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Published On: Mon, May 26th, 2014

Dealing with disease outbreak in Nigeria

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nigeria minister of healthBy Evelyn Okakwu

Nigeria’s Minister of health, Prof. Onyebuchi Chukwu recently charged stake holders in Nigeria’s medical sector to rise up to the challenge of reducing disease outbreaks in Nigeria.

The call was made at the recently organized pre National Council on Health (NCH) meeting in Abuja. During the meeting the minister noted that a number of diseases have emerged in addition to previous ones in Nigeria, adding that blood related diseases stood the chances of increasing in Africa if nothing is done to cub the situation.

“Some parts of Nigeria are endemic to laser fever. The committee will be looking at ways of preventing further spread of the disease. Also we will be looking at yellow fever, though it has not been in Nigeria for about five years, but we have to work hard to keep it that way.

Then we also have the Ebola fever, which is quite close even though we still have not experienced it, we would be looking critically at the ways of preventing it from getting further closer to Nigeria.

As the minister rightly stated, “We must not wait for an annual meeting like this to look into certain health related issues.”

Prominent among the diseases mentioned is the Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans. EVD outbreaks have been reported to have a case fatality rate of up to 90%. The outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests.

The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.

Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals.

In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

Ebola then spreads in the community through human to human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.

Health care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.

Among workers in contact with monkeys or pigs infected with Reston ebolavirus, several infections have been documented in people who were clinically asymptomatic.

However, the only available evidence comes from healthy adult males. It would be premature to extrapolate the health effects of the virus to all population groups, such as immuno-compromised persons, persons with underlying medical conditions, pregnant women and children. More studies of RESTV are needed before definitive conclusions can be drawn about the pathogenicity and virulence of this virus in humans.

EVD is a severe acute viral illness often characterized by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

People are infectious as long as their blood and secretions contain the virus.

Ebola virus was isolated from semen 61 days after onset of illness in a man who was infected in a laboratory.

The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is 2 to 21 days.

No licensed specific treatment or vaccine is available for use in people or animals.

Another disease mentioned by the Minister is the yellow Fever. It is a viral infection transmitted by a bite from infected mosquitoes most commonly found in parts of South America and Africa.

When transmitted to humans, the yellow fever virus can damage the liver and other internal organs and be potentially fatal.

The World Health Organization estimates there are 200,000 cases of yellow fever worldwide each year, resulting in 30,000 deaths. Although it has reportedly not been witnessed in Nigeria in the last five years, yellow fever appears to be on the rise internationally, due to a decreased immunity to infection among local populations, deforestation, climate change, and high density urbanisation

The Center, for Disease Control and prevention CDC provides symptoms and preventive measures for the infection.

The world Health Organization (WHO) provides symptoms and preventive measures for the Yellow fever disease.

The Centre for Disease Control and Prevention (CDC) has identified 45 countries with a risk of yellow fever transmission, many of them with tropical climates

How Does Yellow Fever Spread?

Yellow fever is typically spread to humans from bites by infected mosquitoes. People cannot spread yellow fever among themselves through casual contact, although the infection can be transmitted directly into the blood through needles.

A few different species of mosquitoes transmit the yellow fever virus; some breed in urban areas, others in jungles. Mosquitoes that breed in the jungle also transmit yelllow fever to monkeys, who, in addition to humans, are a host for the disease.

Yellow fever gets its name from two of its most obvious symptoms: fever and yellowing of the skin. The yellowing occurs because the disease causes liver damage, hepatitis. For some people, yellow fever has no initial symptoms, while for others; the first symptoms appear from three to six days after exposure to the virus from a mosquito bite.

An infection with yellow fever typically has three phases. The first phase of symptoms can last for three to four days and then, for most people, disappears. The first phase is generally non-specific and cannot be distinguished from other viral infections.

The initial symptoms of yellow fever are: Fever and chills, Flu-like symptoms such as muscle aches, headache, and vomiting.

The next phase is remission, which lasts for 48 hours. Patients improve. The majority recover.

Unfortunately, a third, more toxic phase of infection occurs for 15% of patients. Ultimately, a condition called viral hemorrhagic fever can develop, with internal bleeding (hemorrhaging), high fever, and damage to the liver, kidneys, and circulatory system. The World Health Organization estimates that up to 50% of people worldwide who reach this severe phase of infection die, while half recover.

The third phase symptoms of yellow fever are:

Jaundice (liver damage), which causes yellowing of the skin and eyes, Hepatitis (inflammation of the liver), internal bleeding (hemorrhaging), vomiting blood, Shock, and multisystem organ failure leading to death.

The preventive measures for the disease are as follows:

The very first step towards preventing yellow fever is to ensure that vaccination against the infection is achieved, then avoid mosquito bites.

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