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Ebola: Time for precautionary measures – Punch

The Citizen by The Citizen
May 23 2018
in Public Affairs
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Fed Govt orders Ebola screening at airports, land borders, others

Africa is once again courting global attention for the wrong reasons. Following a recent outbreak of yet another round of the deadly Ebola Virus Disease in the Democratic Republic of Congo, no fewer than 26 lives have been lost from 49 suspected cases of infection. It is another incident that will once again expose the dysfunctional state of health infrastructure in many countries of the continent, especially the lack of adequate and qualified personnel needed to deal with a disease that has become endemic in Africa.

Besides, the situation is likely to cause panic, far beyond the borders of the DR Congo itself, because of the potential risk it poses to the rest of the world. Ebola is a disease known for its high fatality rate and a phenomenally high rate of infection. For these reasons, until the current outbreak is effectively contained, every part of the world is considered to be at risk. This is why the World Health Organisation called a meeting of its Emergency Committee, in Geneva, which decided on Friday that conditions for the declaration of a Public Health Emergency of International Concern had not yet been met.

But while the WHO is, as usual, seeking practical measures to control the spread, it is time for Nigeria to brace herself to prevent a possible import of the disease into the country. Wary of its propensity for massive devastation, many countries are already taking steps to enforce travel restrictions, contrary to the WHO’s advisory. According to a BBC report, quoting the WHO Deputy Director General for Emergency Preparations and Response, Peter Salama, 13 countries within the region have taken steps to boost their border screening and control measures.

These are the same steps Nigeria should be taking by now, since Ebola infection is made possible, primarily, by human-to-human or animal-to-human channels. The last time Nigeria witnessed an outbreak, which came as a result of an infected Liberian-American, Patrick Sawyer, taking advantage of border control lapses to sneak into the country, no fewer than eight people died from 19 confirmed cases. They included Sawyer, the index case, and, sadly, members of the medical team that attended to him.

Experts believe Nigeria was particularly fortunate to have escaped with what could be considered a slap on the wrist. The other West African countries, namely Guinea, Liberia and Sierra Leone, were not that lucky. By the time the most deadly outbreak of Ebola in history was brought under control, some 11,193 lives had been lost, from 27,352 cases of infection, the WHO said. The impact of that 2014 to 2016 epidemic also reverberated in far-flung countries like Italy, the United Kingdom, France, the Netherlands and the United States.

Ebola, formerly known as Ebola haemorrhagic fever, is a deadly infection caused by a virus of the same name. First detected in the DR Congo in 1976, it is named after River Ebola, near where it claimed its first victims. The first simultaneous outbreaks in Nzara area of South Sudan and Yambuku in Congo in 1976 claimed 151 and 280 lives respectively. Since then, there have been 24 recorded outbreaks around the continent, mostly in the DR Congo.

Ebola 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. From the outbreaks recorded so far, fatality rates average 55 per cent but could be as high as 90 per cent.

What makes the current outbreak particularly dangerous is the fact that, from the remote village of Bikoro, it has spread to Mbandaka, a one million people city and water transport hub, from where it could launch out to other parts of the country and beyond. Experts believe that one of the reasons why the West African outbreak was so deadly was because of the ease with which it spread to the capital cities of Conakry in Guinea; Monrovia in Liberia and Freetown in Sierra Leone.

Salama, in his elucidation, said that it was much easier to contain Ebola in small villages. He said, “We have urban Ebola, which is a different animal from rural Ebola.” Having spread to Mbandaka, “the potential for an explosive increase in cases is now there,” he told the BBC. This is why it is important that the disease should be prevented from entering Nigeria, a country of close to 200 million very active and highly mobile population.

Traced to the wild bats, duikers, chimpanzees, monkeys and gorillas, experts believe that Ebola virus has come to stay and there would always be outbreak of the disease for as long as there is contact between humans and the animal hosts of the virus. For this reason, preventive measures should be given utmost priority attention. Personal hygiene, especially the washing of hands with soap and running water, cannot be overemphasised. Wherever there is an outbreak, it is important to avoid crowded situations and contact with dead bodies.

When an outbreak occurs, the tracing of contacts for quarantining and monitoring is one of the best ways of limiting transmission. Although Ebola has no known treatment, vaccines are being developed which could be applied in the case of an outbreak, even when the vaccines have not yet been sufficiently tested and approved.

In handling Ebola, it is always important to be proactive, rather than wait for infection to take place before trying to manage it. This is why the move by Lagos State to stop corpses coming into the country from the DR Congo should be commended. If the situation fails to improve drastically, there is nothing wrong in the Nigeria Football Federation calling off the forthcoming pre-World Cup friendly between the Super Eagles and the Congolese national team. Following a similar action by Liberia, Sierra Leone also cancelled all its football engagements at the height of the last outbreak in West Africa in 2014. No safety precautions should be downplayed.

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