MERS In Nigeria – It’s Closer Than We Think

Imagine this.....

It's the summer time and the kids are on break. Being a family man, Emeka takes his wife and children on a holiday to Dubai. While there, they partake in the touristic experience, including a nice camel ride in the desert.

Gbenga is a managing director for Africa in a top international company based in Lagos. In between an annual conference in Abu Dhabi, he decides to go explore town, taking in the sights at a local farm.

Both have a great trip. Both return home to Nigeria with the Middle East Respiratory Syndrome (MERS). Yes, that deadly infectious virus spreading through South Korea and around. These situations are quite plausible and realistic. On June 6, 2015, a German man died from MERS contracted from a trip taken in February this year to the Middle East. 

What is MERS?

MERS causes fever, cough and shortness of breath. Extreme cases can result in respiratory failure, organ failure and death. It is poorly understood, with no safe and effective vaccine and no precise treatment. Human transmission appears to have come from contact with livestock such as camels. It seems to be transmitted from human to human through respiratory secretions. High risk people include those with a weakened immune system, the elderly, and those with chronic ailments such as diabetes, or lung disease. 

After the rigors of the Ebola virus, is Nigeria ready to handle another public health storm? Given recent new Ebola cases in Sierra Leone and Guinea, the possibility of yet another Ebola outbreak still remains. Yet, Nigeria needs immediate screening for MERS from travelers coming from high risk areas such as Middle Eastern and South Asian countries. 

The Nigerian Response

On June 10, 2015, the office of the Nigerian Security Adviser (NSA) sent out an alert about the possibility of a MERS outbreak in Nigeria.  The Ministry of Health has been advised to activate an immediate response plan. While the World Health Organisation (WHO) has not declared MERS as a public health emergency, it has stated that the rise in cases and deaths signifies a “wake-up call”. 

Issues to Ponder On and Take Action

The Ministry of Health should work with airport officials, and airlines such as Emirates to implement screening on arrival. Flight crew should be offered guidance on who to report to at the Nigerian international airports. Hospitals should be on alert and should ask suspected patients about travel histories, and provided with an office to report suspected cases. 

MERS Virus In Camels in Northern Nigeria

A report published by the USA ‘s Centers for Disease Control and Prevention (CDC) in August 2014, found evidence of the MERS coronavirus in African camels, including Nigeria. A high prevalence of seropositivity (94%) was observed in the sample of Nigerian camels collected from Kano, Sokoto, Borno and Adamawa states. This means that the Ministry of Health should additionally look into the high possibility of cases developing in Northern Nigeria. Given the challenges due to the insurgencies in these areas, this requires great effort on the part of the government. It involves disseminating information on MERS to the public, and community leaders in these areas. It means ensuring that some form of skeletal structure is in place to handle the high possibility of MERS transmission, which can further affect already displaced communities. 

Current Status

While the Nigerian public shouldn’t panic, it is important that increased awareness takes place. In the current outbreak, as of June 17, 2015, South Korea has reported 23 deaths, and over 160 diagnosed, all stemming from an original case of a businessman returning from the Middle East, a month ago. Although there have been no reported MERS cases in nearby West African countries, it remains a flight away. Even worse, as the USA CDC’s study clearly shows, it is already in Nigerian camels and a lot closer than many Nigerians think.

Author, Dr Obianuju Helen Okoye is a medical doctor and epidemiologist based in Missouri, USA. A former US NIH Clinical and Research Fellow and US State HIV Epidemiologist, she is the author of What the World Can Learn From Nigeria’s Successful Handling of Ebola

She can be reached on Twitter at https://twitter.com/docokoye

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