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Saturday, 3 August 2019

Preparing Nigeria against DR Congo Ebola fallout


Like a hydra-headed monster, the Ebola Virus Disease that made a frightening comeback in Democratic Republic of Congo in August last year is still raging, one year after the outbreak. This is coming after the epidemic of 2014 to 2016 in West Africa, which affected 27,352 people, resulting in 11,193 deaths.  Given the scope of infection, which mildly affected Nigeria, threatening to wipe out whole communities across Guinea, Sierra Leone and Liberia, and the number of casualties, it was declared the worst EVD outbreak ever.

The DRC case has already led to more than 1,800 deaths from about 2,500 cases of infection and is deemed the second worst infection after the West African epidemic. So far, there have been no signs of any let-up, despite the collaborative efforts of the country’s authorities and the international agencies battling to contain its spread. Unfortunately, instead of ebbing, reports indicate that the viral infectious disease has continued to spread, claiming lives almost on a daily basis. It has spread to the eastern part of the country, killing two people on Wednesday. While it took 224 days to arrive at the first 1,000 cases of EVD, it has taken just 72 days to reach the next 1,000 cases.


Many cannot but wonder why the EVD situation in DRC has taken such a turn for the worse, despite the availability of tested vaccines, a privilege that was lacking during the West African crisis. The reasons are, however, not far-fetched. Even though the disease, formerly known as Ebola haemorrhagic fever, was first discovered in DRC in 1976, the people have displayed an utter lack of understanding of the containment strategies, especially those concerning the isolation of infected persons and contact tracing to limit the speed of its spread.

People are reportedly dying at home because they refuse to be taken to treatment centres. Apparently, since most of the people that report at the centres do so very late, they end up not surviving the disease. For that reason, even relations of infected persons, sometimes prefer to keep them at home and administer drugs on them to bring down the temperature rather than seek treatment. “People are waiting for the last minute to bring their family members and when they do, it’s complicated for us,” Mathieu Kanyama of the Ebola Treatment Centre run by the Alliance for International Medical Centre told Associated Press.  

What this means is that the person brought for treatment must have infected many other people before seeking treatment. “Behind every person who has died there is another person who has developed a fever,” another doctor was quoted as saying. Besides, there have been reported cases of violence and hostilities towards the medical personnel by the locals. Aside from mistrust of the health workers, many even believe EVD does not exist, which makes it even more dangerous.

It is therefore not surprising that after four meetings of a panel of independent experts, a decision was taken for the World Health Organisation Director-General, Tedros Ghebreyesus, to declare that the outbreak constitutes a “Public Health Emergency of International Concern.” WHO has declared a public health emergency only four times since it was introduced in 2007, showing how rarely it is done.

Technically, this means that people should show more commitment to what is happening in DRC by mobilising enough resources to stop in its tracks the morbid advance of the disease. Usually, one of the considerations for declaring a PHEIC is whether the disease could constitute a threat to other countries. WHO is always reluctant to declare an emergency to discourage countries from imposing trade and movement restrictions against people from the affected country, which could be damaging to their economy.

In the case of DRC, WHO has advised against border closure or trade restrictions. But given the fact that the disease has already struck in Uganda and on the verge of entering Rwanda, there is the need for countries, including Nigeria with her porous borders, to take steps to protect their borders and airports. Instructively, speaking on the DRC EVD situation, the President of the American Society of Tropical Medicine and Hygiene, Chandy John, has described the possibility of the disease spreading abroad as “a plane ride away.” He says WHO’s declaration “raises the risk that the disease could spread internationally.”

One could not agree more. All it takes to have an outbreak in Nigeria is for an infected person to hop on the plane and land in an unsuspecting country, just as Nigeria’s index case, Patrick Sawyer, did on July 20, 2014. Any dead body being shipped into the country should be properly identified to ensure that it is not coming from the DRC. Since the world is now a global village, there is the need to raise the alert level in all the states, especially the border states, and the international airports. Nigeria cannot afford to be lax about border vigilance at this stage. During the West African epidemic, cases of infection and deaths also spread to Senegal, Mali, Italy, the United Kingdom, France and Switzerland due to contacts made by people who had travelled to the affected areas.

EVD is a deadly infection caused by a virus of the same name. It is usually characterised by an onset of fever, intense weakness, muscle pain, headache and sore throat.  These symptoms progress to vomiting, diarrhoea, rash, impaired functions of the kidney and liver, sometimes resulting in internal or external bleeding. While the span between infection time and fatality could vary from two to 21 days, it is quite often between five and 10 days. The usual cause of death is organ failure. More importantly, it has no identifiable cure.



For EVD, eternal vigilance should be the watchword. There is the need for people not to forget their basic hygiene such as washing their hands with running water after returning from an outing. There should also be less of bodily contact with people, especially the shaking of hands. People with feverish conditions should not hesitate to see a doctor.


Punch

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