Need For NCDC To Emulate Ghana’s Health Service In The Fight Against Marburg Virus

By Isaac Asabor

It is not an exaggeration to say that one of the biggest lessons of the Covid-19 pandemic is that speed matters. The window of opportunity to find and stop a rapidly spreading virus is vanishingly small and intolerant of mistakes. To aptly put it, virus moves faster than you think. Amidst the heightened days of the COVID-19 pandemic in 2020, Jeremy Farrar, Director of the Wellcome Trust, which funds health-related research, said, “Acting late is a disaster”. Since the world began to witness the prevalence of the COVID-19 pandemic, how far and how fast the pandemic could spread is by each passing day become explanatorily becoming crystal clear. Since the pandemic became a health issue to humanity, particularly in this part of the world, the unspoken question on everyone’s mind, has been “How fast can the virus spread? Without doubt, the answer to the question is what most of us cannot answer as we are bereft of good intuition in that regard. However, the reason cannot be farfetched as the problem is that our human brains tend to extrapolate in a straight line from recent experience, but infectious diseases spread exponentially.

At this juncture, not few readers of this piece may have been wondering on why I am directing the call to the Nigeria Centre for Disease Control (NCDC) given the fact that I recently wrote an opinion that tasked the leadership of the Centre to take its fight on virus diseases beyond COVID-19 which it is popularly known for by not a few Nigerians. The opinion article titled, “Tasking NCDC to Function beyond Fighting COVID-19”, and published few days ago.

It is expedient to say that the rationale for making another call to the Centre cannot be farfetched as the NCDC is the country’s national public health institute, with the mandate to lead the preparedness, detection and response to infectious disease outbreaks and public health emergencies.

Again, I am directing the call to NCDC as it stands as the only health authority in Nigeria that can emulate the Ghana Health Service (GHS) in putting strategies in place to adhere to safety measures to prevent Marburg disease.

According to the World Health Organization (WHO), “Marburg virus disease is a highly virulent disease that causes hemorrhagic fever, with a fatality ratio of up to 88%. It is in the same family as the virus that causes Ebola virus disease. Two large outbreaks that occurred simultaneously in Marburg and Frankfurt in Germany, and in Belgrade, Serbia, in 1967, led to the initial recognition of the disease. The outbreak was associated with laboratory work using African green monkeys (Cercopithecus aethiops) imported from Uganda. Subsequently, outbreaks and sporadic cases have been reported in Angola, Democratic Republic of the Congo, Kenya, South Africa (in a person with recent travel history to Zimbabwe) and Uganda. In 2008, two independent cases were reported in travelers who visited a cave inhabited by Rousettus bat colonies in Uganda.

“Human infection with Marburg virus disease initially results from prolonged exposure to mines or caves inhabited by Rousettus bat colonies. Once an individual is infected with the virus, Marburg can spread through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids”.

The Ghana Health Service (GHS) has asked regional and district health facilities, as well as public health emergency management committees, to include the Marburg viral disease on their agenda by way of preparedness and response plan to contain the Marburg virus following a confirmed case of the Marburg virus in neighboring West African country, Guinea, in which the victim a victim has reportedly died of the deadly disease. The media reported few days ago that besides, facilities at all border posts, including port health units, particularly those along the western border and all landing beaches, are to heighten surveillance for Marburg.

The GHS has in the same vein indicated that the Noguchi Memorial Institute for Medical Research has the capacity to confirm the Marburg virus and those samples from suspected cases could be transported there, and has warned that under no circumstance should a public or private transport be used in transporting a suspected Marburg case; rather the respective District Directors of GHS should be contacted for the transfer of such persons to a health facility.

Again, it was explained that the Marburg virus disease can be transmitted to people from fruit bats and spreads between humans through the transmission of bodily fluids and that it is a severe, fatal illness with symptoms including headache, fever, muscle pains, vomiting of blood and unusual bleeding.

In the same vein, the media which conveyed preventive measures about the disease reported that “The preventive measures include avoidance of contact with body fluids (such as urine, saliva and sweat of people who show symptoms; hand hygiene; and not handling items that many people have come in contact with and dead bodies, including participating in ritual for the funeral or burial of suspected or confirmed Marburg cases.

“The last piece of advice is that we should seek medical care when we develop fever or show other symptoms.

As reported in one of the country national newspapers, it was stated that it would continue to commend the leadership of the GHS for giving timely information on diseases, more especially infectious ones like the COVID-19 pandemic, to guide healthy public behavior.

The Ghanaian media, particularly as reported by the Ghanaian Times said the biggest problem in healthcare is the ‘health misbehavior’ of people, including the patient in some cases. It stated in its report with the headline, “Adhere to safety measures to prevent Marburg disease, adding that “We have seen this in the refusal of people to adhere to the COVID-19 safety measures.

“Medical history has it that infectious diseases, whether endemic or pandemic, are not new in these days. The literature says the Plague of Justinian (541–542 AD) was the first known pandemic on record.

“The smallpox, for example, is said to have killed more people than all the wars in history, but today it has been eradicated alongside the 1918 influenza pandemic and other such diseases”.

At this nexus, it is expedient to say that this call could not have come at a better time, particularly as not few Nigerians are now aware that the mission for the NCDC is ‘To protect the health of Nigerians through evidence based prevention, integrated disease surveillance and response activities, using a one health approach, guided by research and led by a skilled workforce’.

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