Sunday, 13 April 2014

Nigeria under Ebola threat— Experts


Health inspectors at work

Experts advise authorities to take measures to forestall a possible outbreak of the Ebola virus disease in Nigeria, writes ARUKAINO UMUKORO
The news of the outbreak of Ebola fever in some countries in West Africa, including several parts of Guinea, Sierra Leone and Liberia has sent shock waves across the region, and reverberated in other parts of the world.
West African countries like Senegal have since closed their land borders to check inter-border spread of the disease.
With death tolls rising in the affected countries, Assistant Director-General of the World Health Organisation, Keiji Fukuda, recently described the outbreak as ‘one of the most challenging Ebola outbreaks’ the organisation has ever faced.
According to recent WHO figures, there have been 157 suspected cases in Guinea, 101 of them fatal, while 67 of the cases were confirmed in WHO laboratories.
The disease has no known cure or treatment yet.
“There is nothing available right now to eliminate it,” said the President of the Nigerian Medical Association, Dr. Osahon Enabulele, in an interview with SUNDAY PUNCH. He called on the Federal Government to seal the country’s borders so as to prevent the spread of Ebola virus in the country.
He said, “Anywhere you have movements of people, from one location to the other, the likelihood is high. That calls to attention the need for us to check our borders. More often than not, when there are movements to some of these affected countries, especially when there is a very defective, weak surveillance system at the entry points—land, air and sea—people from endemic regions are given access in the country.
“That leads to the possibility of having it spread into those new locations, especially if there is contact with those infected persons. So, if those surveillance mechanisms are not on ground, if the level of suspicion is not high, then we could have an infected person coming into the country.”
With over 170 million people, mostly in crowded urban areas, a possible outbreak in Nigeria could be disastrous.

In the same vein, veterinarian virologist and President of the Nigerian Academy of Science, Prof. Oyewale Tomori, noted that Nigeria was at risk of an outbreak of the Ebola virus, considering that the affected countries are in West Africa.
Tomori said, “For it to suddenly appear in Guinea and other places, it means that every country is at risk. As long as there is travel between countries, we are liable to exposure to whatever they carry.”
Enabulele stressed the need for people to know the symptoms of Ebola virus.
The symptoms include haemorrhagic fever, weakness, muscle pain, vomiting, diarrhea and, in severe cases, organ failure and unstoppable bleeding.
“It still boils down to having a very high level of suspicion, especially among the citizens, to identify anyone who may have an unrelenting fever, with some features like sore throat, headache, body pains, deep coughing and breathing, vomiting and diarrhea. Also, when a person is experiencing bleeding, especially from the nose, it could be symptoms of viral haemorrhagic fevers,” Enabulele explained.
Tomori urged hospitals in the country to increase their level of suspicion and awareness about the virus, while people with an unusually high fever should be quarantined, especially now that it has spread to West Africa.
He said, “Anybody that has yellow fever and has gone for treatment and there is no response, should quickly report to the hospital. And if anybody comes into this country from that part of West Africa, they need to be monitored for about two to three weeks, if they develop fever, because this could be due to the incubation period of the disease.”
According to WHO, the first outbreaks of Ebola was recorded in 1976; 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.
The incubation period of the Ebola virus varies, noted Enabulele.
“Averagely, it is about 12.5 days. But the count rose from about 2 days to about 25 days, with an average meantime of about 12.5 days. That substantially reflects the incubation period. So, if one gets infected now, within two or 25 days, one can come down with it,” he said.
A few days ago, while answering questions from State House correspondents at the Presidential Villa, Abuja. the Minister of Health, Prof. Onyebuchi Chukwu, denied earlier rumours of an outbreak in the country, but admitted that the country was at risk, considering the rate at which the virus had spread to other West African countries.
 Chukwu also said the National Centre for Disease Control would raise awareness of the threat posed by the virus, via television and radio jingles, as well as newspaper adverts.
He said, “Ebola has been moving eastward towards Nigeria as well and we are already facing danger from the Central African Republic, even with what is happening in Congo, people are also migrating to Chad and Cameroon are also in our borders.
“So, Nigeria is in danger, but we have recently said that in addition to the leaflets that we are producing for Lassa and other fevers, we will now emphasise Ebola fever.”
Ebola virus disease currently has no vaccine.
However, Tomori was skeptical about the country’s ability to handle the emergency of a possible outbreak.
“We are not prepared for that. Our public health system is not ready for such because it is weak. The laboratory systems are poor and the awareness is not there,” he said.
Tomori’s view was corroborated by an infectious disease specialist and professor of public health, New York University, Dr. Joseph Onigbinde.
Onigbinde said this was a major reason why the country’s health authorities needed to be on high alert and take regular precautionary measures to avoid an outbreak.
He further said the Ebola virus would not have spread in these countries if the necessary precautionary measures were taken.
“I think the outbreak was not properly managed at the start by the ministries of health in the affected countries. They did not act on time. It took them some weeks before they alerted the WHO. By that time, the virus was already spreading. Ebola virus patients need to be quarantined, because they can easily transmit the infection to other people and it spreads very fast,” he told our correspondent.
WHO said the Ebola virus disease has a fatality rate of up to 90 per cent. This is enough reason for the country to take proactive measures to prevent any occurrence, noted Enabulele.
He further said, “It is a very devastating disease and it rapidly kills if not detected on time and no supportive measures are made to ensure that the person is rehydrated and some of those issues confronting the patient are taken care of. If precautionary measures are not taken by the people and health workers, who also attend to these health patients, it is a very devastating, fatal ailment.
“For now, government has promised to put in place modalities, heightening the level of surveillance at the border points. So, let’s hope that, with the declaration, there is no outbreak and we can maintain that; because if we have this issue of Ebola virus, what we have seen of cholera may just be child’s play.
 Source: Punch

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