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Man lives in hostile environment filled with microbes which periodically cause terrible diseases and result in international health concerns. Such was the case with Ebola Virus Disease (EVD) which
caused worldwide concern between 2013 and 2015. This issue of the journal features a review article by Aiyede et al., on the spread of EVD in West Africa and the ways the epidemics were handled in the various countries. The support from many international organizations including the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), United Nations Children’s Emergency Fund (UNICEF), United States Agency for International Aid (USAID), World Food programme, United Nations Mission for Ebola Emergency Response and Medêcins Sans Frontiêre /Doctors Without Borders (MSF) facilitated control efforts and many lessons were learnt which will be useful for controlling such epidemics in future. The authors traced the origin of EVD in Africa to the first outbreaks in Democratic Republic of Congo (former Zaire) and Southern Sudan in 1976. The epidemic in West Africa started in December 2013 with spread from Guinea to Sierra Leone and Liberia. The other countries affected in the sub-region were Nigeria, Senegal and Mali. The authors provided the sequence of events in chronological order in the various countries. The case fatality rate ranged between 0 and 75% with an approximate mean of 40%.
The review highlights the importance of cross-border surveillance in controlling spread between countries which has to go hand-in-hand with the availability of rapid point-of-care diagnostic tests.
The diagnostic tests have to be highly sensitive and specific. Availability of real-time PCR technology in many laboratories has made this possible. The need for rigorous contact tracing and close monitoring of those in isolation, shown to help contain the epidemic in these countries, must be borne in mind. The education of traditional and faith healers also contributed to the success achieved and highlights the need to avoid detrimental rituals and cultural practices. The necessary behavioural changes, strict adherence to hand washing, contact avoidance as well as other personal hygiene practices which were the norms during the EVD epidemic must continue at all times and in all places (not only in hospitals or when in contact with health officials). The role Immunization played for
containing the epidemic cannot be downplayed.
We have largely come out of EVD epidemic in West Africa but the lessons learned must not be quickly forgotten as we face challenges from other pathogens like Lassa fever and Zika virus. This is the essence of this reminder.
A. Ogunniyi
Editor-in-Chief