Climate change, Ebola and Lassa fever

By Greg Odogwu

 

For those who still doubt the reality of a warming Earth, there is now undeniable evidence that global temperatures are increasing. Of course, no one would now give the excuse that the statistics authenticating climate change are based on scientific mumbo jumbo; they are now based on direct temperature measurements and observations of other impacts such as melting glaciers and polar ice, rising sea levels, and changes in the lifecycles of plants and animals.

And the sad truth is that it is having far-reaching consequences for every aspect of life – food, water, air and governance. Higher temperatures have not only affected health, education, food production, energy and water supplies, but all these and other sectors have affected one another. This costs the world a great deal; but it is vital that global health interventions recognise and factor in these inter-sectoral impacts in emerging strategies.

Significantly, the health sector seems to be most affected because of its peculiar fundamental concerns. Alarming figures from the World Health Organisation’s recent study show that seven million people died in 2012 because of air pollution. Another WHO study captured in the recently released Intergovernmental Panel on Climate Change report, shows that climate-altering pollutants cost the world $1.9trn every year, taking into account money spent on health interventions. Besides respiratory diseases like asthma, studies have shown a link between air pollution and heart disease and cancer – visible traumas springing from climate change.

Today, some other diseases have joined the litany of climate change influenced maladies. Recently, the Wildlife Conservation Society released a report whereby it enumerated about 12 diseases likely to get worse as a result of climate change. The “deadly dozen” include Bird flu, Babesiosis, Cholera, Ebola, parasites, Lyme disease, Plague, Red tides, Rift Valley fever, Sleeping sickness, Tuberculosis and Yellow fever.  The WCS was quoted as saying that to prevent these ailments from becoming as destructive as the “black death” (which wiped out a third of Europe’s population in the 14th century) or the flu pandemic of 1918 (which killed an estimated 20 million to 40 million people worldwide, including 500,000 and 675,000 people in the US) the world should vigorously engage in monitoring wildlife to detect signs of these pathogens before a major outbreak.

Now, let us concentrate on the hemorrhagic fever, Ebola. Ebola is a deadly viral disease characterised by massive bleeding and destruction of internal tissues. It can be highly contagious through contact with infected bodily fluids; it has a very high fatality rate of about 90 per cent. The virus is lethal to both humans and other primates, and has no cure. In addition, it is unclear where the disease, which causes fever, vomiting and internal or/and external bleeding, comes from – though scientists suspect fruit bats. Ebola virus is named for the Ebola River in the Democratic Republic of Congo, where it was first identified in 1976. Since then, it has visited Africa off and on, killing thousands in its wake. As you read this, fresh cases detected weeks ago have killed about a hundred people in Guinea, with similar outbreaks recorded in neighbouring Liberia and Mali.

Interestingly, in as much as the definite vector of the virus is not known, what is clear is that outbreaks tend to follow unusual downpours or droughts in central Africa, which is a likely result of climate change. This also makes the scourge dangerously unpredictable; because climate change is a risk factor which the whole of tropical Africa faces and which effectively puts all of us at risk.

To illustrate, a research published as far back as 2006 in the journal, “Transactions of the Royal Society of Tropical Medicine and Hygiene”, asserted that Ebola outbreaks would worsen with global warming. The researchers reported that, “Illness and deaths among animals were most prevalent during periods of prolonged drought-like conditions in the rainforest, which indicates that severe environmental stress may facilitate disease transmission.” The study later concluded that with some climate models projecting drier conditions in Central African rainforests due to climate change, it was possible that incidences of Ebola could increase in the future. This is a very remarkable conclusion because current Ebola outbreak has justified the study.

For us in Nigeria, we still have Lassa fever to grapple with. Named after a village in Borno State where it was first detected in 1969, Lassa fever remains that dreadful viral epidemic that keeps visiting. Ebola and Lassa fever are part of a larger group of viral haemorrhagic fevers and are the two most important ones epidemiologically in the tropical African context. However, in as much as Ebola is rapidly lethal and is dramatically perceived as a global plague because of the international attention, Lassa fever is much more endemic.

The case fatality rate of Lassa fever is only around one per cent, but the disease claims more lives than Ebola fever because its incidence is much higher. It is estimated that there are 300,000 infections and 5,000 deaths per year. Just last year, when Lassa hit about 13 Nigerian states, the Chief Medical Director of Irrua Specialist Hospital Benin, Prof. George Akpede, said there had been 60 per cent increase in suspected cases and 80 per cent increase in confirmed cases across the country. He said more than 51 million Nigerians were at risk with the annual number of illness estimated at 3 million and the annual number of deaths estimated at about 58,330.

Therefore, I think it will serve Nigeria better to concentrate on improving on the widely faulted strategies deployed in tackling Lassa fever. Perhaps, as we gird-up for Lassa fever, we would in the same gear be getting ready for any potential Ebola threat.

What should our government do? Firstly, instead of the knee-jerk approach the government used in constituting the Ad hoc/Emergency Rapid Response Committee months after Lassa fever hit town, it should constitute Standing Rapid Response Committees immediately, for both Lassa and Ebola. Secondly, Nigerians should be exposed to the truth that bush burning triggers these deadly vector-borne diseases, as animal carriers could be chased out of their habitats into our own abodes thereby infecting us.

Thirdly, Nigeria has poor disease surveillance infrastructure, and this is disturbing; we must improve on disease surveillance across the length and breadth of the nation. Fourthly, our education system has to be strengthened with relevant animal-related research courses. In fact, right from secondary school, students should be encouraged to embrace such courses. The situation whereby everyone wants to study medicine; and only drop outs and “second-choicers” are herded into courses like Zoology, Animal Science, Veterinary Medicine and Laboratory Science, is a sad one. This has to stop; so that our government’s critical epidemic research-response institutions will have a crop of “genius cadre” in its ranks.

Fifthly, government must establish laboratories for epidemiology and animal health inspection and research, equipped with ultra modern instrument and manned by well-motivated staff. Finally, we must not lose sight of the fact that NIMET’s recent 2014 prediction of reduced rainfall does not only have an inherent food security signature in it; therein embedded is a potential epidemic threat! Ebola is known to move in such tropical wet-to-dry seasons; and Nigeria, being a nation with porous borders and on-the-move populace, cannot afford to be caught unprepared.