been working actively with African Union Member States and partners on preparedness and response to the disease in the continent. “

Most African airlines with direct flights to China quickly suspended them, and countries activated surveillance and quarantine measures.

ADVERTISEMENT

Many had experience with trying to prevent the spread of the devastating West Africa Ebola outbreak that ended in 2016. Global health experts point to that as a sign of preparedness in this outbreak. The Africa CDC was created in response to the Ebola outbreak, and many countries established public health institutes.

Nigeria was praised for quickly containing cases when the Ebola outbreak reached there in 2014 after an infected man from Liberia landed in Lagos. Nineteen people were infected and seven died, but officials were praised for effective public awareness campaigns.

“The Ebola outbreak taught us a lot of lessons,” the director of the Nigeria Center for Disease Control, Chikwe Ihekweazu, wrote in a commentary for The Conversation last month. As of December, all 36 of Nigeria’s states had a rapid response team in case of a disease outbreak, he wrote, and 22 states had emergency operations centers.

Nigeria is also currently dealing with an outbreak of Lassa fever — an indication of the health challenges that many African nations face.

With the new virus case announced in Nigeria, Africa’s most populous country with 190 million people and numerous air links around the continent and beyond, other nations warned of possible spread.

“Given these recent developments globally and in Africa, it is not unlikely that we will have importation of COVID-19 to South Africa,” that country’s National Institute for Communicable Diseases said.

Separately, South Africa said two citizens who had been working on the Princess Diamond cruise ship have the virus and will stay in Japan for treatment. South Africa said it was informed by Japanese authorities Tuesday after the quarantine on the ship ended.

In a separate statement, South Africa said it planned to evacuate more than 130 citizens from China’s Wuhan city where the outbreak began. It did not say when that would happen.

South Africa is the first major country in sub-Saharan Africa to evacuate its citizens, while thousands of African students remain stranded. Several governments have said it’s safer to stay in place and not risk spreading the virus back home.

In Kenya, the High Court on Friday ruled that all 239 passengers who arrived Thursday on a China Southern Airlines flight should be found and quarantined at a military facility until declared virus-free. The case was brought by the Law Society of Kenya and others amid a public outcry. The court also suspended all flights from China for 10 days.

Separately, President Uhuru Kenyatta ordered that a national isolation and treatment facility be completed within a week.

___

Anna reported from Johannesburg. AP journalists Danica Kirka in London, Carley Petesch in Dakar, Senegal and Tom Odula in Nairobi contributed.