The return of yellow fever epidemic

RECENTLY, yet another tragedy struck the country amid the ongoing battle against the coronavirus pandemic. For over two months now, Enugu and Delta states have witnessed a “strange ailment”, now confirmed to be yellow fever. Yellow fever, an acute viral haemorrhagic disease transmitted by infected mosquitoes, with symptoms including fever, headache, jaundice, muscle pain, nausea, vomiting and fatigue, has claimed many lives in the states. Often, a small proportion of patients who contract the virus develop severe symptoms and approximately half of them die within seven to 10 days.

For 21 years, the country was reported to have banished the dreaded disease until September 2017 when it was rediscovered in Kwara State. Since then, it has battled thousands of infections yearly, with outbreaks previously limited to states like Ebonyi, Cross River, Benue, Gombe, Sokoto, Katsina, Yobe, Kwara, Kogi, Osun, Edo, Bauchi, Borno, and Kano. Last week, the Director-General of the Nigeria Centre for Disease Control (NCDC), Dr. Chikwe Ihekweazu, confirmed the fears of many when he indicated that, as of November 13, the country had recorded 222 suspected cases of yellow fever, 19 confirmed cases, and 76 deaths in three states, namely Bauchi, Delta and Enugu. Virologists link the upsurge in cases to the country’s vaccination coverage for children, pointing out that many people had been left out of the national routine immunisation schedule. They aver that the mass yellow fever campaign from 2012 to 2016 to vaccinate about 104 million Nigerians, which had not been completed, had left many people without enough antibodies against the disease in the country.

According to the NCDC boss, in response to the spike in cases in the affected states, the step had been taken to establish the cause of the disease through the agency’s national reference laboratory, even as it had deployed a Rapid Response Team to Delta and Enugu states to support outbreak investigation and response activities. Ihekweazu urged parents to ensure that their children receive the free yellow fever vaccine, adding that those in doubt of their vaccination status should visit a health facility to request for the vaccine. He said:“The government has committed to the World Health Organisation’s (WHO) Eliminate Yellow Fever Epidemic (EYE) strategy to ensure everyone has access to the vaccine against the disease and that we do not record outbreaks in our communities. There is nothing strange about the disease, which was first detected in Nigeria over 40 years ago. We know how the virus is transmittable and we have an effective vaccine that provides immunity for life.”

It is indeed saddening that amid the widespread menace of hunger and deprivation, and soaring insecurity, Nigerians are now confronted with another existential challenge in the form of yellow fever. Typically, the government’s handling of the epidemic has been poor as usual, with states like Kogi as usual denying the existence of any infections. Officialdom should be concerned that the country offers a bad example to the world whereby nearly every bad thing thought to have been extinguished sooner or later returns with deadly force. Its experience with polio illustrates this point very clearly.  There is therefore a need for the federal, state and local governments, where the latter exist at all, to undertake a comprehensive review of the health sector while taking all necessary measures to curtail the spread of yellow fever.

To be sure, for the general populace, there is a need to abide by the NCDC’s commonsensical recommendations, including keeping the environment clean in order to prevent the breeding of aedes mosquitoes which spread the virus and other infectious diseases; sleeping under insecticide-treated nets to prevent mosquito bites, and seeking immediate medical attention at a hospital if feeling ill. Besides, it is crucially important that all Nigerians have their vaccination status ascertained. As noted by the Executive Director, National Primary Health Care Development Agency (NPHCDA), Dr. Faisal Shuaib, records on the ongoing outbreak from Delta, Enugu and Bauchi states showed that those involved had never taken the yellow fever vaccine, even though a single dose of the  vaccine provides life-long protection.  Needless to say, the vexing issue of the country’s reliance on imported vaccines, which are  fraught with dangers because of the difference between the in-country strains of the virus and the strains used in producing them, should be addressed without delay.

 

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