21 February 2019

Kenya: Scientists Prospect Zika and MERS Scourge in Kenya

Photo: Rafaelgilo/Wikimedia Commons
Aedes aegypti, one of the transmitters of the Zika virus.

As the Kenya Medical Research Institute (Kemri) Annual Scientific and Health Conference concluded last Friday, infectious disease expert Njenga Kariuki made a startling revelation during his keynote speech.

Fearing how close Kenyans live to animals, and the country's fragile health system, he and his colleagues are prospecting two deadly viruses -- Zika and Middle East respiratory syndrome (MERS-CoV) -- that ravaged Mombasa and Marsabit counties.

While none of the 2,300 expectant women in Mombasa tested positive for Zika, 90 percent of the camels in Marsabit had MERS-CoV.

In 2015, Zika virus wreaked havoc in Latin America, resulting in a surge in children born with microcephaly, a condition that presents with a deformed head, but has underlying irreversible damages to the central nervous system.

FATALITY

In 2012, the incurable MERS-CoV jumped from camels in Saudi Arabia to people, and moved to South Korea.

It quickly killed hundreds of people before health officials could act.

By July 2018, nearly two in five (36 percent, 791) of all the 2,229 cases of MERS-CoV had resulted in deaths in 27 countries.

In an interview, Prof Kariuki told the Nation that his fear does not come from a vacuum: The viruses, just like people, board planes and enjoy the perks of a globalised world; Kenya's Jomo Kenyatta International Airport acts as connection for many people travelling.

"If Zika would come to Kenya, we asked where it would feel most at home, and we found it is at the Coast [region] where the aedes mosquitoes that transmit the virus are in plenty and responsible for other diseases such as Dengue fever, which are already a public health menace there," Prof Kariuki said.

Kenya also neighbours the origin country of Zika, Uganda, with a porous border as the only barrier.

TRANSMISSION

MERS-CoV belongs to a large family of dangerous corona viruses that cause diseases ranging from the common cold to another deadly one, Severe Acute Respiratory Syndrome.

The viruses are able to change form so quickly that interventions that are safe and tested on humans and targeted at them may not work after a few days or weeks.

The viruses are also spread through the air, especially if there is an infected, coughing person in proximity, making it difficult to contain them.

It is therefore not comforting that the type of camels that act as reservoir for MERS-CoV are in Marsabit and living very close to people.

There are very many questions; the history of the country in disease prevention makes the answers scary.

MANAGEMENT

With its history of public health gaffes in controlling diseases that pale in comparison to the coronas such as cholera, will the country survive MERS-CoV?

The prospecting of diseases in Mombasa and Marsabit comes at a time when Africa and the world in general are experiencing the wrath of diseases that were once thought to have been eradicated or controlled, waking up to terrorise humanity.

Studies have painted an increasingly disturbing pattern of diseases, either new or existing ones, increasing in incidence.

Most of these diseases, if not all, are zoonotic (coming from animals to people) such as the deadly Ebola, MERS-CoV and Zika virus.

According to the US Centres for Disease Control and Prevention, zoonoses include a wide range of mass killers such as anthrax, Ebola, swine flu, West Nile virus, bird flu, Crimean-Congo haemorrhagic fever, Rift Valley Fever (RVF), Hendra virus and slow killers such as rabies and brucellosis.

OUTBREAK

Kenya has had its fair share of attacks: The 1997 outbreak in North Eastern region is considered the most devastating, where 27,500 infections occurred in Garissa, the largest ever recorded outbreak of RVF in East Africa.

The 2006/2007 RVF in Garissa remains the worst to be documented in sub-Saharan Africa.

Donors, the World Health Organisation, ministries of Health and researchers are marshalling all the arsenal at their disposal to respond -- from building health systems, manufacturing diagnostics and research.

The pathogens, having lived longer than mankind, are smarter and use their memories of how they have survived these attacks a million years before to mutate faster than people can respond.

In Kenya, the threat of these viruses is closer, and is silenced by political talk that dominates every decision, including matters of life and death.

VULNERABILITY

Kenyans not only live with and eat the carriers of these diseases, but are also encroaching into wildlife zones where these viruses live.

"In the developed world, animals are a preserve of the rich, kept in ranches and pens; in Africa and Kenya that is very different," Prof Kariuki said.

In Kenya, small-scale farmers own nearly 70 percent of the country's livestock.

In March 2016, Dr Thumbi Mwangi - an epidemiologist who is part of the prospecting team - studied 1,500 households and their livestock in 10 villages in western Kenya.

He tracked 6,400 adults and children, 8,000 cattle, 2,400 goats, 1,300 sheep and 18,000 chicken.

His results, published in the journal PLOS One, revealed that for every 10 cases of animal illnesses or deaths that occurred, the probability of human sickness in the same household increased by about 31 percent.

RELATIONS

Prof Eric Fèvre, a professor of veterinary infectious diseases at the Institute of Infection and Global Health at the University of Liverpool, and based at Nairobi's International Livestock Research Institute, has a response to Dr Thumbi's explanation.

In a blog on microbiologysociety.org on November 11, 2015, Prof Fèvre wrote:

"The intensification of farming, for example, leads to closer relationships between individuals and animals, generating opportunities for more rapid mutations as organisms move from host to host, while also providing a structured way for those pathogens to enter highly ordered food chains that branch out and reach very large numbers of people."

Central Kenya, for instance, has experienced many cases of deadly anthrax.

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