The recent outbreak of yellow fever in the country is disheartening. It is a sad reminder of the inadequacy of the nation’s healthcare delivery system. It is quite unfortunate that 59 years after independence, Nigeria still lacks a comprehensive national public health system that can withstand the threat of pandemic diseases. Now that the disease has spread to Bauchi, Borno, Kano, Gombe and Katsina states, efforts should be intensified to halt its escalation to other states.
According to the Nigeria Centre for Disease Control (NCDC), the latest outbreak has killed 23 persons and infected 169 others in the affected states since the first case was reported on August 1.
The Bauchi outbreak was not an isolated one. On July 30, NCDC announced that there had been deaths from an unknown fever in Izzi area of Ebonyi State in the South East. The disease was later discovered to be yellow fever. A previous outbreak of the disease in the state caused at least 20 deaths before it was detected by the local authorities. Between September 2017 and December 2018, over 1, 900 cases of yellow fever were reported across 14 states and not less than 70 people were killed.
The yellow fever virus, which is endemic in tropical areas, according to medical experts, spreads through the bites of infected mosquitoes. There is no human-to-human transmission of the virus, but about 60,000 Africans are reported to die annually from the disease, which is common in parts of Africa and South America. Children are most at risk of the disease. Although there is no cure yet for the viral infection, the disease can be prevented with vaccine. A single shot provides immunity for life.
The symptoms of the disease include fever, muscle pain, headache, nausea and dehydration. But it can later become more serious and can lead to heart, liver and kidney problems. Yellow fever usually kills about 50 per cent of patients with the more-severe form. Once the infection enters the acute phase, patients may experience signs and symptoms that include fever, headache, muscle aches in the back and knees, sensitivity to light, nausea, vomiting, loss of appetite and dizziness, among others.
Yellow fever also has a toxic phase, which could be fatal. Symptoms of that phase include yellowing of the skin and the whites of the eyes; abdominal pain and vomiting, sometimes of blood; decreased urination; bleeding from the nose, mouth and eyes; slow heart rate; liver and kidney failure; brain dysfunction and coma.
In Nigeria, yellow fever vaccine is available for free in primary health care centres. But the country lacks the required number. The United Nations Children’s Fund (UNICEF) observes that yellow fever has remained endemic in Nigeria because the immunisation rate in the country is very low. It is believed that only four in 10 children that are two years and older are inoculated. Health experts have projected that yellow fever would continue to ravage the country until a high percentage of the population is immunised against the disease.
There is currently a global shortage of yellow fever vaccines, and that is affecting immunisation in some countries. For instance, Nigeria could have access to only 20 million doses of the vaccine, an amount far too low for the country’s 200 million people. Unfortunately, yellow fever is not the only disease killing Nigerians. Last year, the NCDC confirmed that 992 persons died of cholera, Lassa fever, yellow fever and monkey pox. The centre said cholera caused 830 deaths, Lassa fever, 149, yellow fever, 13, and monkey pox, one person.
Nigerian health authorities should tackle this perennial scourge that is fast becoming an annual menace. Every Nigerian should be immunised against the disease. Government should mount a sustained public enlightenment campaign on yellow fever, its causes, prevention measures and treatment. Government should equip all primary healthcare centres in the country, especially in the rural areas. There should be a synergy between government, the NCDC and the affected states in order to stop the disease from spreading to other states. Every suspected case must be taken to the nearest medical facility for urgent treatment.