Forty-five years after the first outbreak of Lassa Fever in Nigeria, the health sector is still grappling with the scourge currently ravaging some cities in the country. Martins Ifijeh writes
The smile on the faces of Nigerians since the containment of Ebola Virus Disease (EVD) over a year ago is being threatened by the recent outbreak of Lassa Fever, which has so far spread from Taraba to Rivers, Nassarawa, Bauchi, Kano, Plateau, Gombe, Niger, Oyo and Edo State, killing several persons in a space of two months.
This, again has brought Nigerians into a familiar scenario of fear and uncertainty, as people express deep concern whenever there are disease outbreaks in the country, considering that every epidemic of this nature leave scores dead, while several others struggle with treating themselves.
As at the last count, available information suggests that over 40 persons have been said to had lost their lives to the disease which has assumed epidemic proportions with over 90 persons already infected, this year alone.
According to the World Health Organisation (WHO), Lassa fever is an acute viral haemorrhagic illness caused by Lassa virus, a member of the arenavirus family of viruses. It is transmitted to humans from contacts with food or household items contaminated with rodent excreta. The disease is endemic in the rodent population in parts of West Africa. Person-to-person infections and laboratory transmission can also occur, particularly in the hospital environment, in the absence of adequate infection control measures.
Though it was first discovered in the 1950s, the virus causing Lassa fever was not identified until 1969 in a town named Lassa in Borno State. Apart from Nigeria, Lassa fever is also endemic in other African countries like Liberia, Sierra Leone, Guinea, Central African Republic and Congo DR.
Experts are of the opinion that the government should as a matter of urgency embark on massive sensitisation programmes across the country in other to forestall further spread of the disease.
Speaking with THISDAY, a Virologist, Professor Sobowale Oludare, said if the country had upgraded its surveillance system, as well as laboratory support facilities after the last Ebola outbreak, it would have been much easier to quell the growing spread of Lassa Fever currently in several states of the federation, adding that until the country get it right, there will continuously be outbreaks.
“With our surveillance system in place, it would be much easier to predict various outbreaks and then promptly address it before it snowball into taking several lives, which is unfortunate for a country that prides itself as the giant of Africa,” he explained.
According to the virologist, over 80 per cent of infected persons may not present symptoms, but that about 20 per cent of those infected will present symptoms, adding that on majority of cases, the symptoms could be mistaken for malaria, cold or flu.
“Early symptoms of the disease occur within the first and third week after being infected, and they include fever, diarrhea, vomiting, abdominal pain, headache, chills, nausea, sore throat, conjunctivitis, backache, facial swelling, mucosal bleeding, and joint pains. Late symptoms include bleeding from the mouth and rectum, bleeding from the eyes, ears and nose, eye swelling, swelling of the genitals and rashes all over the body that often contain blood, coma and even death. In some patients, temporary or permanent neurological problems may occur,” he noted.
He said with the several symptoms presented by the virus, it was best to carry out diagnosis whenever any of the symptoms was noticed, so as not to confuse other illnesses like typhoid and malaria for Lassa Fever.
But how can the virus be transmitted and what should be done to prevent it? Prof. Oludare provides a guide. According to him, not all types of rats present the Lassa virus, “the mastomys rodents, often known by locals as the rat with the long mouth, is the specific type of rat that carry the virus. Though it’s a bush rat, it can also live within and around homes or anywhere they find food. Homes with poorly stored food could be a ready host for them,” he explained.
He said apart from their fluids, urine or faeces in foods, other ways they can infect humans are when they are killed and prepared for food. “It can also spread through person-to-person contact. When body fluids, blood, urine or semen of an infected person gets in contact with an uninfected person’s fluid, there is the possibility of transfer of the virus through such medium.
“Lassa fever transmission can also occur when one comes in contact with fluid discharge from dead bodies,” noting that it could also remain in the semen of an infected person for up to three months.
With the fatality rate associated with the disease, coupled with the frequency of occurrence in the country, one wonders if the various governments are doing enough to tackle the scourge which has taken the lives of thousands of Nigerians.
Available information suggests that there are only two laboratories in the country with the capacity to screen blood for Lassa fever. The Irrua Specialist Teaching Hospital (ISTH) in Irrua, Edo State and the Lagos University Teaching Hospital (LUTH). However, the federal government has consistently said there were other centres where the tests can be done, but the level of capacity of these centres still remain subjects of debate.
