Soon after Ghana’s confirmation of the deadly Marburg virus disease when two people who later died tested positive for the virus this July, the Nigeria Centre for Disease Control has rolled out guidelines to prevent an outbreak in Nigeria. Though its potential impact on the Nigerian population is currently rated as moderate, the fact that the country shares maritime borders with Ghana and other West African countries recommends taking strong proactive measures. A practical, strategic, and comprehensive plan should be adopted to keep it out.

First detected in Guinea in 2021, the Marburg virus, which resembles Ebola, is a highly virulent disease that causes hemorrhagic fever, with an average fatality ratio of up to 50 percent depending on the strain and case management. The European Centre for Disease Prevention and Control documented an initial outbreak in Europe with a 24 percent fatality rate, but due to unexplained factors, its subsequent outbreaks have shown extremely high case fatality rates in two African countries: 83 percent in Congo and 88 percent in Angola. Worse, the clinical diagnosis of MVD has been ascertained to be difficult.

Many symptoms of MVD mimic other diseases like malaria, typhoid fever, or viral haemorrhagic fever like Lassa fever. While it is still unknown how the Marburg virus first spread from its animal host to humans, the World Health Organisation suggests unprotected contact with infected bat faeces or aerosols as the most likely route.

Studies by the United States Centres for Disease Control and Prevention reveal that the virus spreads through direct contact through broken skin or mucous membranes in the eyes, nose, or mouth; with blood or body fluids (urine, saliva, sweat, faeces, vomit, breast milk, and amniotic fluid) of a person who is sick with, or died from MVD, or objects contaminated with body fluids from a person who is sick with, or has died from the disease. These include clothes, beddings, needles, and medical equipment.

MVD can also be sexually transmitted through the semen from a man who recovered from the disease. It can remain in certain body fluids of a patient even if they no longer have symptoms of severe illness. With an incubation period of two to 21 days and a sudden onset of symptoms marked by fever, chills, headache, and myalgia, it also manifests nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea.

Other symptoms are jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction. “Early supportive care with rehydration and symptomatic treatment improves survival. There is yet no licensed treatment proven to neutralise the virus, but a range of blood products, immune therapies, and drug therapies are currently under development,” says the WHO. The President, Major General Muhammadu Buhari (retd.), federal and state health ministries should act fast to prevent this deadly virus from entering the country.

Widely commended for their swift response to the MVD outbreak, Ghana’s health authorities have put structures in place to contain the spread of the disease, said Reuters.

In Nigeria, the NCDC Director-General, Ifedayo Adetifa, said although no case of Marburg virus disease had been reported, “several measures are being put in place to prevent an outbreak in-country.” He said the National Reference Laboratory had the capacity to test for MVD, while point-of-entry surveillance had been heightened, and “trained rapid response teams are on standby to be deployed in the event of an outbreak and the NCDC’s Incident Coordination Centre is in alert mode.” These measures should be faithfully implemented.

Nigeria is already combating several other infectious diseases and cannot afford to host the deadly MVD. There are already 847 confirmed cases of Lassa fever reported in the country, distributed across 24 states and 99 local government areas.

The monkeypox situation report by the NCDC for week 28 revealed that confirmed cases have increased to 117, from the previous 101 with no fewer than 338 suspected cases in the country. Thirty-one states have reported suspected cholera cases in 2022. From January 3, 2020 to July 5, 2022, Nigeria recorded 257,637 confirmed cases of COVID-19 and 3,157 deaths. It experienced a 67 percent surge in infections in early July, statistics by the WHO and NCDC indicate.

Unfortunately, all this is occurring at a period when there is a frightening brain drain in the country’s health sector. Primary health centres are in a deplorable state and the state governors are too preoccupied with politics, channeling resources towards the 2023 elections and neglecting the health of the populace. More than half of registered medical doctors have migrated abroad for greener pastures, says the Nigerian Medical Association. The President of the Nigerian Society for Virology, Clement Mboto, said, “If you go to 90-99 percent of our hospitals, we don’t have virologists because there is no provision for them to practice. Within the country, we are only about 200.” This is lamentable.

For individuals and groups, there should be adequate awareness and public sensitisation by government agencies on avoiding fruit bats, and sick non-human primates. Measures taken should prevent person-to-person transmission of the virus by avoidance of direct physical contact with patients, or excretions from patients suspected to have MVD. Individuals, religious houses, organisations, and corporate bodies should adhere to safety rules, including wearing protective gowns, gloves, and masks.

Public health professionals should be notified of symptoms of MVD and possible exposure to the Marburg virus, and patients strictly isolated to curtail its spread. All hospitals and health centres across the country should be equipped with laboratory equipment like antigen-capture Enzyme-linked Immunosorbent Assay testing and Polymerase Chain Reaction, which can be used to confirm cases of MVD.

The country’s porous borders should be effectively patrolled, and illegal movement of people and goods flow adequately policed to prevent trans-border infections. Surveillance in states sharing borders with other countries should be stepped up. The federal and state governments should collaborate to prevent a Marburg epidemic.

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