Nigeria, the latest country to be hit by the dreaded Ebola virus disease, announced her first case last Thursday in the commercial hub, Lagos. A 40-year-old Liberian-American citizen, Patrick Sawyer, who had been living in Liberia since 2008, arrived in Nigeria on July 20. He had taken ill during his trip from Monrovia, Liberia, and was later hospitalised upon arrival in Nigeria. On July 25, news broke of his death. Results of all the tests conducted on samples collected from the sick man, both locally and abroad, confirmed that he was suffering from the disease. The virus, which is spread through human contact, has no cure. Between 1976 when the first outbreak of EBV was recorded in Congo DR and South Sudan and now, more than 2,000 deaths have occurred from 3,140 cases.
But we saw it coming. In our April 17, 2014 editorial, we rightly warned, “There is the need for the presence of medical experts at seaports and airports to control the influx of people into the country, especially people from countries where the (Ebola) infection has been reported.” Unfortunately, as this case showed, our health authorities failed to make a good contingency plan and effective surveillance at entry points.
For those who know the havoc that Ebola is capable of wreaking, the latest development has heightened concern, even around the world. With many of her 170 million population travelling all over the world, Ebola poses a serious health challenge to Nigeria and the world. That explains why serious countries are already taking proactive measures.
The death of the Liberian-American has suddenly sparked a series of containment activities in Nigeria. But given the proven dictum in medical practice that prevention is better than cure, some of these actions should have been taken before now. Even when the Minister of Health, Onyebuchi Chukwu, announced in April that “Ebola has been moving eastwards 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, (which) are also in our borders,” nothing concrete had been done until now. Most depressingly, when the World Health Organisation held an 11-country health ministers meeting on July 2 and July 3 in Accra, Ghana, to fashion a response to the disease, Nigeria’s absence was conspicuous.
The threat of a global pandemic is rising –Severe Acute Respiratory Syndrome in 2003, the H5N1 bird flu of 2005 and the H1N1 swine flu of 2009. Diseases know no borders, and a health emergency in one country could, without control, become a burden for others. Other lethal virus infections that our health authorities should watch out for include influenza virus, mosquito-borne viral disease known as Chikungunya fever, West Nile virus, SARS and Middle-East Respiratory Syndrome, mainly from Saudi Arabia. Though not yet a global emergency, WHO says since 2012, it has confirmed 228 cases of MERS, 92 of them fatal.It was reported that an influenza virus never before seen in people infected at least 82 persons and killed 17 in China in 2013.
Ebola outbreak could be quite challenging. This is why the country’s health authorities should muster all the resources within their control to ensure that the disease does not get to the level in Guinea, Sierra Leone and Liberia, where lack of resources, inadequate infection control measures, and mistrust of health workers pushed it “out of control,” according to Doctors Without Borders, the Paris, France-based non-profit organisation.
The disease is also known as the Ebola Haemorrhagic Fever, apparently because of the tendency of the virus to create holes in veins and cause profuse internal and external bleeding, especially through the eyes, nose, ears and mouth. The absence of cure means that medical officials are only left with the option of providing support and palliative care, such as keeping the patient in a hygienic and quarantined environment, providing them food and electrolytes, as well as ensuring that they are kept constantly re-hydrated to replace lost body fluid.
EVD, caused by Ebola virus, has five main strands, the deadliest of which is responsible for the current devastation. Although symptoms and death can take between eight and 10 days, the incubation period (the period between the infection and the appearance of the first symptoms) ranges between two and 21 days. These symptoms include fever, body weakness, sore throat and headaches. These early symptoms, according to experts, progress to diarrhoea, vomiting, internal and external bleeding, and impairment of some internal organs, such as kidney and liver.
Transmission is usually from contact with the body fluids of an infected person, especially with blood, sweat, tears and saliva, among others. Originally, the virus is said to have been transmitted from contact with dead infected animals, which might have contracted it from wild bats. For that reason, people are advised against eating bush meat, especially dead and sickly ones. Besides, personal hygiene is very important. Simple habits such as washing of hands with soap and avoiding crowded places are absolutely necessary. In Liberia, for instance, all football matches have been cancelled to avoid people coming in contact with infected individuals.
President Goodluck Jonathan must not just sit back on this. He needs to set up an inter-ministerial committee immediately that will coordinate the national response to this potential scourge. While immigration officials should make sure they are aware of the signs to look out for in Ebola sufferers, a mechanism for serious screening of those coming into the country, especially from West African countries, should be put in place immediately.
