Nigeria: Another Lassa Fever Outbreak

Lassa fever public health advisory.
28 January 2019

The Nigeria Centre for Disease Control, NCDC, last week Tuesday January 22, 2019 confirmed 16 deaths from 60 cases of Lassa fever even as 590 out of 593 contacts are currently under watch in eight states of the federation. The affected states are Edo, Ondo, Bauchi, Nasarawa Ebonyi, Plateau, Taraba, and FCT. NCDC's Director General Dr. Chikwe Ihekweazu said case fatality rate in confirmed cases is 26.7 percent.

This outbreak is coming hot on the heels of the Lassa fever international conference held in Abuja to mark 50th year anniversary of the discovery of the disease in the country. Each year, Lassa fever kills many and leaves most survivors with disabilities, often due to side effects of the drugs they received. The virus was first discovered in 1969 from a case in Lassa town, Borno State.

Ihekweazu said recent epidemiological data shows that this trend usually occurs during the dry season, between January and April. He said the Lassa fever national multi-partner, multi-agency Technical Working Group [TWG] continues to coordinate response activities at all levels. NCDC's report on Lassa fever indicates that while 46 patients are currently being managed, there are 20 patients at Irrua Specialist Teaching Hospital (ISTH) Treatment Centre, 18 at the Federal Medical Centre, Owo, 3 in Bauchi and 5 in Ebonyi States.

The NCDC boss said an Emergency Operations Centre (EOC) has been activated to coordinate the response. The national EOC comprises of representatives from the World Health Organisation (WHO), Federal Ministry of Agriculture and Rural Development, Federal Ministry of Environment, US Centre for Disease Control and other partners. He said Nigeria now has four laboratories where Lassa fever can quickly be diagnosed.

Speaking about NCDC's preparation for this year's emergency phase, Ihekweazu said NCDC has been providing support to states including provision of emergency supplies and deployment of Rapid Response Teams (RRTs). He said, "The RRTs will work with states in response coordination, contact tracing, case management, risk communication and strengthening infection prevention and control practices." He said since the Lassa fever outbreak of 2018, NCDC has worked with states to ensure better preparedness and improved response. Additionally, risk communication has been strengthened through radio, posters, flyers and social media.

Lassa fever, also known as Lassa haemorrhagic fever (LHF), is a viral haemorrhagic fever caused by the Lassa virus. It is transmitted to humans through contact with food or household items contaminated by infected rodents. Person-to-person transmission can also occur particularly in hospital environment in the absence of adequate infection control measures. Healthcare workers in health facilities are also at risk in contacting the disease. Unlike other diseases, just one case of Lassa fever makes it an epidemic.

For now, there is no vaccine for preventing Lassa fever. Many of those infected by the virus do not develop symptoms. When symptoms occur, they typically include fever, weakness, headaches, vomiting and muscle pains. Less commonly, there may be bleeding from the mouth or gastrointestinal tract. The risk of death once infected is about one percent and frequently occurs within two weeks of the onset of symptoms. About a quarter of those who survive have hearing loss, which improves over time in about a half. Prevention requires isolating those who are infected and decreasing contact with rodents. Other efforts to control the spread of disease include having a cat to hunt rodents in homes, and storing food in sealed containers.

While it is important to advertise through the electronic and print media the location of the four laboratories for diagnosing Lassa fever in the country, the need for primary healthcare offices at the state and local government levels to increase awareness on the prevalence and preventive measures of this disease is of crucial importance. People should be educated to keep their homes clean as rodents are attracted to dirty and unclean environments. This may not the best season to serve and drink gari that is soaked in water as meal.

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