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SASTM Newsflash - Lassa fever - Nigeria


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SASTM Newsflash




Scientists at Nigeria's only hospital that specializes in the treatment of Lassa fever, Irrua Specialist Hospital, Benin were unanimous that this year [2013] is likely to be the worst since 1969 when the 1st case was recorded in Lassa, Borno State, going by early signs. "With the number of patients currently on admission and those who have so far died from the illness, Nigeria may record the worst Lassa fever epidemic this year," head of nurses, Lassa Fever Ward, Irrua Specialist hospital, Mrs Rebecca Atafo told Weekly Trust. Mrs Atafo said the pathetic death of a family of 3, which was wiped out by the dreaded illness in January 2013, shows the gravity of the problem at hand.


The hospital record obtained by the Weekly Trust shows that 100 patients were brought to the institution in January 2013 alone, out of whom 40 died. According to the breakdown of the cases by the scientist at the research and documentation centre of the hospital, Ikponwonsa Ordia, Edo State has the highest figure of 38 reported cases out of whom 15 died. Ondo State has the 2nd highest with 19 patients, out of whom 8 died; this was followed by Taraba State with 8 cases brought to the hospital, out of whom 3 died. Other states include Benue with 6 patients, Plateau (2 patients), Rivers, Nasarawa and Ebonyi (one each), as well as Abuja (5) among others.


Ordia said that by the end of February 2013, the number of patients brought to the hospital had risen to 190, out of whom 100 died, while 30 are still in critical condition. He said these figures only represented cases brought to the hospital in Irruah, when the situation has gotten too bad to handle, explaining that many more must have died from the illness across the country. He said the victims from Taraba and Ebonyi States are health workers, wondering what could have happened to the patients they got infected from and their families.


Chief medical director of the hospital, Professor George Akpede said although the outbreak has been reported in more than 13 states, the epidemic may be countrywide. Confirmed cases from affected states show that the death rate is higher than the official statistics had revealed. Reports from Plateau State showed that the virus has claimed 3 lives from the village of Tuwan in Kanke local government area of the state alone. Health workers were unanimous that the illness is not limited to Tuwan alone.


In Nasarawa State, 5 cases were confirmed within Tudun Gwandara, in Karu Local Government Area after diagnoses at the Dalhatu Araf Specialists' Hospital (DASH) in Lafia. There was also an official confirmation of one death from the illness in the state. Weekly Trust [newspaper] also learned that the virus claimed 2 lives in Ebonyi State out of the 6 confirmed cases, apart from the one listed by doctors at Irrua.


Prof Akpede said there had been a 60 per cent increase in suspected cases and an 80 per cent increase in confirmed cases across the country. He said more than 51 million Nigerians are at risk, with the annual number of illnesses estimated at 3 million and the annual number of deaths estimated at about 58 330. He said 15-20 per cent of patients hospitalized for Lassa fever die from the illness. "The death rate during epidemic is, however, far higher, ranging between 30 and 60 per cent. The death rate is particularly high for women in the 3rd trimester of pregnancy and for the fetus, about 95 per cent of which die in the uterus of infected pregnant mothers," he revealed.


Former commissioner for health in Edo State Moses Momoh agreed that there is really a Lassa fever epidemic across the country. He said the disease, which is seasonal and restricted to Edo central, has now spread to all parts of the state and now occurs all year round. "It is no longer a seasonal disease," he noted, while calling for joint action by stakeholders to tackle the menace.


Worried by the upsurge of the disease, the federal government has sent an intervention team to some of the affected states to "investigate and put in place preventive measures to avoid the spread of the disease." Minister of health Onyebuchi Chukwu said the team went with drugs from the ministry and with personal protection equipment; they will investigate the cases. They will do contact tracing and mount environmental control. "Then, they will meet with the state officials to come up with information and education materials that can be distributed to people in their own languages," he said. The minister said the aim of distributing the information materials in the vernacular was to facilitate awareness on prevention.


