This article is more than 5 years old. Information may no longer be current.
Nonedemic regions in Africa at high risk for viral hemorrhagic fever outbreaks
Click Here to Manage Email Alerts
Regions in Africa that are currently considered nonendemic for viral hemorrhagic fever are actually highly susceptible to outbreaks, according to researchers.
Peter Piot, MD, PhD, professor and director of the London School of Hygiene & Tropical Medicine, and colleagues conducted a multistage analysis to identify African regions at risk for zoonotic spillovers, prolonged disease transmission and global disease spread of viral hemorrhagic fever infections. They specifically assessed the risk for Crimean-Congo hemorrhagic fever, Ebola virus disease, Lassa fever and Marburg virus disease.
According to the analysis, areas susceptible to zoonotic spillover of Marburg virus disease stretch across the continent. Crimean-Congo hemorrhagic fever risk is also widespread, with Sahel, the Horn of Africa and southern Africa at highest risk for zoonotic spillover. Meanwhile, the risk for Lassa fever is highest in western Africa, and the risk for Ebola virus disease is highest in western and middle Africa. The researchers noted that many areas with no previous outbreaks had a high risk for zoonotic spillover, including Boumbaet-Ngoko in Cameroon for Ebola.
When examining outbreak receptivity, Piott and colleagues found that at least 90% of districts in Central African Republic, Chad, Somalia and South Sudan have the greatest potential for outbreaks and the poorest response capabilities. Guinea, Madagascar and Sudan were also highly susceptible to persistent human-to-human disease transmission. The risk for international spread of disease was highest in South Africa and at-risk districts in Nigeria.
“Several locations rank highly for localized outbreaks but are comparatively less likely to spread elsewhere due to their isolation,” the researchers wrote. “Other locations, many in western Africa, rank highly both in terms of viral hemorrhagic fever outbreak potential and capacity to spread in the absence of effective interventions.”
The researchers concluded that their findings highlight “key transition points” where interventions are needed to prevent epidemics.
In a related editorial, Chikwe Ihekweazu, MPH, DTM&CM, FFPH, national coordinator and CEO at Nigeria Centre for Disease Control, and Ibrahim Abubakar, PhD, FFPH, FRCP, director of the University London College’s Institute for Global Health, discussed the critical role of national public health institutes (NPHIs) in outbreak prevention and response efforts.
“Not enough emphasis in the post-Ebola narrative has been placed on strengthening NPHIs to fulfill their global health security mandate,” Ihekweazu and Abubakar wrote. “Instead, too much responsibility has been placed on WHO, which, despite improvements in technical expertise on emergency response, does not have sufficient resources — should they be expected — to respond to all threats in a continent as vast as Africa, or the local presence to rapidly deal with emerging viral hemorrhagic fever threats.
“To build strong, science-based institutions takes time and effort; however, it is the only sustainable way that research can lead to the development of a robust global health response capacity to emerging infections, including viral hemorrhagic fevers.” – by Stephanie Viguers
Disclosures: The authors report no relevant financial disclosures.
Click Here to Manage Email Alerts