COVID-19: East Africa susceptible to more zoonotic diseases

In the past few months, coronavirus (COVID-19) has become a household name after wreaking havoc on all aspects of humanity. Travel has been halted in most parts of the world due to the deadly virus’s knack to spread at breakneck speed.

But even though coronavirus has now infected more than 1.4 million and killed over 80,000 people worldwide, there are more zoonotic diseases in East Africa that are even more lethal. Take Rabies, for example, which has a mortality rate of nearly 100 per cent.

For the uninitiated, zoonotic diseases are the ones that pass from animals to humans. The novel coronavirus, for instance, is said to have leapt into humans at a wildlife market in Wuhan, China, while Ebola’s origin can be traced to fruit bats and apes.

Then there is HIV/Aids, which was caused by human contact with chimpanzees that were carrying the Simian Immunodeficiency Virus (SIV). SIV later mutated into the deadly Human Immunodeficiency Virus (HIV) and has since claimed millions of human lives.

In East Africa and the wider sub-Saharan Africa, zoonotic diseases have been exerting arduous public health and economic burden to local communities, especially in rural areas, for many years. Most of these diseases just don’t get global media attention because they rarely turn into pandemics.

See, the world pays more attention to emerging zoonotic diseases that are a threat to global health and economy while endemic zoonotic diseases, which mainly affect poor African populations with little political voice, are given less attention.

In East Africa, for instance, the “region is endemic with multiple zoonotic diseases and is one of the hotspots for emerging infectious zoonotic diseases with reported multiple outbreaks of epidemics such as Ebola, Marburg and Rift Valley Fever,” according to a research paper, Zoonotic Disease Research in East Africa, published by BMC in 2018.

In 2007, a joint meeting on integrated control of neglected zoonotic diseases in Africa, which was organised by the World Health Organization and held in Nairobi, Kenya, concluded that “these persistent zoonoses remain neglected in most of the African countries where they are endemic because of lack of information and awareness about the extent of the problem, lack of suitable diagnostic and managerial capacity, and lack of appropriate and sustainable strategies for prevention and control.”

Well, here are some zoonotic diseases that are common in East Africa…

As mentioned earlier, rabies is the most dangerous zoonotic disease known to mankind, with a mortality rate of almost 100 per cent. Simply put, death is almost guaranteed once you exhibit symptoms of rabies!

This one leaps from infected animals to humans through saliva or bite, and the culprits include dogs, foxes, bats, skunks, coyotes and raccoons. Present in over 150 countries worldwide, rabies claims at least 59,000 lives worldwide per year, with more than 36 per cent (about 21,000) of these deaths occurring on the African continent.

With at least one person succumbing to rabies every nine minutes, the disease is considered a public health failure because it’s very much preventable with a simple vaccination.

Symptoms of rabies include general weakness, fever, hallucinations, headache, cerebral dysfunction, insomnia, agitation, anxiety, confusion and hydrophobia (fear of water).

The most recent outbreak of Ebola was just last year in the Democratic Republic of Congo (DRC) and Uganda. West Africa also bore the brunt of this deadly virus about five years ago when it ravaged Liberia and neighbouring countries.

The virus causes severe viral hemorrhagic fever, diarrhea, vomiting and severe bleeding from most openings of the victim’s body.

First discovered in 1976 near the Ebola River in DRC, Ebola is believed to have emanated from fruit bats and apes, which are eaten by some people in Central Africa. Though not so contagious like the current coronavirus, Ebola is one of the most deadly zoonotic diseases with a mortality rate of between 50-90 per cent, according to the World Health Organisation.

Since it was first discovered 44 years ago, Ebola — formerly known as Ebola Hemorrhagic Fever — has sickened and killed over 34,000 and 14,000 people, respectively. But last year’s approval of the first Ebola vaccine means that it is now more preventable, moving forward.

The Human Immunodeficiency Virus (HIV), which causes Acquired Immunodeficiency Syndrome (AIDS), originated in West African chimpanzees more than 40 years ago.

As humans hunted down chimpanzees for bush meat, they got into contact with the blood of the apes that were infected, giving rise to one of the most lethal diseases of our generation.

Since HIV/Aids was discovered over four decades ago, it has infected more than 75 million people and killed at least 32 million, leaving psychic wounds among many people, especially in sub-Saharan Africa where it has killed more people than anywhere else in the world.

Even though there are now antiretroviral drugs that make the disease manageable, the prevalence rate of HIV/Aids is still quite high in many African countries, including in eastern Africa where it ranges from between 10-30 and 1-25 per cent among adults in urban and rural areas, respectively.

It is estimated that more than 50 per cent of adults and between 10-15 per cent of children admitted to hospitals in the eastern African region are victims of HIV/Aids. For the last four decades, HIV/Aids has remained the main killer of people aged between 15-45.

First discovered in 1967 in Marburg and Frankfurt, Germany, the Marburg virus is said to belong to the same family as that of Ebola, originating from imported African green monkeys in Uganda. The reservoir host of the virus, however, was found to be the African fruit bat.

Like Ebola, Marburg’s mortality rate also stands at about 54 per cent and its symptoms include high fever, diarrhea, vomiting and severe bleeding from most openings of the victim’s body.
The most recent outbreak of the disease in eastern Africa was reported in 2017 in eastern Uganda on the country’s border with Kenya, where it killed at least three people before the country’s ministry of health quickly contained it.

In the previous years, Marburg has ravaged parts of Uganda, DR Congo, Angola, South Africa, USA, the Netherlands and Kenya.

Rift Valley Fever
Rift Valley Fever, which primarily affects animals, was first detected in the Rift Valley of Kenya in 1931 during an investigation into an outbreak on a sheep farm.

Several other outbreaks have since been reported in many countries in Africa, including in Somalia, Tanzania and Egypt. The disease was also reported in Saudi Arabia and Yemen about 20 years ago — the only countries outside Africa to have been affected.

According to scientists, the majority of human infections are a result of contact with the blood or organs of animals that are infected, and those at a higher risk of contracting the disease are herders, veterinarians, farmers and slaughterhouse workers. Fortunately, no human-to-human transmission of the disease has been documented since it first broke out almost a century ago.

Cases range from mild to severe, sometimes causing symptoms such as retinal lesions, intense headache, lethargy, a purpuric rash, memory loss, confusion, disorientation, hallucinations, passing blood in the faeces, vertigo, convulsions, severe liver impairment, vomiting blood and bleeding from the nose or gums, among others.

Fortunately, the mortality rate of the Rift Valley Fever is said to be less than 1 per cent.