Lassa Fever ravages Nigeria

Sat, Feb 10, 2018 | By publisher


Health

Lassa fever spreads in Nigeria, defying the effort of the federal government to contain the disease which has so far killed 31 persons

By Anayo Ezugwu

THE incidence of Lassa fever cases in Nigeria has continued to increase despite ongoing efforts by the federal government to control the disease. The epidemic is currently ravaging 15 states where at least 31 people have died in the past one month. A total of 105 cases have been recorded since the resurgence of the current Lassa fever outbreak in 2018.

Of these figure, 77 cases were confirmed by laboratory and three cases classified as probable. The affected states are Bauchi, Plateau, Taraba, Nasarawa, Benue and Kogi states. Others are Ebonyi, Rivers, Imo, Anambra, Edo, Delta, Ondo, Osun and Lagos states.

Isaac Adewole, minister of health, on Monday, February 5, at the Emergency National Council of Health in Abuja, confirmed that 10 health care workers were affected in four states; seven in Ebonyi with one health worker affect in Nasarawa, Kogi and Benue states each.

According to him, of the 31 deaths from Lassa fever outbreak, four health workers died as a result of the disease; three in Ebonyi and one in Kogi. The minister, therefore, said the meeting was summoned to discuss the state of public health challenges in Nigeria with focus on some of the challenges that bedevilled the nation in the past few weeks.

Realnews reports that Lassa fever has been a recurrent epidemic in the country. Nigeria has battled with series of outbreaks in the past few months. According to Adewole, the federal government has taken measures to control the disease the way Nigeria dealt strongly with Ebola in 2014 which was acknowledged by the international community.

“The success against Ebola created a situation whereby every other public health challenge in Nigeria is likened to a tea party. Therefore, assume that Lassa fever and other challenges would be likened to malaria, that they are not serious,’’ he said.

The minister said Nigeria had also dealt with the resurgence of polio, adding that the issuance of recertification will be tougher than it was before. “The international community will not come to Nigeria’s rescue or certify the country polio free until everyone is sure that Nigeria is polio free, and that is another health challenge.”

Adewole said the country had dealt with measles yet there is persistent case of measles across the country despite the available vaccines, adding that government has already commenced nationwide campaign against measles. Acknowleding that Lassa fever has been persistent in the country over the past 30 years, the minister appealed to the Nigeria Institute of Medical Research, NIMR, and other research institutes to look into the changing dynamics of the disease.

“Lassa fever use to occur only during dry season but now we are contending with an all year transmission of Lassa fever. NIMR director-general, other research institutes will need to find out whether we are dealing with new strain of Lassa fever virus in the country,” he said.

It appears that Nigeria is grossly deficient in its response to the Lassa fever menace. Since early 2015 through most of 2017, Lassa fever outbreaks have been commonplace in the country.

Between January and December 2017, a total of 733 suspected Lassa fever cases with 143 laboratory confirmed cases and 71 deaths were recorded in 97 LGAs and 29 States of the Federation. Two deaths from Lassa fever were also recorded at the Lagos University Teaching Hospital, LUTH, with at least 150 suspected cases, mostly healthcare workers, placed under surveillance.

According to World Health Organisation, WHO, about 80 percent of people who become infected with Lassa virus have no symptoms. One in five infections resulted in severe disease, where the virus affects several organs such as the liver, spleen and kidneys.

WHO said Lassa fever is a zoonotic disease, meaning that humans become infected from contact with infected animals. The animal reservoir or host of Lassa virus is a rodent of the genus Mastomys, commonly known as the “multimammate rat.” Mastomys rats infected with Lassa virus do not become ill, but they can shed the virus in their urine and faeces.

Because the clinical course of the disease is so variable, detection of the disease in affected patients has been difficult. When the presence of the disease is confirmed in a community, however, prompt isolation of affected patients, good infection prevention and control practices, and rigorous contact tracing can stop outbreaks.

Because the symptoms of Lassa fever are so varied and non-specific, clinical diagnosis is often difficult, especially early in the course of the disease. Lassa fever is difficult to distinguish from other viral haemorrhagic fevers such as Ebola virus disease as well as other diseases that cause fever, including malaria, shigellosis, typhoid fever and yellow fever.

The incubation period of Lassa fever ranges from 6–21 days. The onset of the disease, when it is symptomatic, is usually gradual, starting with fever, general weakness, and malaise. After a few days, headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and abdominal pain may follow. In severe cases facial swelling, fluid in the lung cavity, bleeding from the mouth, nose, vagina or gastrointestinal tract and low blood pressure may develop.

Protein may be noted in the urine. Shock, seizures, tremor, disorientation, and coma may be seen in the later stages. Deafness occurs in 25 percent of patients who survive the disease. In half of these cases, hearing returns partially after 1-3 months. Transient hair loss and gait disturbance may occur during recovery. Death usually occurs within 14 days of onset in fatal cases. The disease is especially severe late in pregnancy, with maternal death and/or fetal loss occurring in more than 80 percent of cases during the third trimester.

– Feb. 10, 2018 @ 4:00 GMT |

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