Containing disease outbreaks in Nigeria through continuous surveillance, research

Four years after the first Ebola case was reported in Nigeria on July 20, 2014, several researches are ongoing to discover cure as well as prevent further infectious disease outbreaks and epidemics in Africa.

Nigeria has been charged to strengthen efforts to avert emerging or reemerging pathogens of Lassa fever, Human Immuno-deficiency Virus (HIV), Ebola Virus Disease (EVD) and Zika virus.

This followed several studies carried out in different parts of the country to boost and strengthen Nigeria’s preparedness towards further disease outbreak, which showed that the human immune system is increasing with a complex array of cell types that in principle are responsible for containing foreign infectious disease pathogens.

The studies also revealed that the immune-pathogenesis of the pathogens would promote understanding of the infectious disease development and improve prospects for effective diagnostics, drugs, treatment and vaccines.

The study by a professor of Immunology and Infectious Disease at the Harvard School of Public Health and co-discoverer of HIV2, Prof. Phyllis Jean Kanki, conducted on survivors and exposed contacts, using the T cell based assay, immune system sentries CD4 (helper) and CD8 (killer) responses to EBOV proteins such as glycoprotein and viral protein 40 (VP40), showed that it could be recognised in an immunoblot (analytical technique) and also responsible for decreasing the virus viremia as well as limiting the disease consequences in contrast to those that develop full blown disease.

Viremia is a medical condition where viruses enter the bloodstream and hence have access to the rest of the body

Kanki, while delivering a lecture on disease outbreaks and epidemic management, at the University of Lagos (UNILAG) maiden Pro-Chancellor yearly Lecture Series, titled: “Responding to Nigeria’s Diseases Outbreak and Epidemics: Ebola, Zika and HIV,” said Ebola virus is a Ribo Nucleic Acid (RNA) Filovirus that is no stranger to the African continent, with Nigeria having a long history of infectious disease outbreaks and epidemics, such as meningitis, Lassa fever, avian influenza, Ebola virus, Zika virus and the HIV.

The lecture came about four years after the first Ebola case was reported in Lagos on July 20, 2014.

Kanki said the studies performed in nonhuman primates showed that candidate EBOV vaccines require a strong antibody response in order to contain the virus, but that the T cell response is critical and required for protection.

A T cell, or T lymphocyte, is a type of lymphocyte (a subtype of white blood cell) that plays a central role in cell-mediated immunity.

She added that the T cell responses have been used previously in her laboratory to study HIV-2 in measuring HIV-1, noting that although, the T cell responses to EBOV have been previously documented in those patients with the disease, it was the first study to show its responses in asymptomatic individuals.

Meanwhile, Kanji said studies were conducted to determine if Zika virus was still circulating in West Africa, as it was estimated that 450 million people lived in areas suitable for Zika transmission, with 112 million of that number living in Nigeria.

She said the T cell response test showed that Zika virus and Dengue virus continues to be an endemic flaviviruses spread by mosquitoes and a number of human pathogens.

Flavivirus is a genus of viruses in the family Flaviviridae.

This genus includes the West Nile virus, dengue virus, tick-borne encephalitis virus, yellow fever virus, Zika virus and several other viruses which may cause encephalitis, as well as insect-specific flaviviruses (ISFs) such as cell fusing agent virus (CFAV), Palm Creek virus (PCV), and Parramatta River virus (PaRV).

She said there are an estimated 400 to 600 million infections on a yearly basis, with clinical manifestations ranging from mild fever, arthralgia, headache, maculopapular rash (a flat or raised red bump on the skin) to haemorrhagic (characterized by bleeding) fever and death.

The virologist noted that due to the similarities with other fever causing pathogens, it is often misdiagnosed.

“We did our study in Jos and we actually found about five percent of people with fever of Zika virus, so it is already there.

We detect it through the blood sample, urine or saliva.

There are different tests that can be done, but we need to have them put in place on a regular basis, so that we can have surveillance throughout the country,” she stressed.

Kanki said with the research findings on the three pathogens responsible for epidemics or outbreaks in Nigeria, there is need for continuous research on the immune-pathogenesis and continuous surveillance, which is key to the public health of Nigeria for emerging or reemerging pathogens of the infectious diseases.

She added that further observations showed that there should also be continued surveillance of HIV drug resistance to help evaluate the quality of treatment programme and inform rational health policy.

Commending the studies, the Minister of Health, Prof. Isaac Adewole said Nigeria is open towards partnership to ensure it averts future occurrence of diseases outbreak and epidemic.

“Talking about Nigeria disease outbreak and epidemic, it needs serious intervention and help because we are interested in protecting the health of the nation.

The world is undergoing a major transformation for quite a number of reasons, one, there is global warming and two there is increase of transportation, and therefore any disease outbreak in one part of the world could easily transported to another part of the world.

“The concerns now at the World Health Organisation (WHO) headquarters is that, we must prepare for Lassa fever, Ebola, Zika virus, HIV and what we do not know is the nature of outbreaks and where it will start…”