The 2019 novel coronavirus disease (COVID-19) is a communicable respiratory disease caused by a new strain of coronavirus that causes illness in humans. Scientists are still learning about the disease, and think that the virus began in animals. At some point, one or more humans acquired infection from an animal, and those infected humans began transmitting infection to other humans. 

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Domestic and wild animals such as cattle, sheep, goats, antelope, and deer can become infected when they breathe in or ingest spores in contaminated soil, plants, or water. People get infected with anthrax when spores get into the body. When anthrax spores get inside the body, they can be “activated.” When they become active, the bacteria can multiply, spread out in the body, produce toxins (poisons), and cause severe illness. This can happen when people breathe in spores, eat food or drink water that is contaminated with spores, or get spores in a cut or scrape in the skin.

The symptoms of anthrax depend on the type of infection and can take anywhere from one day to more than two months to appear. Cutaneous Anthrax include a group of small blisters or bumps that may itch, swelling can occur around the sore, A painless skin sore (ulcer) with a black center that appears after the small blisters or bumps and most often the sore will be on the face, neck, arms, or hands. Inhalation Anthrax involve fever and chills, chest discomfort, shortness of breath, confusion or dizziness and cough, nausea, vomiting, or stomach pains, headache, sweats (often drenching), extreme tiredness and body aches. Gastrointestinal Anthrax symptoms involve fever and chills, swelling of neck or neck glands, sore throat, painful swallowing, hoarseness, nausea and vomiting, especially bloody vomiting, diarrhoea or bloody diarrhoea, headache, flushing (red face) and red eyes, stomach pain, fainting and swelling of abdomen (stomach). Injection Anthrax include fever and chills, a group of small blisters or bumps that may itch, appearing where the drug was injected, a painless skin sore with a black center that appears after the blisters or bumps, swelling around the sore and abscesses deep under the skin or in the muscle where the drug was injected.

All Type of Anthrax can be treated by Antibiotics and Antitoxin. Antibiotics can also prevent anthrax from developing in people who have been exposed but have not developed symptoms. Ciprofloxacin and doxycycline are two of the antibiotics that could be used to prevent anthrax.

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Human infection with avian influenza is generally through direct contact with infected animals or contaminated environments. This includes consumption of raw, contaminated poultry blood. these viruses have not acquired the ability of sustained transmission among humans.

Common initial symptoms of the A(H5) and A(H7N9) avian influenza viruses are high fever and cough followed by dyspnea or difficulty breathing. Abdominal pain, bleeding from the nose or gums, diarrhea, vomiting, encephalitis, and chest pain have also been reported. For A(H7N7) and A(H9N2), disease is typically mild.

Treatment of avian influenza is recommended for at least 5 days. As soon as possible, neuraminidase inhibitors should be prescribed, though they can be administered at various stages of illness. Corticosteroids should not be used routinely unless necessary.

Influenza viruses, with the vast silent reservoir in aquatic birds, are impossible to eradicate. Zoonotic influenza infection in humans will continue to occur. To minimize public health risk, quality surveillance in both animal and human populations, thorough investigation of every human infection and risk-based pandemic planning are essential. In affected countries, people should avoid contact with high-risk environments such as live animal markets and poultry farms, any free-ranging or caged poultry, or surfaces that might be contaminated by poultry droppings. People should also avoid contact with dead migratory birds or wild birds showing signs of disease, and should avoid consumption of undercooked eggs, poultry or poultry products. Hand hygiene with frequent washing or use of alcohol rubs is recommended.

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There is currently no specific antiviral drug treatment regime and no commercial chikungunya vaccine. Treatment is directed primarily at relieving the symptoms, using antipyretics, analgesics and fluids. Most cases recover completely within weeks.

Prevention and control are usually done by destroying or reducing natural and artificial mosquito breeding habitats, and by using insecticides to control mosquitoes. Using insecticide-treated mosquito nets and wearing clothing that minimizes exposure to mosquito bites can be helpful.