However, experts, advice the federal government to find a lasting solution to the menace instead of waiting for an outbreak before deploying its men to affected areas. "Why would the government wait for an outbreak before it begins to think of printing information materials on prevention to residents of the affected areas? What purpose would that serve in the 1st place," a medical doctor with a private hospital in Jalingo, Dr Joseph Banjamin, queried. He said that for a disease that is seasonal, intervention was supposed to be an all-round thing. "Between last year [2012] and now, what has really been done in the area of prevention across the country, especially since the areas prone to attacks are known? Are health centres more empowered to deal with the situation now than they were last year? How equipped is the specialist hospital in Irrua to deal with the spread?"

he asked.


Director of administration of Irrua Specialist Hospital Mr Tony Edeko said the manpower and equipment available at the hospital are grossly inadequate to deal with the rising cases of Lassa fever. He said the hospital requires more isolation facilities and dialysis machines in addition to manpower to enable it to deal with the new reality. A former vice chancellor of the Ambrose Alli University, Ekpoma, Professor Dennis Agbonlahor, has said poor funding and lack of political will are responsible for the prevalence of Lassa fever endemics in Nigeria. Prof Agbonlahor said the Nigerian government had yet to show enough commitment towards Lassa fever eradication over the years.


The former AAU VC said funds donated by foreign donors for establishment of Lassa fever laboratories in each of the zones of the federation were collected by some officials of the Federal Ministry of Health but never accounted for.


Prof Agbonlahor said Lassa fever has claimed more lives than more publicized infectious diseases such as meningitis, HIV/AIDs, acute diarrhea, among others. He said over 100 000 lives had been lost to Lassa fever between 1969 and 2013, adding that many unrecorded deaths occurred in rural areas.


Prof Agbonlahor said 23 states in Nigeria were affected by Lassa fever in 2012 out of which 87 deaths were recorded. He said Lassa fever cases were confirmed in Nigeria only 39 years after its 1st outbreak in 1969 because there were inadequate laboratory diagnostic facilities for confirming suspected cases of Lassa fever. Prof Agbonlahor said vaccination against Lassa fever in the country has not been possible due to lack of funding and political will. He urged the federal government to establish zonal diagnostic offices for Lassa fever across the country and to also show more interest and concern on the control and eradication of the disease.


Meanwhile, Dr Nasidi Abdulsalami, director, Nigeria Centre for Disease Control, said there has been no new case of Lassa fever since drugs were sent to Ondo and Benue. He said the cases in Ondo are still confined to Ose Local Government Area. "But we are expanding our reach on prevention, not just with Lassa fever but other similar diseases as well. As you know, this is the season. We are in a meeting to increase the reach of prevention. We are also implementing and strengthening the early warning and reporting system to catch any suspected new case," he said.


Communicated by: ProMED-mail


This review describes vividly the extent of the current epidemic of Lassa fever affecting central and northern Nigeria but neglects consideration of the fact that the reservoir host of Lassa virus is the rodent known as the "multimammate rat" belonging to the genus _ Mastomys_. These rodents produce large numbers of offspring and are numerous in the savannas and forests of west, central, and east Africa. Most relevant is their habit to readily colonize human homes. The _Mastomys_ spp. rodents shed the virus in their urine and faeces. Therefore, the virus can be transmitted through direct contact with these materials, through touching or eating food contaminated with these materials, or through cuts or sores. Because _Mastomys_ rodents often live in and around homes and scavenge human food remains or poorly stored food, transmission by this means is common. Contact with the virus also may occur when a person inhales tiny particles in the air contaminated with rodent excretions. Therefore, control of human infection will require general improvement of living conditions and rodent control rather than reliance on deployment of medical care and a vaccine which does not yet exist.




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The information provided in SASTM Newsflashes is collected from various news sources, health agencies and government agencies. Although the information is believed to be accurate, any express or implied warranty as to its suitability for any purpose is categorically disclaimed. In particular, this information should not be construed to serve as medical advice for any individual. The health information provided is general in nature, and may not be appropriate for all persons. Medical advice may vary because of individual differences in such factors as health risks, current medical conditions and treatment, allergies, pregnancy and breast feeding, etc. In addition, global health risks are constantly evolving and changing. International travelers should consult a qualified physician for medical advice prior to departure.

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