THE RESURGENCE OF YELLOW FEVER

All Nigerians should be vaccinated against the disease

Victims of the yellow fever disease are on the rise. As of 30th August, a total of 84 suspected cases, including 26 deaths had been reported across nine local government areas in Ebonyi State. This was followed by the alarm of another resurgence of the disease by the executive chairman of Bauchi State Primary Health Care Development Agency, Dr. Rilwanu Mohammed. Nigeria has been experiencing sporadic outbreaks of yellow fever since September 2017 when the first case was confirmed in a seven-year-old child in Ifelodun Local Government of Kwara State. But the latest report across the nation, which indicates a high number of fatalities, is more disturbing.

The renewed spike is a wake-up call on the federal government to be more proactive in dealing with the disease. Following the fatalities recorded during the 2017 outbreak which were in dozens, more than three million people were vaccinated in an initial emergency campaign, with the aim of quickly containing it. However, the virus continues to spread in parts of the country where people remain largely unprotected. That is why all the relevant stakeholders must join hands with the government this time around.

Yellow fever is an acute viral disease of typically short duration, although it cannot be spread from one person to another. In most cases, symptoms include yellowness of the eyes, sudden fever, chills, loss of appetite, nausea, muscle pains particularly in the back, and headache. In about 15 per cent of victims, within a day of improving, the fever relapses, abdominal pain occurs, and liver damage begins causing yellow skin. If this occurs, the risk of bleeding and kidney problem also increases. But fortunately, the disease is a vaccine-preventable one. It is also curable with vaccines known as 17D.

Since yellow fever is a completely vaccine-preventable disease and a single shot provides immunity for a lifetime, it is important that all Nigerians should be vaccinated. An added advantage is that the vaccine is freely available in all primary health care centres in Nigeria. Available information indicates that there is a global stockpile of vaccine meant for yellow fever outbreaks. Since we live in the tropics, and cannot completely eliminate mosquitoes, prevention remains the most potent weapon against the disease. It is therefore trite that the common aphorism that prevention is better than cure should be embraced by all.

The interruption of regular mass vaccination campaigns in Nigeria has contributed mainly to the current resurgence of yellow fever. On the continent, the resurgence started in equatorial Africa, followed by Cameroon where no fewer than 173 fatalities mostly children under the age of 10 were recorded in 1990. The disease then moved to West Africa and since 1995 this has been the region most affected. To control the spread, there is an urgent need to commence a massive reintroduction of the vaccination programmes, especially at child birth. This should be done through enlightenment campaigns throughout the local governments of the federation.

By accident of geography, Nigeria is one of the diseases’ high risk countries in Africa, and is transmitted from an infected person to another through female mosquito bite. The federal government should show readiness in ensuring local production of vaccines, as well as commit to establishing a reference laboratory in the country soonest to reduce the challenges with sample transportation and laboratory turnaround time in the current outbreak across the country. These steps, we believe, will ultimately reduce the response time and consequently the morbidity and mortality rates in the present situation. The current outbreak is another sad commentary on the nation’s tepid health sector, and it must be stopped from becoming another epidemic.