…26 states, FCT most affected by Monkeypox
…182 Lassa fever infections across 33 states
…2,339 cholera cases, 74 deaths in 30 states
…WHO anticipates winter surge in Covid-19 deaths
‘…Our health care system in a shambles’
…We’ve not learnt any lessons from Covid-19 – Disease expert
Danger looms and Nigerians are worried as it appears there is no end in sight to the deadly infectious diseases outbreaks as the country continues to record rising cases of Monkeypox, Lassa fever, and Covid-19; BENJAMIN SAMSON reports.
Monkeypox
Cases of Monkeypox have continued to rise across the country as the data from the Nigeria Centre for Disease Control (NCDC) have indicated that the disease has spread to 26 states and the Federal Capital Territory (FCT), raising fears among citizens.
Since the beginning of this year, several countries have also witnessed an unprecedented outbreak of Monkeypox, prompting the director-general of the World Health Organization (WHO), Tedros Adhanom Gebreyesus, to, on July 23, declared Monkeypox a public health emergency of international concern; the organisation’s highest level of alert. In this way, WHO aims to enhance coordination, cooperation of nations, and global solidarity against the disease.
The latest NCDC situation report showed that in the first week of August alone, 60 suspected cases were recorded from 10 states out of which 15 new confirmed cases were recorded.
The states that have recorded Monkeypox cases since the beginning of the year are Lagos (20), Ondo (16), Adamawa (13), Rivers (13), Delta (12), Bayelsa (12), Edo (9), Nasarawa (9), Anambra (7), Imo (7), Plateau (6), Taraba (5).
Others are Kwara (5), Kano (5), Abia (4), Cross River (3), Borno (3), Oyo (3), Gombe (3), Katsina (2), Kogi (2), Ogun (2), Niger (1), Bauchi (1), Akwa Ibom (1) and Ebonyi (1) as well as FCT (7).
Other diseases
Similarly, investigations by Blueprint Weekend have revealed that the data from NCDC showed that Nigeria has so far recorded 182 suspected cases of Lassa fever across 33 states; 2,339 suspected cases of cholera with 74 deaths in 30 states.
Experts’ views
Speaking with this reporter, a public health physician and infectious disease expert, Prof. Adebayo Sobowole, said Nigeria would continue to record cases of infectious diseases because the conditions for re-infection abound.
He said, “We cannot stop disease occurrence because it is in equilibrium. All these things are natural phenomena that occur. Some of these diseases have always been there, but on a small scale. Just like human beings don’t want to die, all these organisms don’t want to die too; so they keep mutating and trying to find better ways to survive.
“Lassa fever and others have been there even before the 1960s. We are having an increase just like we are having an increase in population, and when you have many people who are eligible to be exposed, many more people will come down with signs and symptoms of diseases.
“The conditions that make for emerging and re-imaging infections abound locally and globally. When Covid-19 came, we had hope that it would create an opportunity for us to learn lessons, but the lessons are quickly forgotten. People are more interested in moving on with their lives than learning lessons and how they can apply that to forestall further occurrences, but unfortunately, we’ve not learnt any lesson; our health care system can’t provide basic care for people.
“Our approach has not shown that we’ve learnt lessons as a country. Clearly, we have not heard the last of infectious outbreaks. Ideally, we should not be having so many outbreaks, though we may be having sporadic occurrences, but every time we are in a panic mode, it is clear that the plan and preparedness are inadequate.”
Dearth of vaccines
Likewise, an epidemiologist and microbiologist with the African Field Epidemiology Network, Dr. Bodejo Akinbode, in a chat with this reporter, decried the lack of vaccines in Africa; a development he partly attributed to the attitude of international health organisations and western countries towards vaccination in Africa.
He said, “A surge in Monkeypox infections has particularly been reported since early May in the West and Central African countries where the disease has long been endemic. Africa remains the only part of the world with no doses of the vaccine.
“Only weeks after cases of Monkeypox were detected outside of Africa, vaccination campaigns began in Western countries as they have started inoculating at-risk populations with smallpox vaccines that protect against Monkeypox. Yet, despite thousands of cases since Monkeypox emerged in Africa in 1970, and hundreds of deaths, not a single vaccination campaign has been set up on the continent. This explains why the world is now dealing with yet another global health emergency.
“We have been working on Monkeypox in Africa for several years, but nobody was interested. Once referred to as a neglected tropical disease, WHO had been working on Monkeypox with very few resources. However, once Western countries began getting affected by the disease the world reacted. It was the same with the Ebola and Lassa fever. We have to stop this discrimination.
“Despite these few deaths last month and signs that it would spread further, Nigeria is fighting Monkeypox without a vaccine just as it did with Ebola and other infectious diseases, this is very risky. Even doses of the smallpox vaccine which has shown effectiveness against Monkeypox, are not available.”
Funding
However, an infectious diseases physician at the Federal Medical Centre, Keffi, Nasarawa state, and a member of the Nigerian Infectious Diseases Society, Dr. Ngozi Kalu, called for more funding to the health sector in order to increase surveillance against infectious diseases across the country.
She said: “First, federal, state and local governments must increase funding for epidemic preparedness. Indeed, it is cheaper to prevent and detect than to respond to an infectious disease outbreak. Covid-19 has shown how the impacts of pandemics go beyond the health sector. A simple way to implement this is via a budget line item that could be called ‘epidemic preparedness’ and then define what that covers.