Recent Outbreaks in Africa

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Symptoms appear 12 hours to five days after ingesting contaminated food or water, and it can kill within hours if untreated. The signs and symptoms include rice water stools, fishy odour stools, vomiting, rapid heart rate, loss of skin elasticity, dry mouth, low blood pressure, dehydration, muscle cramps, restlessness or irritations especially in children, sleepiness or tiredness. However, some infected people may not show any symptoms.

Prevention and control can be achieved by consuming clean water and food, and by providing proper hygiene conditions and access to basic services. Adopting basic hygienic behaviours such as regular handwashing with soap after defecation and before handling food or eating, and safe preparation and conservation of food are essential. Vaccination with Oral Cholera Vaccines (OCV) has proved effective in cholera control. The primary treatment for cholera is the use of oral rehydration salts (ORS) and the use of antibiotics.

Recent Outbreaks in Africa

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The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians. Human-to-human transmission can occur resulting from close contact with the blood, secretions, organs or other bodily fluids of infected persons. Hospital-acquired infections can also occur due to improper sterilization of medical equipment, reuse of needles and contamination of medical supplies.

The incubation period depends on the mode of acquisition of the virus and it varies from 1 to a maximum of 13 days. Onset of symptoms is sudden, with fever, muscle pain, dizziness, neck pain and stiffness, backache, headache, sore eyes and light sensitivity. There may be nausea, vomiting, diarrhoea, abdominal pain and sore throat early on, followed by sharp mood swings and confusion. After two to four days, the agitation may be replaced by sleepiness, depression and lassitude, and the abdominal pain may localize to the upper right quadrant, with detectable liver enlargement.

General supportive care with treatment of symptoms is the main approach to managing CCHF in people. The antiviral drug ribavirin has been used to treat CCHF infection with apparent benefit. Both oral and intravenous formulations seem to be effective.

Agricultural workers and others working with animals should use insect repellent on exposed skin and clothing. Insect repellants containing DEET (N, N-diethyl-m-toluamide) are the most effective in warding off ticks. Wearing gloves and other protective clothing is recommended. Individuals should also avoid contact with the blood and body fluids of livestock or humans who show symptoms of infection. It is important for healthcare workers to use proper infection control precautions to prevent occupational exposure.

Recent Outbreaks in Africa

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The Aedes aegypti mosquito is the primary vector of dengue. The virus is transmitted to humans through the bites of infected female mosquitoes. After virus incubation for 4-10 days, an infected mosquito is capable of transmitting the virus for the rest of its life. Infected symptomatic or asymptomatic humans are the main carriers and multipliers of the virus, serving as a source of the virus for uninfected mosquitoes. Patients who are already infected with the dengue virus can transmit the infection (for 4-5 days; maximum 12) via Aedes mosquitoes after their first symptoms appear.

Dengue should be suspected when a high fever (40°C/104°F) is accompanied by 2 of the following symptoms: severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands or rash. Symptoms usually last for 2-7 days, after an incubation period of 4-10 days after the bite from an infected mosquito. Severe dengue is a potentially deadly complication due to plasma leaking, fluid accumulation, respiratory distress, severe bleeding, or organ impairment.

There is no specific treatment for dengue fever. For severe dengue, medical care by physicians and nurses experienced with the effects and progression of the disease can save lives – decreasing mortality rates from more than 20% to less than 1%. Maintenance of the patient’s body fluid volume is critical to severe dengue care.

The main method to control or prevent the transmission of dengue virus is to combat vector mosquitoes. Careful clinical detection and management of dengue patients can significantly reduce mortality rates from severe dengue.

Recent Outbreaks in Africa

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Symptoms are similar to those of other infectious diseases such as malaria, typhoid fever and meningitis and this makes diagnosis difficult. The symptoms appear after 2 to 21 days and include fever, fatigue, muscle, pain, headache, and sore throat, followed by vomiting, diarrhoea, rashes, symptoms of impaired kidney and liver function, and in some cases internal and external bleeding (e.g. oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

There is currently no proven cure for Ebola but there are experimental vaccines that can protect against infection. Early diagnosis and treatment can help a patient recover. Clinical care includes rehydration with fluids and body salts and treatment of specific symptoms such as low blood pressure, vomiting, diarrhoea and infections. Hand hygiene and a number of interventions can help control the spread, including surveillance, contact tracing, isolation of confirmed patients, laboratory testing, safe burials, and working with communities to reduce risk factors.

