Tuesday 5 August 2014

Ebola, not in Akwa Ibom: What government is doing - Dr. Ememabasi

Ebola, not in Akwa Ibom: What government is doing  - Dr. Ememabasi

Dr EmemAbasi Bassey is one of the busiest commissioners in the Akpabio led administration. His tight schedules are not because of Politics but because of Work and services to the Akwa Ibom People. This explains why he resumes at his Duty Post early and closes late

He is one man that has been able to justify his appointment as the commissioner for Health. He represents the brand of Health practitioners that will transform the Health Sector of Akwa Ibom State in no distant time from now. He has manged to work so far without distractions at least for now. He had avery late breakfast interview with THE INK Newspaper in his office last Thursday were he spoke extensively on the dreaded Ebola Virus Disease and explained that the scourge is not in the State. He made known Government efforts to tackle it. Excerpts. 

 This Ebola virus of a thing is creating panic in Akwa Ibom state, please enlighten the reading public.

I will not say it is creating panic in Akwa Ibom state because it has not yet arrived Akwa Ibom State, in fact I think it is one case that has been documented in Nigeria, and that was a migrant from another country. But nevertheless, people have grounds to be anxious and I will emphatically say that the state government is doing everything possible to ensure that if in event we have outbreak in the state, it will be contained.

But to go back to your original question, what is Ebola? Ebola is a virus that was first discovered in the central Africa, what is known as Zaire, what is now known as Congo many years ago but it has actually been restricted to Central Africa and this is the first time that it has been reported outside Central Africa and the outbreak has occurred in west Africa and I will say that this present outbreak is the most dangerous. As we speak now three countries Liberia, Guinea and Sierra Leone, there have a lot of reported issues and over 600 people have died so far and a large portion are care givers and when we say care givers we mean health workers and maybe immediate family members caring for the infected persons.

What is the mode of transmission of this disease?

The reservoir of the infection is actually the fruit bats and also the primates, monkeys, apes and chimpanzees those are the major reservoirs of the infection and human beings have probably contacted them through these things we call bush meats especially the under cooked bush meats I am not saying don't eat bush meat. The emphasis here is under cooked bush meat, even though the outbreak from West Africa was not necessarily from that. The problem would have been a traveler from Central Africa and it has spread. It is a very highly contagious disease, as I said before, it is a virus.

Sorry sir before you continue let us talk about bush meats; you mentioned apes and monkeys have you considered Grasshoppers and other groups of Animals classified as Bush meats?
For now I cannot categorically say that these ones you mentioned could transmit the disease. I am just talking about the known reservoirs but don't forget that a lot of the rodents could actually eat the bone or skeleton of someone who was infected and actually died of Ebola and they could be infected. What we are talking about is the known reservoirs. What we are talking about now is bush meat of any kind now because when you go to buy bush meats you may not even know what kind of meat it is. What we are saying now is that if you want to eat bush meats it should be very well cooked, some people have even gone a step further that you should avoid suya, well, I don't know about that, what I am telling you now is what we have in literature. When we are talking about cooking of bush meat we mean cooking it for quite sometimes for the heat to penetrate the interior and also raise the core temperature to that of the high temperature. Cook it until it is well done.

Ebola is also transmitted through human contacts, what I mean by human contact is somebody who is infected and actually took ill with Ebola can actually transmit the disease through his body secretion or fluids, for example, saliva, semen, sweat even the blood of someone who is actively ill with the virus and not just anybody.

Does it mean someone who is not actively ill cannot transmit the Virus?
For now I am stating what we have in Literature, we are not saying you should find out who is and who is not actively ill but we are saying take precautions.
Ebola has an incubation period from the time you come in contact with it to the time you get ill, an incubation period can be anything between 2 and 21 days, averagely it is between 68 days. An incubation period is the time the virus enters your body and starts multiplying before you now get the symptoms that is what we refer to as incubation period. 

The interesting thing is that after the person falls ill, the symptoms are as if the person is having malaria because you have all the symptoms that someone with malaria will probably have; headache, fever, abdominal pains, weakness, vomiting and loss of appetite. But then the core Ebola the hemorrhagic fever- hemorrhagic means bleeding that is the only distinction. That means that the person will now bleed both internally and externally. He could bleed inside and outside, the person will usually die because of this bleeding. So that is one of the major challenges. It is a disease that has no known vaccine or treatment.

