Lassa fever: Return of the vampire

Since it was discovered in 1969 in Lassa village, North East Nigeria, Lassa fever seems to have made a permanent home in the country claiming lives, especially in the last few years. BAYO ALADE reports that though the disease is not always detected at first contact, efforts to eradicate it are always weak and not continuous.

 

LASSA fever, an acute viral hemorrhagic illness, transmitted to humans through contact with food or household items contaminated by infected rodents, has made its annual resurgence across some states in the country. The disease had ravaged parts of the country almost every year in the last decade.

By the end of 2016 for example, almost 200 people died of the disease in 24 states. In 2017, 18 states were affected in which 82 deaths were recorded.

In a federal government report released on Wednesday 24, January, it acknowledged “the increasing number of Lassa fever cases reported from several states across the country,” noting that “the Nigeria Centre for Disease Control has activated its Emergency Operations Centre (EOC) to coordinate the response to the outbreak on behalf of the Federal Ministry of Health.”

The report also said that “since the beginning of 2018, a total number of 107 suspected Lassa fever cases have been recorded in 10 states: Edo, Ondo, Bauchi, Nasarawa, Ebonyi, Anambra, Benue, Kogi, Imo and Lagos states. As of 21st January 2018, the total number of confirmed cases was 61, with 16 deaths recorded. Ten health care workers have been infected in four States (Ebonyi – 7, Nasarawa – 1, Kogi – 1 and Benue – 1) with three deaths in Ebonyi State.”

The most affected states in terms of mortality had been identified as Ebonyi, Ondo and Edo states where rapid response teams had been dispatched and emergency supplies also sent. In Ebonyi State, three medical personnel at the Federal Teaching Hospital, Abakaliki had been reported dead as a result of Lassa fever.

In Ebonyi, for instance, the state Commissioner for Health, Dr. Daniel Umezuruike, who confirmed the deaths from the deadly contagious disease, said two of the casualties were medical doctors while the third person was a nurse. He added that the index patient who was treated by one of the doctors and nurse survived and had been discharged.

Umezuruike, however, said that the cause of the death of one of the doctors was yet to be confirmed to be from Lassa fever, as he had morbidity of diabetes, adding that the victims reported the cases late because they were self-medicating when the symptoms started showing.

 

Lassa in Kogi

Like Ebonyi, the Lassa fever resurgence has left physical and emotional devastation behind in Kogi State. A young and promising medical doctor, Dr Victor Idowu Ahmed, was one of its victims. The young medical doctor last Sunday gave up the ghost after testing positive to the virus.

The late Ahmed, a 30-year-old doctor, studied medicine at the University of Nigeria, Nsukka and graduated in 2016. His demise came barely two months after being employed at the Federal Medical Centre, Lokoja, having been engaged for his houseman-ship in November 2017.

Ahmed’s tragic fate began when he  started treating a seven-month-old baby brought in for medical attention by its mother. The baby was said to be having some febrile illness. The doctor was to be the one on duty at the Paediatrics unit (Children›s ward) of the FMC, Lokoja on the fateful day.

Sources at the hospital said trouble started few days after as Ahmed complained of malaria for which he was treated. He reportedly returned to his residence in the staff quarters located within the premises of the hospital after the treatment.

However, when his condition didn’t improve after some days, he returned penultimate Friday for further treatment. It was at this point that other doctors attending to him noticed some symptoms of Lassa fever in him. Samples of his blood were thereafter taken to the Federal Medical Centre, Irrua, Edo State, where it tested positive to laboratory tests.

He was immediately evacuated to the hospital for prompt medical attention penultimate Saturday, where concerted efforts were made to save his life. He, however, died last week Sunday.

Ahmed’s death more than anything else has exposed the danger medical personnel face in the country, a situation which the Kogi State chairman of the Nigerian Medical Association (NMA), Dr Tijani Godwin, said must change.

According to Godwin, concerted efforts need to be done to educate the citizenry on how to take health precautions. He said NMA had since the development increased its awareness among the public and its members on the various ways through which the virus could be contracted and spread.

The NMA, he explained further, was educating the public to avoid keeping their foodstuffs in the open place since the virus is contracted from rats. According to him, “since we are in the dry season, there is increased bush burning which had forced the rats out of their natural habitat,” noting that health officers had also been educated to adhere to international best practices while attending to patients who may be brought in for medical attention.

Speaking on the welfare of health care personnel, he said, “We want government to improve the welfare of health care personnel, especially doctors and nurses, laboratory personnel, who always have direct contacts with patients.

“It may interest you to know that hazard allowance of doctors is as little as N5000 per month, whereas you hear of other people taking millions of naira as allowances, wardrobe allowance, newspaper allowance and other allowances running into several millions of naira for those that are not exposed to any risk.

“We are using this medium to appeal to government to use the death of our colleague as a wakeup call to ensure that this hazard allowance is increased to what we can be proud of, this will boost the morale of those working in the hospitals,” he pleaded.

The Chief Medical Director (CMD) of the hospital, Dr Olatunde Alabi, who also harped on precautionary methods by the public, called for early report of all cases of fever. He appealed to residents to «take urgent steps to eliminate rodents from their houses and surroundings.» He added that foodstuffs like garri, rice, beans, maize should be kept in air-tight containers to prevent infection.

 

NCDC cautions Nigerians

The National Centre for Disease control few days back released a report on Lassa fever through which it tried to enlighten Nigerians about the disease.

1. Lassa fever can be prevented through practicing good personal hygiene and proper environmental sanitation.
2. Effective measures include storing grain and other foodstuffs in rodent-proof containers, disposing of garbage far from the home, maintaining clean households, and other measures to discourage rodents from entering homes. Hand washing should be practiced frequently.
3. Health care workers are again reminded that Lassa fever presents initially like any other disease causing a febrile illness such as malaria; and are advised to practice standard precautions at all times, maintaining a high index of suspicion. Rapid Diagnostic Test (RDT) must be applied to all suspected cases of malaria. When the RDT is negative, other causes of febrile illness including Lassa fever should be considered. Accurate diagnosis and prompt treatment increase the chances of survival.
4. Family members who are providing care for patients with Lassa fever should take extra caution. In addition, states are encouraged to ensure safe and dignified burial practices for patients who die from Lassa fever.

As the federal government takes steps to curtail the disease this time amidst a flurry of public enlightenment campaigns it is expected that the efforts this time would be enduring and finally put a stop to the perennial resurgence of the terrible disease.

—Additional report by Yinka Oladoyinbo