Nigeria: Lassa Fever - Ebonyi Shuts Down Hospital, Quarantines Staff, Patients

Lassa fever public health advisory.
27 December 2019

The outbreak of Lassa Fever has reportedly caused the death of Ephraim Ogaranya who was admitted at St Vincent Hospital, Igbeagu in Izzi Local Government Area of Ebonyi State.

The victim was said to have been admitted alongside his sibling, Uchechi Ogaranya, at the hospital. After Ephraim's death, Uchechi was transferred to the South East virology center in Abakaliki for further treatment.

The two siblings were suspected to be infected by the Lassa Fever.

In his reaction, the Ebonyi State Governor, David Umahi, ordered that St Vincent hospital be shut down with immediate effect.

The governor also directed that all the patients and staff of the said hospital are to submit themselves to the virology center at Abakaliki for comprehensive medical examination.

In a statement issued by the governor's special assistant on media, Francis Nwaze, the governor put precautionary measures in place to prevent further escalation of the outbreak.

"The Governor directed that all the family members and close relatives of the above be quarantined at the South East Virology Center, Abakaliki for comprehensive medical examination.

"Also, Governor Umahi has directed that the Ministry of Health under the watch of the Commissioner for Health in conjunction with the Staff of Federal Teaching Hospital, Abakaliki to immediately address all issues relating to the lassa fever outbreak including comprehensive examination of all suspects and clean up of St. Vincent Hospital.

The governor also ordered that precautionary announcements be made in all media houses in the state on preventive measures of Lassa Fever.

He directed that the reports of the progress of the actions of the above directives get to him every two hours.

Lassa fever has become an annual occurrence in many states in Nigeria.

In 2018, a total of 3,498 suspected cases were reported from 23 states.

Of these, 633 were confirmed positive, 20 probable and 2853 negative (not a case).

Also in 2018, 171 deaths among the confirmed cases and 20 probable cases were reported making the case fatality rate in confirmed cases as high as 27 per cent.

Though the disease was more prevalent in Edo, Ondo and Ebonyi states, 20 other states recorded at least one confirmed case across 93 LGAs.

"Since the Lassa fever outbreak in 2018, NCDC has worked with states to ensure better preparedness and improved response. In the last one year, guidelines have been revised, new data management tools have been developed and the laboratory network has been strengthened. Additionally, risk communications has been strengthened through radio, posters, flyers and social media," the NCDC said then.

"A national research plan has been developed, to enable its full integration into the outbreak response to gain a better understanding of the disease", NCDC said.

Improved Diagnosis

A good development that came out from the 2018 outbreak was that researchers were able to improve on the diagnosis of Lassa Fever in the country.

Before then, Nigeria had struggled with the diagnosis of the disease as most of the samples were usually sent out of the country.

Credit: Nigeria Centre for Disease Control (NCDC) situation report But as of today, Nigeria now has four laboratories where Lassa Fever can be quickly diagnosed without much ado.

Lassa Fever is an acute viral haemorrhagic illness, 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.

Health care workers in health facilities are particularly at risk of contracting the disease, especially where infection prevention and control procedures are not strictly adhered to.

NCDC has advised members of the public to focus on prevention by practicing good personal hygiene and proper environmental sanitation.

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. The public is also advised to avoid bush burning.

The disease control agency also reminded health workers that Lassa Fever presents initially like any other disease causing febrile illness such as malaria; and are advised to practice standard precautions at all times, and to maintain a high index of suspicion. Rapid Diagnostic Test (RDT) must be applied to all suspected cases of malaria, it said.

Credit: Nigeria Centre for Disease Control (NCDC) situation report When the RDT is negative, other causes of febrile illness including Lassa Fever should be considered. Accurate diagnosis and prompt treatment increases the chances of survival.

The national guidelines for Infection Prevention and Control, as well as Lassa Fever case management have been developed, and disseminated to states.

NCDC had pledged to remain committed to supporting all states' public health teams to prevent and respond to public health threats.

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