Yellow fever widespread in communities with low immunization, however they name it bizarre illness – Punch Newspapers


Dr. William Nwachukwu, Head of the Yellow Fever Technical Working Group at the Nigeria Center for Disease Control, speaks with DAYO OJERINDE about the recent outbreak of the disease in some parts of the country

To a layperson, how will you describe yellow fever?

Yellow fever is caused by an infectious agent called the yellow fever virus. It causes a systemic disease characterized by an increased amount of virus in the blood, liver, kidney, and myocardial injury, bleeding, and high death. It is caused by the bite of a species of mosquito called Aedes spp. Caused. It shows up as yellowish discoloration of the eyes, skin, urine, and stool. The “yellow” in the name refers to the jaundice that affects some patients.

Yellow fever is not a new disease in Nigeria. Yellow fever outbreaks have occurred in Nigeria since the 19th century. Most of the ethnic groups in Nigeria have native names used to identify the disease, such as in Igbo, Orianchananya; Hausa, Shawara; Yoruba, Iba Ponju; and Ikwerre, Iba Ochananya, etc. Outbreaks had occurred until 1986, but no yellow fever outbreak was observed in Nigeria between 1986 and 2017. This resulted in low yellow fever surveillance activity and a low suspicion index among healthcare workers, poor coverage of yellow fever vaccination in the under five age group, and low herd immunity, leading to the accumulation of high numbers of susceptible people to yellow fever in Nigeria.

Is it a disease or an infection?

A disease is a disorder of the structure or function in a living cell (human, animal or plant), especially one that causes certain symptoms or affects a certain location and is not simply a direct result of physical harm. Yellow fever is a disease. An infection is the penetration of pathogens into the body tissue of an organism, their multiplication and the reaction of the host tissue to the infectious agents and the toxin they produce. An infectious disease, also known as a communicable disease or communicable disease, is the disease that results from an infection that turns yellow fever into an infection. According to the definition of disease and infection above, yellow fever is both a disease and an infection.

How do people get yellow fever?

Yellow fever is introduced into the body through mosquito bites into the skin. This spreads to the local lymph nodes where it multiplies. From the lymph nodes, the virus enters the circulating blood and is localized in some organs of the body such as the liver, spleen, kidney, bone marrow, lymph glands and heart. This can take a few days. The lesions caused by the yellow fever virus are due to the localization and multiplication of the virus in these organs.

The cells (hepatocytes) in the liver, nephrons in the kidneys, stem cells in the bone marrow, and macrophages in the spleen in the organs are affected, resulting in degeneration of these organs. The consequence of this degeneration is the formation of necrotic (dead) tissues. There is a loss of function of these organs. Jaundice due to liver damage, acute kidney failure due to kidney damage, bleeding into the body orifices due to low platelets and disorders of the coagulation system, and shock due to heart failure, etc.

Why is yellow fever always described as a strange disease when it comes to an outbreak?

We have been alerting the public since 2017, when we had yellow fever outbreaks in Nigeria, and therefore the surveillance system has a history of “strange diseases”, “mysterious deaths” and “unknown diseases”. After the investigation, we found that it affected most of those affected / individuals who had low yellow fever immunity, i.e. communities where yellow fever vaccination and other routine vaccinations were very poorly received, access to health care was poor, and symptoms to the population The health authority is also low. The only signal to the public and the health system is a strange disease, a mysterious death, an unknown disease.

What could be responsible for the recent outbreak in some parts of the country?

High vulnerable numbers of people in communities with low herd immunity; and poor reporting of illnesses to early detection and treatment facilities.

Is there any possibility that the outbreak could spread to other parts of the country?

Experience has shown that a yellow fever outbreak in one place spreads to nearby locations (LGAs or states). When we had the first outbreak in 2017, which started from Kwara State, other states were affected, such as Kogi, Zamfara, Kebbi, Katsina and Niger; it also led to outbreaks in the FCT and Nasarawa.

In 2018 we had an outbreak in Edo; other related LGAs / states were affected (Delta and Ondo). In 2019, Bauchi had clusters of outbreaks that also included other states including Kano, Gombe, Plateau, Katsina, Borno, etc. Similarly, there is a tendency for this current outbreak to spread to other LGAs / states, that go beyond what we have now. However, in 2017 only three states – Nasarawa, Cross River, and Akwa Ibom – had nationwide mass vaccination. But now more states have been covered with yellow fever mass vaccination campaigns, which means the spread may be limited.

Is it true that there is no cure for yellow fever?

Yellow fever is a viral disease and most viral diseases are incurable. So also yellow fever; It doesn’t have a specific drug for its treatment. There is currently no specific antiviral drug for yellow fever. However, yellow fever is treated if the patient reports to health care facilities early on. Good and early supportive treatment in hospitals improves survival rates. Specific care to treat fever, dehydration, liver and kidney failure will improve results. Associated bacterial infections can be treated with antibiotics.

What are the symptoms of the disease?

The first symptoms of yellow fever may be sudden onset of fever, flu-like symptoms, chills, nausea, vomiting, headache, back pain, general body pain, and tiredness. Most people recover from the phase. In the late stage of yellow fever infection, approximately 15 percent of cases develop a more severe illness characterized by high fever, jaundice (yellowing of the eyes, skin, or both), bleeding (bleeding) from multiple parts of the body, circulatory shock, and bleeding from multiple organ failure (particularly liver and Kidneys). About 25 to 50 percent of those who develop serious illnesses can die from yellow fever

Why is the disease so deadly as it is caused by mosquito bites?

The main reason it seems fatal is because most people affected have low immunity to yellow fever and report to health facilities very late and some don’t report all until after they die.

How can the disease be prevented?

By vaccination. A single dose of yellow fever vaccine is enough to ensure sustained immunity and lifelong protection against yellow fever. This is done through improved yellow fever vaccination (routine immunization, reactive and preventive mass vaccination campaign). It can also be prevented through good environmental hygiene by removing mosquito breeding sites. Protection against mosquito bites; Use of mosquito repellants; Wearing light-colored, long-sleeved clothes outdoors; Avoid wearing perfume or cologne (some of which can attract mosquitos); Prevent mosquitoes from entering your accommodation; Use of mosquito nets (LLINs) at night when mosquitoes are likely to be present; Protecting travelers by ensuring that every prospective international traveler has a valid yellow fever vaccination certificate; good vector control; and reporting cases to health care facilities early on.

In some situations, the infection can be so mild that it cannot be recognized by the individual, while in some severe cases it can be fatal. The outcome in this case can be either death or life. For those who survive the infection, there are consequences or complications, which means that the individual makes a full recovery. ,, ,,.

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