Nigeria: Lassa Fever and the Challenge of Curtailing Deadly Diseases

A transmission electron micrograph of a number of Lassa virus virions adjacent to some cell debris. The virus, a member of the virus family Arenaviridae, causes Lassa fever.
3 January 2021

Since December last year when the deadly Coronavirus reared its ugly head in a far-flung corner of the world called Wuhan in China, the world has known little peace. Millions have died and are still dying, even as the world is locked in fear following the second wave of the pandemic. Little wonder, therefore, that most other killer diseases are today being mentioned only in whispers, one of which is the equally devastating Lassa fever.

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 is also a haemorrhagic virus, which means it can cause bleeding, though eight out of every 10 people with the virus may display no symptoms. It affects the liver, kidneys or spleens and can be quite fatal. There is currently no vaccine that protects against Lassa fever.

According to data obtained from the Nigeria Centre for Disease Control (NCDC), no fewer than 242 deaths occurred in Nigeria alone last year between the 1st and 51st weeks, even as there were 6,668 suspected cases of the disease, out of which 1,175 were laboratory confirmed.

The figures contained in the NCDC's recent epidemiology report further indicate that three states, Ondo, Edo and Ebonyi accounted for the highest number of deaths, putting suspected and confirmed cases at 23, 81 and 40 respectively.

In total, 27 states recorded at least one confirmed case of Lassa fever across 130 local government areas in 2020. Of all confirmed cases, Ondo State had 36 per cent, Edo 32 per cent and Ebonyi 7 per cent, even as the number of suspected cases significantly increased compared to reported cases for the same period in 2019. Recall that Lassa fever assumed a national health emergency phase on April 28 last year.

Today, Lassa fever has become a disease of the developing world, with hazardous outcomes reported in different parts of the world. Growing concerns of the potentials of Lassa fever virus as a biological weapon is real, yet no lasting solution to this problem has been developed for nearly half a century of its identification in a remote village in Nigeria.

One major challenge of Lassa fever is its high virulence and fatality which is further complicated by the non-specific modes of presentation (mimicking some other fevers). From the foregoing, early presentation and subsequent diagnosis is usually not feasible, especially in our hinterlands and villages.

The contagious nature of the illness poses a big threat to the medical attendants, other hospital workers and the care-givers who often are exposed to the disease unprotected prior to diagnosis and establishment of barrier nursing

Unavailability of safe vaccines and cost effective/efficient rapid kit for diagnosis nearly half a decade after identifying the disease has hampered the containment of the illness. Obviously, the future lies in effective and safe vaccination of the populace as in the case of Yellow fever.

As the world battles to contain the spread of Lassa fever, this newspaper recommends proper education/enlightenment of the Nigerian populace, especially at the grassroots, on the dangers of the disease, its mode of presentation and the need to seek medical treatment early.

Also, awareness campaigns should be intensified with advocacy on clean and safe environment to promote prevention, especially within the endemic areas. Abrogation of practices that might enhance contact with Lassa fever should also be encouraged. Another level of control should involve setting up serviceable diagnostic and treatment centres for Lassa fever within the West African sub-region and beyond to enhance prompt therapy and containment of the illness.

The health personnel that work in such centres should be well protected, paid enhanced salaries and their lives insured. Well designed and funded research should be instituted in this field to facilitate ameliorating breakthroughs.

Finally, the ultimate aim should be towards producing a functional and safe anti Lassa fever vaccine that could be incorporated into the immunization programmes for children and adults respectively. The adverse immunological response to Lassa antibodies such as hearing loss must be taken into cognition prior to the approval of such vaccine for human use.

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