Recent Outbreaks in Africa

• West Africa (Sierra Leone, Liberia & Guinea) – 2014 to 2016. This outbreak was declared over with 28,610 confirmed and probable cases and 11,308 deaths.
• Democratic Republic of Congo – August 2018. This outbreak is still on, affecting 22 health zones mainly in North Kivu and Ituri Provinces, with 2787 confirmed cases, 1867 deaths and 810 recovered as of 9 August 2019.

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The Hepatitis B virus is spread when blood, semen, or other body fluids from an infected person enters the body of someone who is not infected. The virus can be spread through sex with an infected person, injection drug use, and during birth form an infected mother to her baby.

In most cases, Hepatitis B is symptomless. In symptomatic cases, the patients might experience fever, fatigue, loss of appetite, stomach upset, vomiting, grey stool, dark urine, joint pain, yellow skin and eyes. In some cases, the hepatitis B virus can also cause a chronic liver infection that can later develop into cirrhosis (a scarring of the liver) or liver cancer.

There is no specific treatment for acute hepatitis B. Therefore, care is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids lost from vomiting and diarrhoea. Chronic hepatitis B infection can be treated with medicines, including oral antiviral agents. Treatment can slow the progression of cirrhosis, reduce incidence of liver cancer and improve long term survival. The best and easiest way to prevent Hepatitis B is by getting vaccinated. The Hepatitis B vaccine is typically given as a series of 3 shots over a period of 6 months. The entire series is needed for long-term protection.

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The most common modes of infection are through unsafe injection practices; inadequate sterilization of medical equipment in some health-care settings; and unscreened blood and blood products. Today, most people become infected with Hepatitis C by sharing needles, syringes, or any other equipment to inject drugs.

The incubation period for hepatitis C is 2 weeks to 6 months. Following initial infection, approximately 80% of people do not exhibit any symptoms. Those who are acutely symptomatic may exhibit fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, grey-coloured faeces, joint pain and jaundice (yellowing of skin and the whites of the eyes).

There is currently no vaccine for HCV. However, Antiviral medicines can cure more than 95% of persons with hepatitis C infection, thereby reducing the risk of death from liver cancer and cirrhosis, but access to diagnosis and treatment is low. Hepatitis C does not always require treatment as the immune response in some people will clear the infection, and some people with chronic infection do not develop liver damage. When treatment is necessary, the goal of hepatitis C treatment is cure. The cure rate depends on several factors including the strain of the virus and the type of treatment given. Access to HCV treatment is improving but remains limited. In 2015, of the 71 million persons living with HCV infection globally, 20% (14 million) knew their diagnosis. 7.4% of those diagnosed (1.1 million) were started on treatment in 2015. In 2016, 1.76 million people were additionally treated in bringing the global coverage of hepatitis C curative treatment to 13%. Much needs to be done in order for the world to achieve the 80% treatment target by 2030.

Prevention of HCV infection depends upon reducing the risk of exposure to the virus in health-care settings and in higher risk populations, for example, people who inject drugs, and through sexual contact.

The following list provides a limited example of primary prevention interventions recommended by WHO:

• hand hygiene: including surgical hand preparation, hand washing and use of gloves;
• safe and appropriate use of health care injections;
• safe handling and disposal of sharps and waste;
• provision of comprehensive harm-reduction services to people who inject drugs including sterile injecting equipment;
• testing of donated blood for hepatitis B and C (as well as HIV and syphilis);
• training of health personnel; and
• promotion of correct and consistent use of condoms.

For people infected with the hepatitis C virus, WHO recommends:

• education and counselling on options for care and treatment;
• immunization with the hepatitis A and B vaccines to prevent coinfection from these hepatitis viruses and to protect their liver;
• early and appropriate medical management including antiviral therapy if appropriate; and
• Regular monitoring for early diagnosis of chronic liver disease.

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