Dr. Sylvester Ikhisemojie
| credits: File copy
October 12, 2014 by Dr. Sylvester Ikhisemojie
The
world is in fear as a result of the Ebola virus disease that has evaded
all preventive measures and landed almost simultaneously in the United
States and Spain. The Liberian traveller to the US who developed the
disease several days after arriving in the state of Texas has now died.
This has happened despite having access to some of the finest healthcare
facilities on the planet. The patient in Spain is relatively more
stable but her dog, Escallibur, was euthanized after an unsuccessful
campaign by her now quarantined husband to stop it. The reason for that
move by the state was clear: it is known that pets like dogs and perhaps
cats are prone to developing the disease without having any symptoms.
It is not clear if they can transmit the disease to humans. That gap in
current knowledge should worry people. We are not allowed in the present
circumstances to assume things because that could be dangerous.
Preventive actions taken must be with an abundance of caution. Bats,
monkeys, gorillas, antelopes and porcupines are known now to be able to
transmit the disease. Perhaps, grass-cutters, dogs and cats may also be
able to do so. More frightfully, dogs may be able to do this without
showing any signs of this terrifying disease. Pet lovers, owners and
those who eat dogs need also to be particularly aware. What all these
demonstrate is that we are not out of the woods yet and so we must not
lower our guard. This is particularly so at a time when there is an
outbreak of the Marburg fever in Uganda and an out of control Ebola
epidemic in Liberia and Sierra Leone and to a lesser extent, in Guinea
and The Congo.
Enter now the bizarre mix of other viral
infections suddenly announcing their presence around the world. Of most
recent prominence is the Chikungunya virus which bears a striking
similarity to Dengue Fever. It is transmitted from one person to another
by the bite from a mosquito known as Aedes Egypti which is found in
most parts of the tropics. It has been found in parts of Africa, Asia,
Europe and the Americas. It is also seen in the Pacific and Indian
oceans. In recent weeks, it has made a troublesome appearance in the
Central American nations of Venezuela, Colombia and Nicaragua. Hundreds
of people have been sickened and this is an area of the world that has
never previously seen an outbreak. The original outbreak of this
sickness was in Tanzania in 1952 and it means “to bend painfully” or to
become “contorted”. It is not transmitted from one person to another
directly but through that mosquito vector. There have been reports of
more than a few cases in different parts of Nigeria. This infection is
established when a mosquito infected with the virus bites somebody who
has the infection and goes to bite another who does not have it thereby
transferring its infected saliva into such an individual much like it
happens when people contract malaria. Most of the bites occur during
daylight hours but the Aedis egypti is also known to bite people
indoors. There seems to be a peak in these bites in the early morning
hours and in the early part of the evening.
The common symptoms begin some two to
five days after an infection with a feverish phase and may last for up
to 12 days. Majority of those infected will develop symptoms among which
are fever, a reddish rash that can involve the trunk and the limbs as
well as the non-specific symptoms itemised below. It is known that
monkeys, cattle, birds and rodents are natural reservoirs of this
disease. The symptoms may include the following: a high grade fever of
sudden onset, conjunctivitis, headaches which are throbbing in character
and can be quite persistent, nausea and vomiting, severe joint and
muscle aches which are very debilitating, photophobia, loss of taste as
you might also see in malaria. Swelling of the legs may also occur and
it is not related to any kidney, heart or liver disease. However,
certain heart complications have been reported nevertheless.
The symptoms are usually mild amongst
young people and pregnant women. In elderly people aged more than 65
years, however, nearly a third of sufferers could die. Whether this is
due solely to advanced age or the more common illnesses associated with
age is unclear. What is known without a doubt is that the elderly people
fare a lot worse from this disease. Death from Chikungunya fever is
certainly rare but the debilitation it causes with lingering joint pains
and relative incapacitation can last for several months or even years.
The fever can greatly improve together with other symptoms within
sevenp- to 10 days.
Since 2004, Chikungunya fever has reached
epidemic proportions around the world. It is most likely to be
misdiagnosed also in the regions of the world where Dengue fever is
common. There is no known cure for this disease and there is no known
preventive vaccine available. Treatment consists of efforts to replenish
body fluids with intravenous fluids if they are vomiting or not eating,
the administration of antibiotics to deter bacteria which may want to
take advantage of the downgraded immune system and the use of analgesics
and anti-pyretics to control the fever. Cold baths can also be used in
this regard to help in controlling the fever. These are efforts in
essence to help the body combat the infection. Rest and sequestration
from other people is vital if there is going to be any chance of
recovery. There is also no vaccine for this disease.
This disease is diagnosed in the
laboratory with a blood test which can identify the virus or the
existence of antibiotics developed against the infection. These are the
usual ways by which a definitive diagnosis is made and treatment begun.
Treatment is supportive in nature and is by no means tailored to attain
cure. It is important at the point of diagnosis, to separate a sufferer
of this infection from other family members or other patients in a
health facility because they can be a risk to others around them if they
are bitten by the Aedes mosquito.
The preventive efforts must be geared
towards the reduction of the mosquito population, the elimination of
their breeding environment among old broken pots for example, old tyres,
the elimination of pools of stagnant water around the home. Those who
live in densely populated residential neighbourhoods are particularly at
risk because of the ability of the mosquito to navigate in such areas.