“For example, in local councils, it could cover the cost of provision of clean water in health facilities, setting up a good waste disposal system for communities, stipends for community health volunteers who are the first line in reporting infectious disease outbreaks.
“The state government’s epidemic preparedness budget could cover recruitment and deployment of different cadres of health workers to last mile health facilities, setting up and equipping state government-owned laboratories, health communications and advocacy interventions etc. The federal government should budget and allocate more funds to NCDC to support its efforts to prevent and detect infectious disease outbreaks.”
Continuing, she said, “Second, involve the private sector in epidemic preparedness by tapping into its funds, innovation, creativity and networks. There are important lessons on how the private sector rallied to support Nigeria’s response to the pandemic through the Private Sector Coalition Against Covid-19 (CACOVID). This is unprecedented and has raised more than 38 billion naira supporting the provision of palliatives, creation of testing, isolation and treatment centers, provision of Intensive Care Units and molecular testing laboratories.
“Going forward, there are other ways that private sector organizations can support epidemic preparedness. These include supporting the local health system in communities where businesses are located. For instance, a private company could provide boreholes and public toilets in communities. Public toilets are very important due to the contribution of 46 million Nigerians who stool in public to cholera outbreaks.”
Solution
On how these could be addressed, Akinbode urged the federal government to acquire smallpox vaccines to stem the tide of Monkeypox.
“The government should negotiate for a smallpox vaccine as other European countries are doing to prevent more cases of the virus. Washing hands regularly with soap and water or using an alcohol-based hand sanitisers; avoiding contact with any materials that have been in contact with a sick animal or person and isolating infected patients from others who could be at risk of infection remain the best ways to avoid a spread of the infectious virus.
“Since prevention is still far better than cure, I urge Nigerians to continue to observe good hygienic behaviour, especially given the causative factors of Monkeypox, Lassa fever and other infectious diseases. But the ultimate responsibility lies with the health authorities. We cannot afford another outbreak of a major disease in Nigeria.”
Likewise, Kalu warned of the need to practise proper hand hygiene and maintain a clean environment.
“If one has an unexplained fever or has unexplained bleeding, such persons should avoid self-medication, drink plenty of fluids and present himself at a hospital for review. There are effective medications that can be used for treatment, especially if patients present themselves early.
“Monkeypox, Lassa fever and other infectious diseases can be prevented by practising proper hand hygiene at all times; before and after using a toilet; before and after cooking; after being in crowded places; after dealing with animals and at other times.
“Also, it is important to maintain a clean environment at all times, properly dispose waste, rat-proof our homes, keep our foodstuffs in covered containers and find a way to eliminate rats from your homes; possibly keep cats. One should avoid bush meat for now and, if possible, reduce or avoid bush burning. These should reduce your likelihood of being infected with the disease.”
WHO’s warnings
Meanwhile, the WHO has declared that the onset of winter in northern countries could spike Covid-19 hospitalisation and deaths. It, therefore, urged people to get vaccinated to stop the spread of the virus.
WHO’s director-general, Tedros Ghebreyesus, gave the advice at a media conference Wednesday at the UN health agency’s headquarters in Geneva.
Ghebreyesus urged that people get vaccinated to reduce the spread of the disease or, if they were already vaccinated, to get further boosters.
“We are now seeing a welcome decline in reported deaths globally. However, with colder weather approaching in the northern hemisphere; it’s reasonable to expect an increase in hospitalisations and deaths in the coming months.
“Sub-variants of Omicron are more transmissible than their predecessors and the risk of even more transmissible and more dangerous variants remains,” he said.
He said further that vaccination coverage among the most at-risk groups such as health workers and older persons “also remains too low, especially in poorer countries.”
He reminded people across the globe to continue to take action to reduce the risk of infection, even if already vaccinated. According to the WHO boss, the steps include avoiding crowds, especially indoors, and wearing a mask.
“Living with Covid-19 doesn’t mean pretending the pandemic is over. If you go walking in the rain without an umbrella, pretending it’s not raining won’t help you. You’ll still get wet; likewise, pretending a deadly virus is not circulating is a huge risk.”
He revealed that nearly 600 million cases of Covid-19 have been recorded, some 2.5 years into the pandemic globally.
Meanwhile, the director of WHO’s Office of Europe, Dr. Hans Kluge, has said the region had been projected to reach 250 million cases “in a matter of weeks.”
Akin to Ghebreyesus, he also “anticipates the winter surge in cases.”
Kluge said in a statement Tuesday that, “We have made great strides in addressing the pandemic, but the virus is still circulating widely, still putting people in hospital. It’s still causing too many preventable deaths; some 3,000 in the past week alone, about a third of the global recorded total.”
Other climes
Europe is also home to around a third of the global caseload for the continuing Monkeypox outbreak, with 22,000 confirmed cases across 43 countries.
The Americas account for more than half of all reported cases, with several countries continuing to see a rise in infections.
According to the WHO, some European countries, including Germany and the Netherlands, are also seeing a clear decline in infections.
“This development demonstrates the effectiveness of public health interventions and community engagement to track infections and prevent transmission.”