In the wake of the Ebola virus attack in Liberia, the country’s deputy health minister, Bernice Dahn, warned in an emergency meeting in Ghana: “If we do not provide the support to stop the transmission, other countries will get infected as well.”
And that was what happened. According to reports, a Liberian, Patrick Sawyer, who travelled to Lagos by flight, had developed a fever, with vomiting and diarrhoea and
was rushed to a private hospital where it was later found that he had Ebola virus. He died within a few days. His sister had also died of Ebola.
The first outbreak of Ebola virus (EBOV) in 1976 in the Democratic Republic of Congo (formerly Zaire), the virus has affected many other sub-Saharan African countries among them Guinea, Liberia and Sierra Leone, and now Nigeria. Ebola hemorrhagic fever (EHF) causes host immunosuppression, with high viremia, leading to multiorgan failure. The case fatality rate is as high as 90 per cent. There have been more than 600 deaths since the current outbreak.
There are five species of Ebola virus, four native to Africa and one to the Philippines. Ebola virus is a zoonotic. They live quietly among the wildlife species, and from there cause harm to humans, and disappear again. You can only get Ebola virus from coming in direct contact with someone with the virus, and with bodily fluids. This is why the only way to curtail outbreaks is by isolation and barrier nursing, and carefully dealing with patients and careful handling of corpses, using gowns, medical gloves, rubber boots, goggles, and body bags.
We must head off an epidemic – and possibly a pandemic. We must identify the reservoir host. It was thought that chimpanzees were the reservoir host, but as they too are also killed by the virus, they are not. We suspect three species of fruit bat. We must kill all of them, whether infected or not, or else we would be the endangered species!
Ebola virus is more common among poor Africans with deep cultural adherence who can’t afford beef and poultry and resort only to hunting bats, and other forms of wild animal for meat.
Although there is no treatment, a drug, favipiravir, has been tried against Zaire Ebola virus (EBOV) in Vitro and in Vivo. And has shown promise in suppressing replication of the virus in mice. But there are still bottlenecks before it can be tried on humans.
Perhaps, the best hope lies in a vaccine. To be sure, there have been vaccine candidates among vectored vaccines, DNA vaccine, and virus-like particles-based which all have shown efficacy in non-human primate models of the EHF. But the vaccines have not undergone trial. And ethically, vaccines cannot be used unless they have gone through a trial, and then approved.
The usual practice where anyone who has a fever does self-medication including taking herbal medication may not work any longer. Anyone with a fever should seek medical attention. It may not be “malaria and typhoid”.
The grim reality that we now have a disease with no known treatment in our midst is terrifying. Ebola is more dangerous to humans as specie than a terrorist bomb. It can spread rapidly with devastating effects if not curtailed. Insecurity compounds our weak health care system.
All those who have issues with the Nigerian state must for the sake of all of us – including they themselves, work together to fight this new threat.
This is the time to stop further bombings of fellow Nigerians, a common deadly enemy has visited our land.
Bringing in foreign nationals to come through our porous borders in other to bomb Nigerians may be a deadly idea. They may be carrying the virus! With better security, there is greater hope of dealing with the Ebola virus.
Also, our health care facilities must have the right equipment and adequate number of well-trained manpower to deal with the challenge. There is also the need to develop a rapid test for Ebola virus, so that cases won’t go undetected, as autopsy is not a common practice in our culture.
We must be able to collaborate and share information and other forms of technology in tracking the virus. Medical doctors should work hand in hand with veterinary doctors. This is not the best time for doctors to be on strike. We hope that a lasting solution is found quickly so that they can go back to work.
We need the help of international agencies, and the international community. We are talking about Ebola virus in the country with the highest number of black people. As this particular case has shown, with easy travel, no country is immune. There is no better war for the United States, Russia, Israel and other big economies to fight than the war against Ebola virus and its allies.
For a disease without a treatment, it is even tempting for patients not to seek professional help, what with laboratory testing which can be expensive, and so for this tests should be free. There is also the stigma aspect of it. Families may decide to hide any family member as with the case in Sierra Leone.
The people also need to be educated, because as it is in some African countries now, there is hostility to health care workers. Health care workers have even been accused of being the ones spreading the disease. Especially when they are dressed in astronaut-like quarantine clothing and when they ask the people to change their cultural practices especially burials, where there is the traditional cleaning of bodies which can put those mourning at risk of the disease.
We must guard against giving wrong information. Health officials and community leaders must cooperate so that there will be public confidence.
Again, we must do everything possible to deal with the Ebola virus. Proper hygiene must be maintained, with regular washing of the hands. This may not be the time for reusing cutlery, even in five-star hotels, especially as it is a high risk place often visited by foreigners. Disposable cutlery may be preferable. Soft drink companies and breweries must have treatments that can kill the virus too. There should be caution at places like a barber’s shop, salon, stadium, viewing centres, even churches and mosques, especially a church like the Catholic Church that people shake hands and hug when offering one another the sign of peace, and take Communion placed on their tongues by the priest. Placing it on the communicant’s palms may be better. For Muslims, it may be better to have your own kettle or bottle for ablution. There is God!.
Again, we must avoid crowded places, and clustering. No bumping into one another on the streets while walking along. Keep to your right, while I keep to mine. Please, spare me the handshake. And roasted bush meat? No, thank you!
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