Posted on: Mon 18-07-2016

As the dust of the 2014/2015 West Africa Ebola Outbreak, which Nigeria has her own fair share is settling, the re-emergence of Zika virus in South America with pockets of outbreaks in other regions is of great public health importance. Staging the quadrennial Olympic games in South America this august, in particular Rio de Janeiro, which is the second most affected city in Brazil brings about a possible disturbing coincidence for the world. Although, the World Health Organisation (WHO) has allayed the fear of experts across the world saying that Brazil is just one of the nearly sixty countries and territories which to-date report continuing transmission of Zika virus by mosquitoes. Therefore, going by WHO submission, Rio 2016 pose no health threat to expected over half a million visitors to Rio during the Olympics and by extension millions of their nationals back home when the games are over. I hope this will not be a sensational oversimplification of the facts on ground at the end of the day- only time will tell.

Zika virus is a flavivirus, a mosquito-borne arbovirus belonging to the family of other viral diseases like dengue fever and yellow fever. It was first discovered in 1947 in the Zika forest of Uganda from samples from rhesus Monkeys and in 1948 from the mosquito Aedes africanus caught on a tree in the same forest. The first human cases were in 1952 in Uganda and Tanzania with first large outbreak in 2007 on the Pacific Island of Yap, in the Federated State of Micronesia. The present wave of Zika virus epidemics started in 2013 from other Pacific Islands which generated thousands of suspected infections. Signs and symptoms of Zika infection include headache, malaise, mild fever, skin rashes, conjunctivitis, muscle and joint pain; these symptoms are usually mild and last for between two and seven days. A dramatic twist to the history of this disease evolved when microcephaly in babies of infected pregnant women and Guillain Barré Syndrome were associated with its infection. This was first reported in Brazil where more than one thousand and three hundred cases of microcephaly were seen in new births. These neurological sequalae, among others and the possibility of sexual transmission of the virus make it of enormous health importance. In lieu of this, the World Health Organisation on 1^st of February 2016 declared that the recent association of Zika infection with clusters of microcephaly and other neurological disorders constitutes a Public Health of International Concern.

The summer Olympics is a world festival of sports. The 2016 Olympics Games in Rio de Janeiro will not be an exception with the participation of athletes, officials, sponsors, spectators and supporters from the 204 competing countries participating in 28 games. Almost half a million tourists have been estimated by the International Olympics Committee (IOC) to grace this sport fiesta. Such events of great magnitude has its attending health challenges and the Zika virus infection in Rio makes this one a double concern for the world at large, especially countries with poor healthcare infrastructures and indices; Nigeria inclusive. The WHO has not put into critical consideration these countries in my opinion before waving aside the fear of subsequent global zika infections if and when the Olympics game is hosted in Rio de Janeiro this August. It is on record that over 150 medical experts, comprising laboratory scientists, epidemiologists, medical doctors and researchers across Japan,  Britain, United State, Canada, Norway, Philippines, South Africa, Turkey, Lebanon and Brazil among others came together and wrote WHO on the danger of hosting the Summer Olympics in Rio considering the Zika virus epidemics going on there. In their letter to the body, they said it will be unethical and irresponsible to host the games in Rio at a time like this.

The Nigerian healthcare system and the Nigerian populace at large were very lucky the last time Ebola virus came knocking, no thanks to the industrial action by the public health institutions in the country at the time which made the index case, Patrick Sawyer to seek health care in a private hospital else it would have led to seamless transmission and outbreak of the disease if he was attended to in a public health institution. Also, the patriotic and professional approach of Late Dr Stella Adadevoh was a big factors that curbed the spread of the disease in Nigeria, and yet she has not been given a national recognition for laying down her life for her dear country . Therefore, as Team Nigeria is intensifying training and preparation for the games with their supporters, lovers of sports and tourists are warming up, Nigerian government and her health experts should not go to sleep. There should be a well thought-out, tailored epidemic control and surveillance mechanism before, during and after the games for them. This is inevitable so as to prevent possible import of the infection into the country. This is inevitable to ameliorate the possible attending health challenges Zika virus can cause in the country post Rio Olympics.

Nigeria, should from now onward increase surveillance for the virus transmission, microcephaly and other neurological deficits. It is also important to improve epidemic control preparedness viz-a-viz early detection, confirmation and management of potential complications and sequelae of zika infection. This will require adequate data collection, processing, interpretation, and dissemination to appropriate quarters for policy formulation and decision taking. Our National Disease Surveillance system would require revitalization and resuscitation out of its dilapidated and comatose state. Regional centres in the country for such diseases of public health importance should also be reinforced, especially the National Arbovirus Research Institute, Enugu. Starting and improving health education on Zika virus by dissemination of Information Electronic and Communication (IEC) materials and production of radio and television jingles would not be out of place. Targeting the most vulnerable groups like the pregnant women on the danger of Zika infection for their babies is paramount while promotion of protective steps e.g use of mosquito net should be encouraged. Awaiting the confirmation of first case of zika infection in Nigeria before all these are done may spell doom if and when there is an outbreak of the virus in the country.

It will be a high sense of proactivity to screen the contingents of Team Nigeria for Zika virus before leaving for Brazil, so as to have baseline information. Knowing those who are positive to the Zika virus antibody test among them before going to Rio would prevent unnecessary and incorrect labeling and stigmatization when they come back. Samples should also be collected during and after the games for epidemiological tracing. Provision of preventive measures against the virus and its vector for the contingents and others going for the games would also be a novel idea. Insecticide treated nets, mosquito repellant creams and insecticide sprays would go a long way to safe guard against being infected by the virus. The fact that the virus can be sexually transmitted would necessitate supply of condoms for Team Nigeria, though abstinence must be preached too. Follow-up of these contingents and their families after the games; especially their spouses and those that may be pregnant soonest after should be ensured. All these highlighted measures fall within the purview of the World Health Organization Zika Strategic Response Plan which is based on the tetrapod of detection, prevention, research and care and support. Therefore capacity building and strengthening through multi-sector and international collaborations with our boundary neighbours will be of great deal. Training and re-training of our medical experts with introduction of emergency drills on Zika virus epidemics should also be considered. Timely and adequate release of funds should be made available to avert this potential public health threat while our politicians and health administrators, for the sake of national interest, should not mismanage, misappropriate or embezzle such funds when made available.

The global economic crunch and present realities in Nigeria should propel concerned authorities to be proactive in dealing with this threat. Going through any grave epidemic outbreak at this time may have a devastating negative impact on the country. As a nation, we should not assume that we are immune to the virus invasion despite the WHO’s believe to same. As I am looking forward to a glorious outing for Team Nigeria in Rio de Janeiro, one which will surpass our best record so far at the 1996 Atlanta Olympics, I am not wary of the possible health implications the threat of Zika virus may have on Nigeria- hence this clarion call.

 

Dr. Dele Atiba

[email protected]

08063264061

for Stella Adadevoh Support Group (SASG)

facebook page: Stella Adadevoh Support Group - SASG

---

---