Lassa Fever still threatens with several cases emerging and disappearing in some states of Nigeria as expert battle against odds to keep the deadly ailment in check. MAUREEN IKPEAMA writes on its prevention. Her piece:
LASSA fever, a deadly, acute viral hemorrhagic illness has resurfaced in Nigeria. Early this year, 2018, there were reported cases of Lassa fever in different parts of the country.
Lassa fever is an acute, viral disease carried by a type of rat that is common in West Africa. It can be life-threatening. It can cause bleeding,. Sometimes, the patient may not have symptoms. If it affects the liver, kidneys, or spleen, it can be fatal.
Lassa fever is endemic to a number of West African countries. The World Health Organisation, WHO disclosed that in some areas of Liberia and Sierra Leone 10 to 16 percent of all hospital admissions are due to Lassa fever.
International travel has aided the spread of Lassa fever. In 2015, a person returning from Liberia to the U.S was diagonised of Lassa fever. Lassa fever causes about 5,000 deaths per year. The spread of Lassa fever is through the faeces and urine of the multi-mammate rat, commonly found in Sierra Leone, Liberia, Guinea, and Nigeria.
It was proven that once a mastomys rat is infected with the virus, it can excrete the virus in its faeces and urine for the rest of its life. The virus can spread easily, especially as the rats breed rapidly and can inhabit human homes.
It is a common knowledge that the rats live in and around human habitation and they often come into contact with foodstuffs. Sometimes people eat the rats, and the disease can be spread during their preparation.
The most common method of transmission is by consuming or inhaling rat urine or faeces. It can also be spread through cuts and open sores, person-to-person contact via blood, tissue, secretions or excretions, but not through touch. Sharing needles may spread the virus, and there are some reports of sexual transmission.
Lassa fever can also be passed between patients and staff at poorly equipped hospitals where sterilisation and protective clothing is not standard.
Lassa fever was first discovered in Nigeria, when two missionary nurses became ill with the virus in 1969. In the village of Lassa, where it was first documented.
Symptoms of Lassa fever vary. They include pulmonary, cardiac, and neurological problems. Symptoms generally appear within 6 to 21 days after infection occurs.
Medical experts said that an estimated 80 percent of infections do not produce significant symptoms, although there may be a general malaise, headache and a slight fever. In the remaining 20 percent of cases, Lassa fever becomes serious. Other symptoms can include: bleeding in the gums, nose, eyes, or elsewhere, difficulty breathing, a cough, swollen airways, vomiting and diarrhea, both with blood difficulty swallowing, hepatitis, swollen face, pain in the chest, back, and abdome, shock, hearing loss, which may be permanent, abnormal heart rhythms, high or low blood pressure, pericarditis, a swelling of the sac that surrounds the heart, tremors among others.
It is worthy to note that around 1 percent of all cases, Lassa fever is fatal, and around 15 to 20 percent of all hospitalisations for the disease will end in death. Death can occur within 2 weeks after the onset of symptoms due to multiple organ failure.
None of the most common complications of Lassa fever is hearing loss, which occurs in around 1 and 3 infections. This hearing loss varies in degree and is not related to the severity of the symptoms. Deafness caused by Lassa fever can be permanent and total. It is said to be particularly dangerous for women in the third trimester of pregnancy. The symptoms of Lassa fever vary widely, and diagnosis can be difficult.
The disease can resemble other viral hemorrhagic fevers, including the Ebola virus, malaria, and typhoid.
Rehydration and treatment of symptoms can improve the chances of survival if there is an early diagnosis. Other treatment focuses on relieving symptoms and maintaining body function. This includes managing fluid levels, electrolyte balance, oxygenation, and blood pressure.
As mentioned earlier, the virus was first identified in 1969 from a case in the town of Lassa in Borno State, Nigeria. In December 2016, the Federal government of Nigeria raised the alarm over the resurgence of the deadly disease.
Federal Ministry of Health, disclosed that since the beginning of 2018, a total of 107 suspected Lassa fever cases were recorded in ten States: comprising of Edo, Ondo, Bauchi, Nasarawa, Ebonyi, Anambra, Benue, Kogi, Imo and Lagos State. By 21st January 2018, the total number of confirmed cases was 61, with 16 deaths recorded. The ministry revealed that Ten healthcare workers were infected in four States (Ebonyi – 7, Nasarawa – 1, Kogi – 1 and Benue – 1) with three deaths in Ebonyi State.
Just recently, a case was reported in Enugu State. Few days later, two suspected cases were also recorded and from the records the patients were quarantined in two local government areas of the state to prevent spread of the disease..
Though the state Commissioner for Health, Dr. Fintan Ekochin said “There is no new confirmed cases of Lassa fever in Enugu State. He added that “All contacts of the index case are being monitored and this will last for 21 days. Currently, some people have exited the monitoring period.” The Nigeria Centre for Disease Control, NCDC, has quarantined the two new suspected patients(one from Udi and the other from Nkanu East) at an isolation centre in the state, while their family members have been restricted in their houses for 21 days.
Lassa fever can be prevented. The main focus of prevention is “community hygiene,” to control the rat population. This includes: regular hand-washing, storing foods in rodent-proof containers, keeping garbage away from the home, keeping pet cats, avoiding blood and other bodily fluids when caring for sick relatives, following safe burial procedures, using protective equipment in a healthcare setting, including masks and eyewear.
Additional prevention methods include: clearing bushes and clutter around the buildings to make the environment unattractive to rats. Food, cooking utensils and drinking water should be kept in rat proof containers, avoid using rats as food sources. Health-care workers caring for patients with suspected or confirmed Lassa fever should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials such as clothing and bedding. When these preventive measures were put in place, the spread of Lassa fever would be reduced.