In addressing the current outbreak in the country, the Federal Government, through the Ministry of Health has said that it was putting all measures in place to quell the growing epidemic now confirmed by laboratories to be Lassa Fever Viral Disease.
According to the Minister of Health, Prof. Isaac Adewole, he said the outbreak would be brought to a timely end in the shortest possible time, adding that since the first case of the recent current outbreak was reported from Bauchi in November, 2015, the ministry has not been unaware of how to tackle it.
He stressed that “in response to these reported outbreaks, the Health Ministry has taken the following measures to curtail further spread and reduce mortality among those affected: Immediate release of adequate quantities of ribavirin, the specific antiviral drug for Lassa fever to all the affected states for prompt and adequate treatment of cases, including deployment of rapid response teams from the ministry to all the affected states to assist in investigating and verifying the cases as well as tracing of contacts, clinicians and relevant healthcare workers had been sensitised and mobilised in areas of patient management and care in the affected states.”
He also advised the affected states to intensify awareness creation on the signs and symptoms of the disease, including preventive measures such as general hygiene.
The minister assured Nigerians that the country has the capability to diagnose Lassa fever, adding that all cases reported so far were confirmed by our laboratories. “However, due to the non-specific nature of Lassa fever symptoms and varied presentations, clinical diagnosis is often difficult and delayed, especially in the early course of the disease outbreak,” Adewole said.
He explained that the Nigeria Centre for Disease Control (NCDC) was already coordinating all response activities, while they report to him.
He advised healthcare workers seeing patients suspected to have Lassa fever to immediately contact the State Epidemiologists or call the Nigeria Centre for Disease Control and Federal Ministry of Health using the following numbers: 08093810105, 08163215251, 08031571667 and 08135050005.
Meanwhile, the Lagos State Government has also called on its residents to be vigilant and imbibe basic proper hygiene, as well as avoid contact with rats and store foods in rat proof containers. “Lagosians should observe good personal hygiene, including hand washing with soap and running water regularly, while also disposing waste properly in order to discourage rodents from entering the house.”
The State Government also called on the public to report cases of symptoms or persistent high fever to the nearest health centre, as fluids from an infected person can be extremely dangerous.
According to the Minister of Health, Prof. Isaac Adewole, he said the outbreak would be brought to a timely end in the shortest possible time, adding that since the first case of the recent current outbreak was reported from Bauchi in November, 2015, the ministry has not been unaware of how to tackle it.
He stressed that “in response to these reported outbreaks, the Health Ministry has taken the following measures to curtail further spread and reduce mortality among those affected: Immediate release of adequate quantities of ribavirin, the specific antiviral drug for Lassa fever to all the affected states for prompt and adequate treatment of cases, including deployment of rapid response teams from the ministry to all the affected states to assist in investigating and verifying the cases as well as tracing of contacts, clinicians and relevant healthcare workers had been sensitised and mobilised in areas of patient management and care in the affected states.”
He also advised the affected states to intensify awareness creation on the signs and symptoms of the disease, including preventive measures such as general hygiene.
The minister assured Nigerians that the country has the capability to diagnose Lassa fever, adding that all cases reported so far were confirmed by our laboratories. “However, due to the non-specific nature of Lassa fever symptoms and varied presentations, clinical diagnosis is often difficult and delayed, especially in the early course of the disease outbreak,” Adewole said.
He explained that the Nigeria Centre for Disease Control (NCDC) was already coordinating all response activities, while they report to him.
He advised healthcare workers seeing patients suspected to have Lassa fever to immediately contact the State Epidemiologists or call the Nigeria Centre for Disease Control and Federal Ministry of Health using the following numbers: 08093810105, 08163215251, 08031571667 and 08135050005.
Meanwhile, the Lagos State Government has also called on its residents to be vigilant and imbibe basic proper hygiene, as well as avoid contact with rats and store foods in rat proof containers. “Lagosians should observe good personal hygiene, including hand washing with soap and running water regularly, while also disposing waste properly in order to discourage rodents from entering the house.”
The State Government also called on the public to report cases of symptoms or persistent high fever to the nearest health centre, as fluids from an infected person can be extremely dangerous.
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