How will you know you have come in contact with the disease?
You will never know you have come in contact with an Ebola virus carrier. What you have to do is to be careful and like I keep on telling you it is only one reported case of Ebola in Nigeria. If and when it does come to Nigeria, we will need to change the life style of the people at least for the period of time when the epidemic is ranging. You will not know that someone has Ebola by just looking at him. As I told you the symptoms are almost the same as malaria, typhoid and fever. You know the millions of people in this country that has malaria and that means you will have to start running away from everybody? No,. But like I said, Ebola has no known cure, so what we as Doctors do are simply supportive. We are trying to support the person hoping that the disease will run its course and the person will survive, there are people who have survived it in Central Africa. In some places there are saying 90% mortality rate while some are saying 60%. What we do is supportive hoping that the person will recover and that the person's immune system will be able to fight and support the person so he or she will eventually overcome that virus.

Basically how do we prevent ourselves?
I want to state categorically that Ebola is not air borne; it has to be by contact with secretion and fluid. We don't want people to go about in the street and wear mask.

Also it cannot be transmitted through exchanging of money or even in swimming pool and so on. What we advise people to do is to go back to the basics that is when you shake hands with people continuously try and wash your hands as much as possible. Then to the care givers they must be some sort of barrier between them and the infected person.

Most of the many viruses are very fragile, it can be killed easily by heat, even exposure to sunlight can kill it, and bleach can kill. Just normal washing with the soap even soda while it is not advisable to use it (soda) is because it contains a lot other chemicals that can damage the skin. Even in this office I shake a lot of people as a political office holder, but I just go into the office and wash my hands because I know washing my hand in front of you may look bad. That was long before Ebola. Just hand washing with soap, any kind of it can prevent a lot of diseases. 

People should wash hands, even the care givers. People should eat well cooked bush meats. Also people should try and stop rodents from entering their houses, I am not saying that rodents carry Ebola but they can also carry other diseases though not as deadly as Ebola. Fumigate your house don't allow bats and rodents. If we do some of these few methods we may also prevent Ebola.

What is the state doing about this scourge?
If you listen long before the first case of Ebola was reported in the country, the Akwa Ibom state Ministry of Health have been sending out news bulletins you can bear me witness. Ever since the first case was reported in Guinea, we have been sending out news bulletins and it is still running. We are trying to educate the public. We have also written the various hospital superintendents on what and what to do, step by step. May be sometime this week at the state level I intend to do a step down training, we had sent some people to training on how to contain the situation. We intend to invite Senior Health workers to the training and we expect that when they go back they will train others. We have set up a state rapid response team for not just Ebola but any medical epidemic. We don't want the state to panic. We will also send out numbers for people to call when we finally get a report of the illness in Nigeria. We are also working with World Health Organization, WHO, we want to see how we can acquire the protective clothing to ensure that our health staffs are protected. We are also thinking of setting up diagnosis centres because ordinary laboratories cannot diagnose Ebola. 

We have also set up a link with WHO so if we have any suspected case we take the blood and sent it down to their reference laboratory for diagnosis. We are also trying to put up health facilities where we can quarantine people; we are not going to mix them with other patients we have the hospital and we are already working on that. So I will say so far there is no outbreak of Ebola yet in the state or country. The terms of reference we have received from the Governor my boss, Chief Godswill Akpabio is to ensure that we do everything; I will give him the credit because I know he has been interested in knowing how far and has been asking how far.

Can someone contact Ebola through sharing of toilet especially pit latrine?
Provided you are sharing the toilet properly, you will not contact it. If I go to that pit latrine and feces are not scattered   all over the place. Remember I said body fluid and feces are body fluids. Provided someone who has Ebola has not gone to mess up the whole toilet ground and I step over it. In my life I had gone to a place where I had to use pit toilet and I was surprise to see how neat the pit toilet was. That is what we are asking people to do.

Even when someone dies and you suspect that this is Ebola please be careful in the disclosure of the corpse because that corpse can actually harbor the virus for some days even after death. That is why you realize that I have been announcing that people should evacuate their corpse because you go to the mortuary they were over flowing but we have had to do a lot of mass burial and we will continue doing it. We don't want our mortuary to become breeding space for epidemics that is why we do that.

Any cure in sight for the virus?
There is no known cure or treatment for Ebola. I cannot really ascertain the claims that bitter Kola can cure it. 

Can it be transferred from mother to child?
It has not been proven yet. Unlike HIV which is slow before it kills, what I suspect will happen in Ebola is that if a pregnant woman has Ebola it may result in abortion or she may even die before the person is born.  You are sick before a week or two you are gone. So for now, it cannot be said to be transferable from mother to child.

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