Every day we read about huge outbreaks of vaccine preventable diseases on pages of newspapers. Yellow fever is one of the vector borne, vaccine preventable diseases that is endemic in Nigeria and has been a source of persistent concern over the years, given that we have a very effective vaccine, available at no cost to patients in every public health care centres in Nigeria. The latest outbreak was in some local governments of Katsina State, with a lot of reported deaths. It’s not something new to us, yet it still catches many of us unaware.
In the last five years, Nigeria was faced with several outbreaks of Yellow fever, Lassa fever, Cerebrospinal Meningitis, Cholera, Ebola and Monkey pox. The outbreak of Yellow fever in Nigeria is reported to have occurred over 30 years ago. A multi-agency national emergency operations centre is coordinating the national response with some sister agencies: the national and state Primary Heath Care Development Agency which has been pushing very hard to increase routine immunization coverage rates in the country.
A vaccine-preventable disease which a single shot of the vaccine protects for at least 10 years or a lifetime, is an endemic viral disease in tropical areas of Africa, an acute viral hemorrhagic disease transmitted by infected mosquitoes usually the Aedes species, from person to person. The “yellow” in the name refers to the jaundice that affects some patients. Symptoms include fever, headache, jaundice, muscle pain, nausea, vomiting and fatigue.
Is our changing climate contributing to flare-ups of infectious diseases? Climate change presents a clear and present danger to human health. Climate plays an important role in the seasonal pattern or temporal distribution of diseases that are carried and transmitted through vectors because the vector animals often thrive in particular climatic conditions. Health impacts are already being demonstrated in Nigeria, climate variability and extreme weather events drive the increase in the frequency and intensity of mosquito-borne diseases. When rains do come, they unleash several years’ worth of mosquito offspring. Once the mosquitos have infested much in that area, it’s typically not long before a serious mosquito-borne disease outbreak takes place.
Under extreme climate changes, particularly rainfall and temperature can also impact both mosquito life cycle and viral replication as well as some other factors such as deforestation, lack of immunization, accelerated urbanization, high mosquito density, low population immunity, and limited mosquito control resources which puts us at imminent risk for widespread and deadly yellow fever outbreaks.
What this tells us is the need to increase awareness and advocacy on the prevalent of this disease and the role of climate change which is of crucial importance. Much can be done to prevent and mitigate the health impacts of climate change, timely information on an impending outbreak which helps the implementation of control measures and risk communications.
Also, we should have an effective epidemiological surveillance system which is well monitored such that outbreaks of diseases can be detected and controlled at the local government level before they snowball into a national emergency. State ministries of health should have their internally developed protocol for responding to these outbreaks with support from the federal government.
There are exciting times ahead in the fight against disease outbreaks and epidemics especially at a time when donor nations are curtailing spending. Now is the time for the Nigerian government to fund early detection and prevention of epidemics. Preventing epidemics before they start saves the government money and improves the health of all Nigerians. We must stop the hawking and selling of fake Yellow Fever cards to passengers at international airports in the country. We must also start thinking ahead and increase funding at the community, local, state and national level to shore up health systems and prevent the spread of outbreaks.
Katsina State and many others have launched the mass injectable yellow fever vaccine program which is now active and managed by the Primary Health Care Development Agency in hospitals, schools, mosques, churches, markets, motor parks and other places. We know that there will be more outbreaks of current disease, new emerging disease threats and re-emergence of those threats we thought we have eliminated. So we need to also increase community to community sensitisation and social mobilisation, increase surveillance, strengthen routine immunizations services and entomological surveys.
We have all it takes. There is no excuse for being caught unprepared. Let’s all advocate for more support! Yellow fever could be near you. Get vaccinated today.
Yusuf Hassan Wada, a Public Health Advocate, wrote from Usmanu Danfodiyo University Sokoto