Zika virus is back on the global radar. With confirmed cases in the most populated countries in the world, China and India, concerns raised over Nigeria’s Zika virus preparedness since the most recent update was issued 2 years ago. Furthermore, Zika virus disease is not on NCDC’s directory of diseases that affect Nigerians although it had previously affirmed that Nigeria is at risk of the Zika virus disease.
In its ZIka virus risk assessment for Nigeria, the NCDC stated: “NCDC plans to initiate surveillance to understand and monitor the epidemiology of Zika virus in Nigeria for the appropriate interventions.” But there has not been any official publicly available publication on the disease since.
Zika is back
Late October 2018, Chinese Customs Authorities reported they had detected the first case of imported Zika virus in 2018 in a man who had recently traveled to the Maldives. The tourist showed symptoms including a fever and rash when arriving at Baiyun International Airport on Oct. 19 in Guangzhou, south China’s Guangdong Province, according to the General Administration of Customs (GAC).
Alarmed customs staff arranged a medical examination and found him Zika-positive two days later, the GAC said in an online announcement without identifying the patient, who was later quarantined at a local hospital.
In a similar way, few days ago, the Zika virus disease reemerged in India with over 20 cases confirmed already thus raising concerns about Nigeria’s preparedness to prevent and contain an outbreak.
Zika is different
The well documented Zika virus experience in Brazil and across Latin America can be seen as a good overview of a classical outbreak of Zika virus disease.
Between 2014 and 2016, a virus spread quickly through the Brazil and other Latin American countries, called Zika virus. Since it usually has very mild, or no symptoms, it took about a year for Brazil to confirm the first case of the disease. By then the outbreak was already widespread.
It was not labelled a public health emergency until February 2016 when microcephaly – which is when infants are born with small heads with permanent brain deficits- and other neurological sequelae were noted in babies born about that time.
The factors associated with the rapid spread of Zika virus in Brazil such as a population that may be non-immune, a high population density, a conducive climate and inadequate control of Aedes mosquitoes could also describe why many African countries are Zika virus-prone zone today. Most of West Africa is at risk of Zika virus including Nigeria, Ghana and Guinea Bissau.
An invisible epidemic
In April – June 2016, just as the outbreak in Brazil was spreading, cases of Zika virus infection and microcephaly in infants were reported in Guinea Bissau.
In a 2017 Lancet article on the extent of Zika virus in Africa, about 6 out of 100 blood samples tested from people with fever in Senegal and Nigeria tested positive for the Zika virus infection. Zika virus was called the ‘invisible epidemic’ in the Lancet article.
Many individuals that are infected with Zika virus won’t have symptoms. Even if they do, it will only be mild symptoms and people rarely die of it.
The most common symptoms of Zika are fever, rash, headache, joint pain, red eyes and muscle pain. In fact, the grave public health significance attached to Zika virus is because of the chance of Zika infection during pregnancy leading to the Zika virus congenital syndrome where babies are infected in the womb and are born with microcephaly and other severe brain defects. It is also linked to other problems in pregnancy, such as miscarriages and stillbirths.
There is no vaccine to prevent Zika. Preventing an outbreak requires mounting an ongoing surveillance for the disease.
Nigeria is not tracking Zika virus
The most recent information about the Zika virus in Nigeria that is available on the official website of the Nigeria Centre for Disease Control which assessed the possibility of the Zika virus outbreak and proposed recommendations for prevention was released 2 years ago and there has been no update since then. You can read it below.
In addition, the regular disease surveillance updates posted on the website does not appear to track Zika virus.
If the Zika virus was described as invisible because of its silent symptoms, efforts must be made that it is not also invisible because of weak efforts and poor funding to prevent an outbreak in the population.
To prevent an outbreak and the congenital Zika virus syndrome, it is important to monitor trends in Zika virus infection. Improved emergency response in the country and disease surveillance are of ultimate importance to prevent a repeat of the Brazil outbreak in Nigeria.