Vigilance for new deadly virus
Another deadly virus is threatening the world, bringing back memories of the coronavirus and how ill-prepared the health systems of many countries, including the Philippines, were in dealing with it back then.
On Jan. 26, India notified the World Health Organization (WHO) of two laboratory-confirmed cases of the Nipah virus (NiV) in West Bengal, both health care workers in the same hospital. Per the WHO, over 190 contacts that have been identified have all tested negative, and no further cases have been detected to date.
This new scare is happening exactly six years after the Philippines reported its first COVID-19 case and should serve as a reminder that viruses evolve quickly and health authorities must constantly keep up in preventing them.
Still, the threat of NiV, a zoonotic illness transmitted from animals to people, has once more drawn the spotlight to the gaps in the Philippines’ epidemic response system and whether the Department of Health (DOH) has learned anything from the COVID-19 experience. This could also serve as a crucial test.
The DOH has assured the public that it is prepared for NiV. But Filipinos cannot be blamed for being skeptical because they have heard these same lines in late 2019 when the coronavirus was first detected in China. On Jan. 30, 2020, the Philippines reported its first COVID case: an asymptomatic patient from Wuhan who arrived via Hong Kong.
‘Proactive border screening’
There were calls back then for stronger checks, but it took three months before authorities tightened the country’s borders.
All it takes is for one carrier to spread the virus domestically before the DOH finds another health crisis in its hands. The country cannot risk that.
We note the quick implementation by the Bureau of Quarantine (BOQ) of “proactive border screening” soon after India reported its two cases. This includes carrying out online health declarations for departing passengers and on-arrival thermal scanning—processes that became routine during the COVID-19 pandemic.
Airports in neighboring countries, including Malaysia, Thailand, Singapore, and Hong Kong, have also heightened health screening measures, particularly for passengers arriving from India.
While there are no new NiV cases that have been reported in the country, 17 individuals in Sultan Kudarat were infected in 2014 after eating horse meat and coming into close contact with infected individuals. The virus was contained, and no new cases have been reported since. Even then, the government cannot be complacent.
According to the WHO, incubation period for NiV ranges from three to 14 days, though rare cases of up to 45 days have been reported. Most of those infected develop a fever, and symptoms involving the brain (e.g. headache or confusion), and/or the lungs (e.g. difficulty breathing or cough). Other symptoms include chills, fatigue, drowsiness, dizziness, vomiting, and diarrhea.
Case fatality rate
The WHO has recommended decreasing bat access to date palm sap and other fresh food products, limiting access to sick animals such as pigs or horses, and routine disinfection of farms.
The DOH, for its part, has advised the public to cook meat thoroughly before consumption, and to only buy products approved by the National Meat Inspection Service.
The public must also be well informed about the biological and epidemiological differences between NiV and COVID-19.
COVID-19, caused by the SARS-CoV-2 coronavirus, was highly contagious because it was transmitted easily through respiratory droplets and aerosols. This led to the rapid spread across international borders despite efforts to contain it.
NiV, on the other hand, has a low contagion rate, and transmission requires close and prolonged contact with an infected individual or contaminated materials. But while it’s not as infectious as COVID, its case fatality rate is high, ranging from 40 percent to 75 percent, which makes it dangerous. In addition, it has no vaccine or treatment yet.
Valiant frontliners
Nonetheless, the WHO has assessed that the risk NiV poses is “moderate at the sub-national level, and low at the national, the regional and global levels.” There is no need to panic, but it is best to keep in mind that prevention is still better than cure.
The BOQ has said that, more than imposing travel restrictions, a higher health literacy is more important to prevent the entry and spread of illnesses in the country.
“By focusing on teaching the public and ensuring that frontliners in airports and seaports are ready, the DOH BOQ, in coordination with other health agencies, is helping prevent the entry and spread of any potential illnesses,” it said.
A lot hinges on our valiant frontliners once more as well as on a health monitoring system that should have been tweaked, tightened, and improved over the last six years.
COVID-19 taught the country painful—and expensive—lessons on how a virus could cripple the health system, bring the economy to its knees, and kill many people. There should never be a repeat of that dark era.
