Ebola Virus: West Africa's New Death Sentence
July 17, 2014 - By Paul Omorogbe - Nigerian Tribune
With the recent outbreak of Ebola virus in some West African countries, many are worried about the readiness of Nigeria in combating the spread of the virus. PAUL OMOROGBE in this report writes on the nature of the deadly virus.
News about Ebola virus is not new. The disease has been making headlines since the late 90s. The deadly nature of the disease is quite spectacular to the extent the disease became the subject of a movie titled 'Outbreak,' a 1995 American medical disaster film directed by Wolfgang Petersen.
However, the issues on ground, beyond what the movie depicted, are real. An epidemic may be looming as incidences of the disease have steadily spread eastward, moving from Guinea, Liberia, Sierra Leone. Just last week, a US citizen was tested for the Ebola virus in Ghana. The man was believed to have visited Guinea and Sierra Leone in recent weeks.
With Nigeria being in close proximity to the affected countries, reportedly having 200 entry points with only 40 of these being manned, the question is, how prepared is Nigeria if the disease enters the country?
About Ebola virus
According to information from the World Health Organisation (WHO), the Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans. EVD outbreaks have a case fatality rate of up to 90 per cent. EVD outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests. The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission. Fruit bats of the Pteropodidae family are considered to be the natural host of the Ebola virus. No licensed specific treatment or vaccine is available for use in people or animals.
Origin
Records have it that Ebola first appeared in 1976 in two simultaneous outbreaks, in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. The latter was in a village situated near the Ebola River, from which the disease takes its name.
Medical experts say Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.
Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids.
Reports say that burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. Men who have recovered from the disease can still transmit the virus through their semen for up to seven weeks after recovery from illness.
Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practised.
Infection cases
As of July 6, 2014, WHO announced a cumulative total of 844 suspect and confirmed cases of Ebola hemorrhagic fever (EHF) and 518 deaths being reported from Guinea, Sierra Leone, and Liberia. Of the 884, 626 cases have been laboratory confirmed. In Guinea, 408 cases, with 307 fatal cases and 294 laboratory confirmations, were reported by the Ministry of Health (MoH) of Guinea and WHO.
Active surveillance continues in Conakry, Guéckédou, Macenta, Télimélé, Dubreka, Boffa, and Kouroussa districts.
In Sierra Leone, WHO and the Ministry of Health and Sanitation of Sierra Leone reported a cumulative total of 305 suspect and confirmed cases of EHF as of July 6, 2014. Of these 305, 269 cases have been laboratory confirmed and 127 were fatal. Districts reporting clinical EHF patients include Kailahun, Kenema, Kambia, Port Loko, Western, and Bo. Reports and investigations of suspect cases continue across the country. Laboratory testing is being conducted in Kenema city and Kailahun.
According to information on the US Centres for Disease Control (CDC) website, as of July 6, 2014, the Ministry of Health and Social Welfare of Liberia and WHO have reported 131 clinical cases of EHF, including 63 laboratory confirmations, and 84 fatal cases. Laboratory testing is being conducted in Monrovia.
Travellers seem to be the main conduit for cross-border transmission of the disease. A Bloomber news report stated that this month in Sierra Leone's capital of Freetown an Egyptian was found with the city's first confirmed case of the disease.
The unidentified Egyptian national had travelled from Kenema, the largest city in the nation's Eastern Province, and checked into a clinic east of Freetown, Sidie Yahya Tunis, director of Information, Communication and Technology at the Ministry of Health and Sanitation, told the news agency. "The Ebola disease usually spreads to other places when suspected or confirmed cases in one community move to another, they abandon treatment centres to stay with relatives or they seek treatment outside the Ebola centers," Tunis said.
International efforts
West African countries and international health organisations have met to adopt a fresh strategy to fight the world's deadliest Ebola epidemic plaguing the region.
At a two-day meeting in Accra, Ghana officials committed to better surveillance to detect cases of the virus, enhance cross-border collaboration, better engagement with local communities and closer cooperation with the United Nations, WHO and other partners. Ministers also recommended setting up a sub-regional control centre in Guinea to coordinate technical support.
The decisions involve governments, the United Nations, the US Centres for Disease Control and Prevention, aid agencies and the private sector.
Can it get to Nigeria?
A clinician at the Nigerian Institute of Medical Research, Dr Bamidele Oke, has warned that Nigeria is at risk of contracting the Ebola virus which has led to the deaths of several people in some West African nations.
Appearing as a guest on a televised interview, Dr Oke disclosed that the new strain of the virus which was discovered recently "does not remove the fact that it can get to Nigeria."
On the probability that the virus might get into the country, Oke said that the risk level could not be gauged because of migration. "As we speak now, Saudi Arabia won't allow people from Liberia and Guinea to travel for hajj," he noted.
Some months ago, there were reports that the virus had found its way into the country. The Federal Ministry of Health (FMOH) denied that the reported case had to do with the Ebola virus. According to the Minister of State for Health, Dr Khaliru Alhassan's statement on the reported cases, "laboratory investigation has revealed that it is a case of Dengue Heamorrhagic Fever and not that of Ebola Heamorrhagic Fever as erroneously reported."
Speaking to the issue of a possibility of an outbreak in Nigeria, the minister said, "our laboratories at the Nigeria Centre for Disease Control (NCDC) have the capacity to confirm this Dengue Heamorrhagic Fever and other Viral Hemorrhagic fevers. Additionally, the Ministry has intensified surveillance activities on this disease and all State Ministries of Health alerted. Any suspected case should be reported to the nearest health facility including General Hospitals, Federal Medical Centers (FMCs) or Teaching Hospitals where non-specific and symptomatic drugs against this disease have been prepositioned.
"All our Port Health posts and border medical centres have been put on high alert to screen travelers from countries with confirmed Ebola Heamorrhagic Fever occurrences. Nigerians citizens travelling to these countries are advised to be careful and should report any illnesses with the above stated symptoms to the nearest health facility.
"The Federal Ministry of Health Ministry is in the process of enhancing our multi-sectoral collaboration with the Livestock Department of Federal Ministry of Agriculture, National Emergency Management Agency (NEMA) and our international partners such as World Health Organisation (WHO), US Centre for Disease Control (CDC)."
In the Health Minister, Professor Onyebuchi Chukwu's response to the issue he said, "The Federal Ministry of Health urges the general public to take measures to avert the outbreak or spread of the disease."
Highlighting the precautionary measures, he said, "Persons with high fever, headache, severe abdominal pain, diarrhea and bleeding and especially with a history of travel to Guinea, Sierra Leone or Liberia are urged to report to the health authorities.
"Nigeria has the capacity to diagnose the disease if it appears in our country. The Nigeria Centre for Disease Control (NCDC) is currently studying the outbreak trends and has mobilised its rapid response teams and developed a detailed response plan that includes a comprehensive health education/health promotion to sensitise Nigerians, enhanced surveillance to detect and treat the disease, while mobilising its treatment/isolation centres. An alert has been issued to all State Commissioners of Health to mobilise against the disease."
A doctor with the Lagos State Health Services Commission, who spoke on anonymity, said there was an existing structure in the state for handling cases of an outbreak. He said that from the primary health care centres present in the state, there was a reporting and feedback system put in place by the state to ensure that such cases do not go unnoticed.
However, with the current strike embarked upon by federal and state doctors in the country, what would happen if an outbreak occurred before the strike is called off?
