What to know about Lassa fever

I heard that Lassa fever has started again. Since garri causes the disease, I am going to stop drinking garri till during rainy season,” Aminu told a gathering of friends.

“Yes it is good to keep garri and other foods away from rats from now till April when the dry season is over,” one of them responded with nods of agreement from the others.

While the two friends where right in some aspects, they were wrong in others. Like the duo, there are still many Nigerians who do not have enough knowledge about Lassa fever. The disease is not caused by garri and it is not transmitted through drinking garri alone; also, it is not just any type of rat that causes Lassa fever.

The virus is carried in multimammate rats, the common soft-furred African rat whose female has a double row of breasts. They normally live in bushes and visit nearby homes for food, which they contaminate.

Also, while more cases of the diseases occur during the dry season, it actually occurs all year round so precautions should not be limited to between November and April alone.

Lassa fever is an acute febrile illness with an incubation period of 6-21 days and comes with bleeding and death in severe cases. It was first detected in Nigeria 50 years ago.

Nigeria has continued to experience consistent seasonal and sporadic outbreaks of Lassa fever.

According to the Nigeria Centre for Disease Control (NCDC), Lassa fever is a viral hemorrhagic illness, caused by contact with food or household items contaminated with rodent urine or faeces. The Lassa virus may also be spread between humans through direct contact with blood, urine, faeces, or other bodily secretions of an infected person; laboratory transmission can also occur.

Sometimes a large percent of Lassa fever cases maybe unnoticed because it has similar symptoms for other common diseases.

Outbreaks of Lassa fever have resulted to loss of lives among the general public and health workers.

Asked if people should stop drinking garri completely because of  Lassa fever, Dr Ugochukwu Eze, a physician, said while he would not categorically tell people to stop drinking garri, it is important to note that  people could become infected with the disease if they ate or drank garri or any food left exposed that the multimammate rat had passed stool or urinated in, especially when not cooked, adding that since they do not know  how much the garri they buy from the market has  been left exposed to rats or the virus, caution may demand one to avoid drinking it.

Dr Ogugua Osi-Ogbu, a consultant physician and coordinator for Lassa fever at the National Hospital, Abuja, said the disease occurred mainly in the dry season because bush burning for the next planting season drives rats from bushes into homes.

Indeed at the moment the country is presently witnessing a Lassa fever outbreak. Since the beginning of this year, the disease has claimed 31 lives, and a total of 377 suspected cases have been reported from nine states.

A situation report released by the Nigeria Centre for Disease Control (NCDC) last Friday said between January 14 and 20, 74 new confirmed cases were reported from Edo, Ondo, Bauchi, Ebonyi, Plateau, Taraba and Adamawa states. Also, 12 new deaths were recorded in Ondo, Edo, Ebonyi, Plateau, Taraba  and Adamawa during the period. A healthcare worker was also affected in Ebonyi State.

Edo State is worst hit by the outbreak during the period with 31 cases; Ondo recorded 18 cases; Plateau 10 cases, while the Federal Capital Territory (FCT) recorded one case since the 2019 outbreak.

“Eighty-one patients are currently being managed at Irrua Specialist Teaching Hospital (ISTH) treatment centre, Federal Medical Centre Owo, Bauchi , Plateau Taraba and Ebonyi states. A total of 918 contacts have been identified from eight states. Of these, 803 are currently being followed up, 109 have completed 21 days follow up,” the report said.

The Director, Public Health and Human Service Secretariat in the Federal Capital Territory Administration (FCTA), Dr Humphrey Okoroukwu, said from November 2018 to date, the organisation has responded and investigated 14 cases comprising six females and four males.

He said out of this number, five cases were confirmed positive to Lassa fever and that three of the cases came from Nasarawa State to the FCT to access healthcare.

Dr Okoroukwu said one result was still pending, and that 87 high risk contacts identified have exceeded their 21 day incubation period.

“Only one case has been confirmed positive from November  2018 to January, 2019,” he said.

Minister of Health Prof. Isaac Adewole had during each outbreak urged the public to prevent its spread by not spreading food to dry along the road, keeping food in tightly sealed containers, wearing protective clothing such as masks, gloves, gowns and goggles when caring for patients with Lassa fever, and avoiding contact with Lassa fever patients’ secretions.

He advised that once such symptoms are noticed, affected individuals should report immediately to the nearest health facility

Dr Ogugua Osi-Ogbu, the consultant physician said, “The cover of your pot or water must be ‘rat proof’, the rat must not be able to easily displace it. The same thing goes for food. Washing our utensil is very necessary; cups, plates, cutlery must be thoroughly washed before usage. You don’t just pick them and use for the sake that it has earlier been washed not minding if rats had perched on them.

“We must also know that not every fever is malaria. If you have fever that has been treated and it’s not going away, you must visit the hospital because there could be other reasons, one of which is Lassa fever. The good thing about it is that it is treatable if we start treatment on time.

“A lot of people continue treatment severally thinking they have malaria or typhoid thereby leading them into the late stage of infection.”

Dr Ogugua advised health workers to maintain standard procedures when managing patients. She also enjoined family members of any victim of the disease to take precaution while attending to their infected relations through avoiding direct body contact with the patients’ fluid, and also taking the patients to hospital as soon as sign of ailment is seen.

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