Virus outbreaks: What you need to know

Kenya's Ministry of Health announced that it had heightened surveillance at all border points as a precautionary measure to curb the spread of the disease. [iStockphoto]

Last week, when Tanzania confirmed its first-ever cases of Marburg Virus Disease, the Ministry of Health activated its surveillance and response mechanism and started screening travellers at all border points between Kenya, Tanzania and Uganda to contain its spread into the country.

At the time of the announcement, the disease, which has a fatality ratio of up to 88 per cent, had claimed five lives out of eight confirmed cases in Tanzania's western region of Kagera. The three survivors were under medical care.

The victims had displayed symptoms such as fever, vomiting, bleeding and renal failure, according to Tanzania's Health Ministry and World Health Organisation (WHO).

Following the announcement of the outbreak, Kenya's Ministry of Health announced that it had heightened surveillance at all border points as a precautionary measure to curb the spread of the disease.

Acting Director General in the Ministry of Health Patrick Amoth also called on the public to report any unusual incidents of individuals presenting symptoms of the disease.

As Kenyans are watching the events unfold, there are questions about the seemingly 'new' virus and its nature. What does the news mean? Was it the start of another virus-related nightmare? Kenya and the world are barely recovering from the impact of the Covid-19 pandemic.

Also fresh on Kenyan minds is the rotavirus. Only a few months ago, there was news of shortages of vaccines and warnings of a surge in cases and deaths.

In March last year, there was a buzz on social media about a bug that caused flu-like symptoms, including running nose, fever, sneezing, and headaches.

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While Kenya Medical Research Institute (Kemri) announced that their surveillance showed that there was no outbreak of influenza, there remained a lot of questions about the nature of viruses, where they come from, how they spread, and how to protect yourself from them.

The biggest question, however, remained, 'why is there an increase in virus outbreaks in recent times?

According to Prof Omu Anzala, the increasing frequency of global virus outbreaks has up to recently been mostly of deep concern to biomedical research scientists.

However, the recent acceleration of this trend has now begun to worry even laymen who in many cases do not even know the difference between a virus and a bacterium.

"A big difference being that bacteria can survive without a host and a virus need a host. This means that transmission of viruses, either require a host or a vector. And there lies the issue," Prof Anzala said.

He says that in a virus outbreak, based on mode of transmission and the type of virus, you are more likely to contract the disease by being in contact with an infected person.

"This isn't for all viruses. But one begins to understand the panic," he says.

Why is there an increase in virus outbreaks?

Prof Anzala says that disease patterns follow the interconnection between man, animals, plants and the shared environment. This idea of recognising this interconnection is called the "One Health" concept.

"The idea here is that, as we encroach into previously isolated and unexplored environments, we are likely to encounter new pathogens and perhaps more dangerous pathogens for which we have no existing treatment or cure," he explains.

"Climate change is causing vectors to adapt, possibly leading to more virulent strains of existing vectors," he says.

"A good example is the new malaria vector undergoing further research, but indicating that it is now likely to get malaria in urban centres - particularly in urban slum areas where hygiene and sanitation challenges exist," he adds.

What about bacteria outbreaks?

According to Prof Anzala, there is also an increase in bacterial outbreaks and this is mainly attributed to the misuse of antibiotics - either not finishing your dose or self-prescribing antibiotics habits.

He says that antibiotic misuse leads to greater resistance in bacteria which in turn increases the likelihood of bacterial infection and associated outbreaks.

"There is therefore a lot of reason to be afraid. And more so here in Kenya now that the Marburg virus is next door. This is a virus that has long been detected in West Africa but never made its way to East Africa until now," he says.

He says that there is more concern about virus outbreaks because of the perception perpetuated in movies.

"The Marburg virus and Ebola have been the basis of quite a few horror movies, where most of the other diseases like malaria, and pneumonia barely make it as the themes of entire movie scripts," he says.

"The reason for this is linked to the manner in which these viruses not only cause a horrifying death but also denies the patient any dignity in his or her final hours, given the associated 'viral hemorrhagic fever'," he explains.

He says that this group of infections, Marburg included, interfere with the body's ability to clot blood and leads to severe bleeding - sometimes from most, if not all, body orifices.

"The Marburg outbreak is such a terrifying development for public health specialists as much as for ordinary citizens. And there are several reasons," Prof Anzala says.

"First is the mode of transmission. Viruses are spread through host-to-host contact, and so can travel very widely and very quickly. Second is that there is no treatment or effective management protocols or medications for many viral infections," he adds.

He says another reason for the panic associated with viruses is that the development of effective vaccines, which could prevent such infections, takes time and is also very expensive.

"Most vaccines require a booster as viruses evolve faster than other pathogens. It is central to understanding such infections that we must clearly define the difference between a virus and a bacteria," Prof Anzala says.

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