Outbreak of Hepatitis E in Northeast: One year after By Ndueso Eno

Just over a year, Nigeria was enwrapped in another round of public health emergencies when the Ministry of Health reported an outbreak of acute hepatitis E virus in some parts of the north east.

No fewer than 146 cases were suspected with 21 confirmations and at least, two fatalities as at June 18, 2017 when the World Health Organization, WHO, was officially notified of the outbreak.

Borno state towns of Ngala, Damasak, Monguno and Mobbar, the hapless epicentres where the virus was first reported, span across three Local Governments, bordering Cameroon, Chad and Niger.

With this latest confirmation, Nigeria currently grapples with at least three strains of the hepatitis virus, namely: hepatitis B, C and E all of which pose a significant threat to the health of millions of Nigerians and adjoining countries.

According to the WHO, about 20 to 30 million Nigerians are said to be infected with Hepatitis B Virus, representing one of the highest cases in the globe.

Thankfully, the government has devoted both resources and time to provide vaccination for children and adults even as effort is still ongoing to push back on the disease.

But while the foregoing data on Hepatitis E was reeled out at the earliest stage of the outbreak, health authorities suddenly went blank with information, so much that nothing significant is left to public knowledge on the pool of interventions to stem the Hepatitis E virus.

Experts hold that prevention is key to every viral infection, and the main thrust in the process of avoiding an infection is accurate and timely information.

The apparent dearth of readily available information on the spread, prevention, reduction or eradication of the disease leaves much to the imagination.

Have Nigerian health authorities had a quick success on the elimination of the disease or are simply pandering to the tight-lipped appeal of the age-long oath of secrecy in fighting a public health situation? Certainly, on an election year, that would be a momentous feat with which to unleash campaigns.

But no! Or perhaps, an overwhelmed government piped low? What happened to fliers, leaflets, or radio and television jingles to warn citizens of the present danger of the hepatitis E virus and how to prevent it? It is appalling that the Office of the National Coordinator, National AIDS and STIs Control Programme (NASCP), Federal Ministry of Health under whose purview the hepatitis response is domiciled does not have the all-clear to provide readily-available information on activities of government in tackling the scourge of this epidemic.

With fears the virus could propagate rapidly due to the humanitarian crisis arising from the volatile security in the region, the WHO had recommended among other things, a multisectoral approach between the State Ministry of Health, Nigeria Centre for Disease Control, and Ministries of Water Resources and Environment.

Consequently, the Nigeria Centre for Disease Control had raised a team which was in Borno to support the state’s response to fight the disease along with “the WHO, the United Nations Children’s Fund (UNICEF), Oxfam (representing the Water, Sanitation and Hygiene (WASH) sector), Médecins Sans Frontières (MSF), FHI 360, ICRC (working with Nigerian Red Cross) and North East Regional Initiative (NERI).” On June 18, 2018, one year after the outbreak, however, Nigerians waited endlessly for an update on the outcome of this joint effort to defuse the air of panic and uncertainty that came with the news of another killer disease.

While aware of the parlous state of the nation’s health sector, the air of optimism that it could spring a surprise like the case of the Ebola outbreak in 2014 remains.

Therefore, government owes it a duty, to explain its actions and inactions on matters of public interest, especially those involving life and death.

Despite how much is being done to push back on the spread of the viral hepatitis B, given the absence of vaccines for the hepatitis E and C strains of the disease, effective control or elimination of all strains of the disease begin with public enlightenment.

Instances are rife that the Nigerian public suffering the brunt of these strange viruses is wallowing in unawares, as figures of new infections continue to swell.

As viral hepatitis E remains a public health threat to Nigerians and the rest of the world, government must endeavour to lead efforts towards prevention, cure or management of the disease by arming its citizens with the requisite knowledge and updating them with relevant information where necessary, while resources are mobilised to build healthcare facilities and social amenities such as portable and safe drinking water.

Against this backdrop, it is our responsibility to remind us of the mode of spread of the hepatitis E virus, which is through the faecal-oral route majorly through contaminated water.

There is therefore the need to stick to the WHO recommendation on improvement of the quality and access to safe drinking water as well as improvement of sanitation by treating and dispensing of human waste correctly and improving personal hygiene, and the preparation of safe and clean food.

Eno is the Chief Operating Officer, Ikang Relief Services Network, a non-political, nonprofit humanitarian organization saving lives, promoting self-reliance and dignity through human transformation.

You can reach him on [email protected] relief.org or +234-8029219781

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