#CSRfilesWeekly Edition 167: Unusual Tie: Climate Change, Ebola, Lassa, and Zika

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The United Nations (UN) has again emphasized good health as a sign of sustainable development; nonetheless, sustainable health which is more desirable; goes beyond just maternity health and ending the epidemics of AIDS, tuberculosis and malaria. In the same vein, ending other communicable diseases that may show up is part of the deal. In the past 3 years, previously discovered and new life threatening public health diseases have been on rampage with the likelihood of more to spring up in months or years to come. Presently, the Ebola and Lassa viruses have been the most widely spread viruses in the West African region in the last 3 years and the possibility of the presently South American spread Zika virus, could also be a threat to Africa. We need to talk about these threats more and more if we will achieve a healthy world, by 2030 especially in Africa.

Ebola Virus Disease (EVD)

The wake of January 14, 2016 brought a long-anticipated, yet cheering news of an Ebola-free continent, especially the West African countries who have either been devastated by the Ebola virus (Liberia, Sierra Leone, and Guinea) or have prepared for a repeat  (Nigeria, Mali and Senegal). However, this good news was short-lived as two new cases were reported in Sierra Leone in January 2016, plunging the region again into a high risk of spread. Happily, at the time of writing of this article, no new cases or deaths have been recorded since then. It is hard however, for an average unaffected country’s citizens to comprehend the real mysteries behind this dreaded virus.

Ebola Virus Disease is the deadly Ebola Hemorrhagic Fever caused by the Ebola virus of the Filoviridae family. First discovered in 1976 in South Sudan and near the Ebola River in the present Democratic Republic of Congo (DRC), Ebola has spread through Africa and especially been much deadly in West Africa. Between 1976 and 2012, Ebola had been discovered in DRC, Congo, Sudan, Gabon, Cote D’Ivoire, South Africa, and Uganda (WHO). Though the exact carrier of the virus is still unknown, researchers claim its reservoir is in wild animals most especially Fruit Bats, Chimpanzees, Gorillas, Monkeys, Forest Antelopes, and Porcupines. Main symptoms are fever fatigue, headache, muscle pain, and sore throat and it is spread through direct mucous membrane contact (eyes, nose, mouth) or broken skin contact with infected persons, objects, or animals. Although no treatment has been discovered, an infected person can survive it through rehydration with fluids and treatment of symptoms.

In 2014, Ebola Virus Disease resurfaced again in West Africa and this time, with the largest number of cases and deaths than have ever been recorded in the history of the disease; the highest case in the past had been in 2000 in Uganda (425 cases recorded) and highest death figure in 1976 in DRC (280). The return began in Guinea then spread to Sierra Leone, and Liberia, with light/few appearances in Nigeria, Senegal, and Mali (some cases of foreigners who contacted it in Africa – United Kingdom, United States.

In all, 28,603 cases are recorded with 11,301 deaths (WHO, as reported by health map http://www.healthmap.org/ebola/#timeline, February 3, 2016).

Lassa Virus Disease (LVD)

176, cases, 108 deaths in 20 infected states in just 3 months, the Lassa virus became a population risk and health threatening disease in Nigeria just after a sigh of relief from Ebola. It was first discovered in 1969 in Lassa town, Borno State Nigeria when the virus claimed the lives of two infected victims. As with Ebola, Lassa is predominant in West Africa. It claimed 148 lives in Sierra Leone in 1997 after 799 cases were recorded and dealt a blow on Benin Republic in 2014. Its heavy reemergence in Nigeria is not surprising as it already recorded 1,723 cases with 112 fatalities in 2012 when its second widespread reemerged. The November 2015 outbreak reinstated the fact that something urgent needs to be done to completely eradicate the threats of this virus.

Just like the Ebola Virus, the Lassa virus is an acute viral hemorrhagic illness but this one, from the Arenavirus family. The carrier is the Multimammate rat (many breasts) called Mastomys, which are found commonly in West Africa, putting many countries in the region at high risk. The virus is also endemic in Guinea, Liberia, Sierra Leone, and Nigeria, same countries that suffered the Ebola attack. It is transmitted via contact with food or household utensils infected with droppings, urine, blood, and other secretions from carrier rats or via contact with secretions from an infected person and laboratory submissions. Symptoms include but not limited to: fever, general weakness, vomiting, diarrhea, bleeding from nose, mouth, vagina, gastrointestinal tract, and seizures in the advanced stage, to mention a few. Symptoms surface in infected persons within 1-3 days of infection and death within 14days if the infected is not treated on time or does not respond to treatment, although only 1% of infections result in death. With many of the symptoms of Lassa also same as those of Ebola, the two are often confused in a sick person showing such symptoms. However, Lassa is different from Ebola, as Lassa could die a natural death when contacted without showing any symptom. Although no vaccine has been discovered, effective antiviral drugs are available for treating it.

Situation Summary in Nigeria

Ebola reemerged in Bauchi in November 2015, and Kano afterwards. In February 2016, the Minister of Health, Professor Isaac Adewole announced its spread (suspected case or currently following up contacts) to 20 states; Bauchi, Niger, Taraba, Kano, Rivers, Oyo, Ondo, Edo, Plateau, Gombe, Nasarawa, Lagos, Delta, Ekiti, Ebonyi, Zamfara, Kogi, FCT. The total cases reported (suspected, probable and confirmed): 176; total deaths (suspected, probable and confirmed): 108 (61.4% fatality rate); Total confirmed cases: 78; deaths in confirmed cases: 49 (CFR: 62.8 per cent).

To be continued in the next edition

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