I have waited long enough to write on the outbreak of Ebola Virus Disease (EVD) in Nigeria. I started following the story of the outbreak from the Guinea. It then spread to Liberia and Sierra Leone in March 2014. In July 2014, an Economic Community of West African States ECOWAS commission staff Patrick Sawyer travelled to our country in the name of attending a meeting and infected our people. I am of the opinion that he moved into Nigeria seeking for succour, as naive and callous as his motives were he has put us in this jeopardy we are now.

 

Ebola Virus Disease is a hemorrhagic virus that is aggressive on a human host. Let me take you through the history of the outbreak. In 1976, Ebola (named after the Ebola River in Zaire) first emerged in Sudan and Zaire. The first outbreak of Ebola (Ebola-Sudan) infected over 284 people, with a mortality rate of 53%. A few months later, the second Ebola virus emerged from Yambuku, Zaire, Ebola-Zaire (EBOZ). EBOZ, with the highest mortality rate of any of the Ebola viruses (88%), infected 318 people. Despite the tremendous effort of experienced and dedicated researchers, Ebola's natural reservoir was never identified. The third strain of Ebola, Ebola Reston (EBOR), was first identified in 1989 when infected monkeys were imported into Reston, Virginia, from Mindanao in the Philippines. 

 

Fortunately, the few people who were infected with EBOR (seroconverted) never developed Ebola hemorrhagic fever (EHF). The last known strain of Ebola, Ebola Cote d'Ivoire (EBO-CI) was discovered in 1994 when a female ethologist performing a necropsy on a dead chimpanzee from the Tai Forest, Cote d'Ivoire, accidentally infected herself during the necropsy. 10years after we are experiencing the outbreak in Guinea, at least we now have knowledge of the host but don’t have a cure to the EVD. 

 

The host animal is fruit bat, chimpanzee and monkey and the question that would always be asked is did the affected fruit bat, chimpanzee and monkey that are carriers of the virus travel from where the outbreak started to our country? The virus has been travelling effortlessly across borders, by plane, car and foot, shifting from forests to cities and springing up in clusters far from any previously known epidemic area. Border closures, flight bans and mass quarantines have not been implemented. Everything we do is too small and too late. Ebola has been able to follow its own course because West Africa lacks healthcare workers and other resources needed to monitor the spread. 

 

Now there are different ways EVD can be transmitted from animals to humans. One form of transmission is when humans eat the meat of an infected animal and/or get in contact with an infected animal. It can also be transmitted from human to human, when one comes in contact with the blood and body fluid of an infected person. Now we have identified the mode of spread which could have been done from the beginning of the outbreak in Guinea. The screening of all emigrants coming into our country by air and through the borders should have been carried out February 2014, when the first news of EVD was announced. 

 

Medicine after death, fire brigade approach has always been our method of handling issues; this should not be the trend in this time an age. Prevention they say is better than cure, primary prevention in this case have a better coverage, creates a level of advocacy and maintains a high level of sensitization in the minds of the citizenry.

 

A lot of resources should be invested into the prevention of EVD in order to sustain the life expectancy of our people. If this aggressive virus is allowed to go out of hand, the high risk group which are our health professionals would begin to resist responding to their duty call. Travellers who are also at high risk begin to have undue and unhealthy stigmatization. Still on the prevention, government and the media should not relent in their effort to continually sensitize the people of our country and also the neighbouring country. 

 

Coming to the cure of EVD, researchers are seriously working on a drug that would treat the EVD. The ZMapp drug was used on two American doctors from Liberia who tested positive of the virus and have been reportedly responding in the midst of uncertainty of hundred percent survivals. More research work is ongoing on the ZMapp. GlaxoSmithKline GSK is currently working on a vaccine that would protect healthy individuals from getting infected with the EVD for a short time, but would have to be augmented for a long time protection. I was opportune to attend the commemoration of the African Traditional Medicine 2014 that took place at Events Centre, Alausa, Ikeja where Professor Ositelu, an ophthalmologist with the Lagos State University Teaching Hospital (LUTH) talked about the use of infused Ewedu leaf in the prevention and cure of EVD. This claim should not be overlooked government should sponsor researchers. All herbal claims on the prevention and cure of EVD should be evaluated and substantiated. 

 

What I recommend is that Ebola awareness campaign should be consolidated. Researchers should be encouraged to investigate and find out drugs for cure and vaccines that healthy individuals can take for protection. All hands should be on deck, we should all be at alert and report any suspected case by calling the Ebola numbers given to us by the Ministry of Health. This fight can also not be over if our government do not assist the neighbouring countries affected. Providing aid to them especially when our borders are still open and considering our position in the West African region. The strategy for containing the disease in the country still remains providing an appropriate information, education and communication and sustenance of the surveillance systems.

 

By Kenneth E. E.

Health Management student LUTH