People who live in the rural areas are also not free even if their
population density is less. They should be appropriately dressed for the
outdoors whenever they are venturing outside. They should wear the
traditional wrapper which covers the woman well or as is increasingly
common, wear trousers much as the men are likely to do and the men
should also wear hats which help in providing extra protection outdoors.
This attitude to prevention will avail much. People should also not
fail to use mosquito netting on their doors and windows as well as
sleeping in insecticide-treated nets. Most importantly, it must be noted
here that like the other viral haemorrhagic fevers, this particular one
has no vaccine available and has no cure. Prevention of this infection
is therefore a key factor to control its spread and its possible
complications.
Ask the doctor
Dear doctor, I am a
38-year-old man and I caught my lady using Cytotec. She lost her period
for the month of September and I told her that I am ready for the baby.
Cytotec is for what?
070396xxxxx
Cytotec is a prostaglandin drug
that is used to control vaginal bleeding after childbirth, to induce
labour in women who are scheduled to deliver their babies on certain
dates and as a combination drug to prevent the development of stomach
ulcers in certain people on powerful pain killers. However, the school
girls also know about its usefulness to procure abortions. I suppose
that is the purpose for which your lady used it.
Dear doctor, I am having a swollen heart. What type of food should I be eating? It was shown on X-ray. I don’t want to die now.
090395xxxxx
A swollen heart as you have put it is a
very serious issue indeed. This is not a matter for food. It has to do
with your age and what disease you suffer from that may have predisposed
you to this complication, for it is a complication. You must see your
doctor for further examination and a possible referral to a cardiologist
for yet more tests and treatment. Do so without any further delay.
Dear doctor, I am a
28-year-old virgin. During my period in September, a painful tiny growth
developed on my vulva (labia minora to be specific) but this growth
regressed on its own four days after my period without any treatment.
Sir, what is this strange occurrence and how can it be prevented in the
future?
070577xxxxx
There is no way for me to be certain
about what that could have been. It ranges in possibility from a
Bartholin’s cyst (unlikely because this is usually a growth on the labia
majora) to a simple boil which can occur commonly. The fact that it
regressed on its own shows that it may not really be a problem other
than its nuisance value. However, you should see your doctor for this.
Dear doctor, I am suffering
from Staphylococcus and I have taken several injections but it has yet
to heal. My body gets hot with noises in my tummy. My penis also gets
weak after one round of sex. Please what is the best medicine for it?
080381xxxxx
You need to understand that
Staphylococcus is not a usual cause of disease. Therefore, you may be
taking drugs for the wrong reasons. The bacteria were found in what kind
of specimen? Urine, blood, swab or semen? If so, it is most likely to
be from some contamination rather than an infection because infection
from this organism is often very severe. As a result of all the above
reasons, there is no best medicine for this organism.
Dear doctor, I am a
68-year-old man. Whenever I go to bed between 9 and 10pm, I do not sleep
more than four hours except I take sleeping pills. What is the solution
to this? I am worried.
080225xxxxx
You did not say whether you also sleep
during the day. If that happens, it would explain why you sleep for such
a short period during the night. Generally, most people of your age
would probably sleep for brief periods at a time and do so several times
in a 24-hour-cycle. If that is true with you, there is no need to take
sleeping tablets which could damage you if you use them for a long time.
Dear doctor, is there
orthodox medicine for “jedi-jedi” in a baby less than a year? Please
kindly tell me because my baby has “jedi-jedi”.
080261xxxxx
I have some difficulty understanding what
you mean by “jedi-jedi” as I do believe you may be faced with something
a bit more serious than what is obvious now. There is orthodox medicine
for nearly every ailment described in the world. I believe you should
take your baby to see a paediatrician for detailed examination and the
correct prescription to treat your baby.
Dear doctor, I always have easy sperm release while having sex with a girl. What can I do about it?
0803506xxxxx
I believe your problem is due to a
combination of factors. Of all the possibilities, anxiety and fatigue
from your daily labours may be the key culprits. You should work
judiciously to reduce these challenges in order to get better results
from your liaisons. As long as you can penetrate the vagina, you do not
require drug treatment at this point.
Dear doctor, my friend says
that whenever she removes her panties it will be covered within a few
minutes by some small ants. Is this normal and what drugs can she use to
deal with it?
081894xxxxx
The presence of ants in the pants
indicates there is either an infection resulting in a vaginal discharge
or the urine is sweet, perhaps due to diabetes. So what she needs to do
is simple: see a doctor for the relevant tests to be conducted so that
treatment can be administered.
Dear doctor, I urinate
frequently so I went for fasting blood sugar. The result was 113 but I
learnt it shouldn’t be more than 110. Does it mean I am
diabetic?
080371xxxxx
That result does not mean that you are
diabetic but it may be a warning that you are close to it. It could mean
that your glucose tolerance is impaired or you are becoming resistant
to insulin, the blood-borne substance that controls your blood sugar.
You need, therefore, to have the test repeated while you avoid in the
meantime a diet that is rich in carbohydrates and sugar. A repeat of the
fasting blood sugar with a two hours post prandial glucose measurement
will help make a clear diagnosis.
Nigeria
has clearly overcome Ebola virus disease and for the World Bank and
International Monetary Fund (IMF), this is a commendable feat.
