Professor Isaac Adewole advises Nigerians to be vigilant and report suspected cases of Zika virus to health authorities although there is no new case of the disease in the country now
NIGERIA which has been fighting to interrupt the transmission of Lassa fever in the country is already preparing for another health emergency of international dimension which broke out in the Americas and have been spreading fast.
In late 2014, Brazil detected a cluster of febrile rash illness related to Zika virus in its Northeast region (Bahia) that was subsequently associated with the Zika virus in April 2015. The outbreak spread widely to other parts of Brazil and other countries and by February 2016, Zika viral transmission has been documented in a total of 44 countries and territories). This includes two African countries of Cape Verde and Gabon that reported transmission in between 2015 and 2016.
Zika Virus belongs to the flavivirus group of viruses to which Yellow fever and Dengue viruses also belong. It was first discovered in Zika forest in Uganda in the year 1947. It is transmitted to people primarily through the bite of infected mosquitoes of Aedes species among which are Aedes aegypti, Aedes Luteocephalus and A. albopictus. These are the same mosquitoes that spread yellow fever, dengue and chikungunya fevers. These mosquitoes exist in Nigeria and with the exception of Aedes albopictus, have been found to be transmitting yellow fever and dengue viruses.
Unlike the Anopheles mosquitoes that spread malaria, these group of mosquitoes are active and fly and bite mostly during day time and early evenings. The spread of Zika virus to countries within the geographical zone of the disease vectors of the Aedes mosquitoes is therefore most likely. These mosquitoes typically lay eggs in and near standing water in things like buckets, bamboo holes, bowls, animal dishes, flower pots, discarded plastic bags and vases. They prefer to bite people, and live indoors and outdoors near people.
According to Professor Isaac Adewole, Nigerian minister of health, “It is important, however, to state categorically, that until now in Africa and Nigeria inclusive, this virus does not cause any serious illness and those so far infected individually recover fully with no serious complications”
But the arrival of this virus in some countries of the Americas, notably Brazil, has, however, changed this and its circulation is now associated with a steep increase in the birth of babies with abnormally small heads named scientifically as Microcephalia. It is also associated with increase in cases of Guillain-Barré syndrome, GBS, a poorly understood condition in which the immune system attacks the nervous system, sometimes resulting in paralysis. The clinical presentation of Zika is similar to many other tropical diseases such as Malaria, typhoid fever common cold or another mosquito-borne disease. This usually makes its diagnosis often difficult.
Although two African countries have reported Zika infection in the recent outbreak and in the past, many others, causal relationship between Zika virus infection, birth defects and neurological syndromes has not been established in this continent.
There is, as of now, no known specific treatment for Zika virus disease. Treatment is therefore generally supportive and it include rest, fluids, and use of pain killers and antipyretics. In a pregnant woman with laboratory evidence of Zika virus in serum or amniotic fluid, serial ultrasounds should be considered to monitor fetal anatomy and growth every three to four weeks. Referral to a maternal-fetal medicine or infectious disease specialist with expertise in pregnancy management is recommended.
Professor Adewole said despite the fact that some Nigerians are immune to the Zika virus infection as demonstrated by previous studies, it is important and advisable that Nigerians should be careful and protect themselves from mosquito bites.
“There is no vaccine for Zika virus, and no cure other than rest, plenty of fluids and perhaps over-the-counter medication to reduce fevers, aches and pains as previously mentioned. This therefore means that prevention is most effective means of preventing transmission.
“I advise all Nigerians, particularly pregnant women to avoid travelling to countries infected by this virus in these periods. If however, you are to visit any country where Zika virus is now being actively transmitted, you are advised to protect yourselves from mosquito bites. Pregnant women considering travel to affected areas may wish to consult their health-care provider prior to travel and after return. They should also practice personal and household steps to prevent mosquito, including putting mosquito repellant on their clothes and skin, wear long sleeves and pants, and sleep underneath mosquito nets at night, where possible. I wish to call on all Nigerians to support our pregnant women and help them access anti-mosquito repellants,” he said.
He advised all States of the Federation to immediately embark on health education campaigns to empower communities take actions to protect themselves from Zika Virus as well as other mosquito-borne diseases.
“Nigerians returning from these countries should report themselves to any nearest health centres if they start to feel any sickness that requires care, and such a person should inform the healthcare workers about their travel history. I have instructed the Port Health Services of my ministry to immediately adjust and include points of entry screening to capture anti-Zika activities.
“The Federal Ministry of Health shall collaborate with Ministry of Environment to embark immediately on mosquito population reducing campaigns that will include the use of larvicide (insecticide that kills the mosquito in its larval stage).
“The National Centre for Disease Control, NCDC, has been directed to enhance Zika virus surveillance activities and work with the Arbovirus Research Centre, Enugu to embark on extensive vector control and research activities to confirm the current circulation status of both Zika virus and the mosquitoes that spread it,” the minister said.
The NCDC has activated EOC on Zika to specifically focus on transmission to track Zika virus in communities and in mosquitoes. “Healthcare workers are to report any illness in pregnant women with symptoms similar to any haemorrhagic fever, any birth defects, particularly microcephaly to the State Epidemiologists and the NCDC,” Adewole said.
The NCDC is to expand the field epidemiology training programme, laboratory testing, health care provider training, and vector surveillance and control in at risk areas for Zika virus transmission. All laboratories currently testing for other haemorrhagic fever viruses should include testing for Zika virus also.
He called on all Nigeria’s partners to support the efforts at preventing this new scourge from entering the country.
He also enjoined Nigerians to remain calm and remain vigilant and report any suspected case of an acute febrile illness in pregnant women in particular to any nearest health facility.
“The public is also called to maintain good individual and “community hygiene” to discourage creation of mosquito breeding grounds near homes and nearby surrounding. All States are called upon to commence anti-mosquito campaign including engaging the services of sanitary inspectors with their appropriate deployment. All health facilities in the country are hereby directed to emphasise routine infection prevention and control measures and ensure all pregnant women recive special attention and are treated free, in case of presentation with symptoms similar to any viral haemorrhagic fever,” the minister said.
As of today Brazil and Columbia have been the most affected countries with an estimated cases ranging between 600,000 and 1,700,000.
Nigerian scientists working in Western Nigeria in 1954 discovered Zika virus in Nigeria. Further studies in the years 1975 to 1979 showed that 40 percent of Nigeria adults and 25 percent of Nigerian children have antibodies to Zika virus, meaning they are protected against this virus.
Nigeria’s ministry of health commissioned a novel call-in centre established within the NCDC with specific centre call-in number for handling epidemics and health emergencies. The minister advised that any suspected case can be referred to this centre via these numbers: 097000010-19. This centre shall also provide the NCDC the opportunity for improved coordination with the various States, the FCT and our partners.
“The Lassa Alert system just established is also being deployed to operate the Zika prevention activities throughout the year. All Polio EOC Centres are also directed to activate all their surveillance system in the country to compliment NCDC activity.
“The Federal Ministry of Health, with full cooperation and involvement of our partners and the private sector, shall mobilise all resources to ensure enhanced readiness and effective prevention and control measures. I therefore seek for your full cooperation in this fight to see that we keep you all safe and healthy,” Professor Adewole said.
— Feb 22, 2016 @ 01:00 GMT