Lassa fever: Challenges, solutions

By Toluwalope Kowo

THE word ‘Lassa Fever’ may not readily ring a bell unlike “Ebola” that swept across sub-Saharan Africa and beyond killing many people when it broke out. Now, the recurrence of Lassa fever in Nigeria and West Africa as a whole has signaled a clarion call for surveillance and stiffer measures to quickly stem its speed before it grows into a monster. To stem the spread of the disease, medical experts say government should not only mount surveillance during an outbreak, the surveillance should be a way of life that must be sustained. Besides this, establishing aggressive campaigns to educate and enlighten the public on the disease will go a long way in creating the collective force to combat it.

Knowledge, invariably, is power and the quest for adequate information about Lassa fever has made lot of people to be more eager in knowing what Lassa fever is and all that is associated with it. According to medical findings, it is hemorrhagic fever (LHF), an acute viral infection associated with persistent high fever caused by a virus. We should not be unaware that the word ‘Lassa’ is not a coinage but the name of a town in Borno State, Nigeria, where the virus was first discovered when it infected two female missionaries who later died due to poor handling and knowledge of the disease in 1969. The disease became known in other places in West Africa and since then it got the name “Lassa Fever” because its symptoms are close do those of normal fever. The recent report about the disease in some States in Nigeria affected by the newest outbreak and the number of people killed by the virus has reawaken peoples’ consciousness about the disease as deadly ‘Sister Ebola’, Wikipedia report has it that, Lassa fever frequently infects people in West Africa. It results in 300,000 to 500,000 cases annually and causes about 5,000 deaths each year.

Having knowledge of how the disease spreads will in no small measure prepare people for the health challenges and empower them with precautionary measures. Lassa fever unlike Ebola that is highly contagious and could infect a person even with a handshake, the virus can be contracted by eating infected bush rat or eating food contaminated with rodents especially multimamate rats’ excrete/urine that is deposited in foods and water or person to person when there is direct contact with body fluids such as blood, urine, saliva, among other infected persons.

The virus carrier is probably the most common mouse in equatorial Africa, ubiquitous in human households and eaten as a delicacy in some areas. The virus is shed in their excreta (urine and faces), which can be aerosolized. In fatal cases, Lassa fever is characterized by impaired or delayed cellular immunity leading to fulminant viremia.

The importance of public enlightenment and education on Lassa fever cannot be over emphasized. The public should understand and know its signs and symptoms when they come in contact with the disease. The first sign is that the illness usually starts with fever, general weakness and malaise. Others signs and symptoms are headache, sore throat, pain behind the breast bone, nausea, vomiting, diarrhea, cough, abdominal pain and swollen face, bleeding (from mouth, nose and vaginal), gastro-intestinal tract and low blood pressure.

In battling with Lassa fever or better still preventing it, people must avoid contact with rats and keep their houses and environment clean, they must cover all foods and water properly, discard any food parteaten by rats, cook all foods thoroughly, aspeople should not spread food where rats can have access to it and as soon as they suspect any symptoms relatively similar to Lassa fever or have persistent fever that is not responding to the standard treatment for malaria and typhoid. Victims are enjoined to report to the nearest health facility for early treatment. Today, Nigeria’s surveillance system has been said to be too weak to detect and pick up Lassa fever early enough. Surveillance is like insurance. If you do not pay your insurance premium, you will pay for it when the trouble comes. What happens is that people think they do not need it. Surveillance enables you to monitor what is going on like when you have more febrile cases coming into your hospitals. Despite advancement in medicine, it shows that Nigeria’s healthcare system is weak in disease prevention and control.. Typical signs and symptoms of Lassa fever patient should look out for after three weeks of coming in contact with the virus include abdominal pain, back Pain, chest Pain, conjunctivitis, cough, diarrhea, facial swelling, fever, mucosal bleeding, Pro-teinuria, Sore Throat, Vomiting in severe cases and Encephalopathy. Others are haemorrhage hypotension, pleural effusion, seizures, swelling of face and neck, The following domestic and other measures can be adopted to prevent the outbreak. First, rodents should be kept out of homes and food supplies, as well as maintenance of effective personal hygiene. Gloves, masks, laboratory coats, and goggles are advised to be disposed while in contact with an infected person. It is important to practice hand washing hygiene and also wash with salt and warm water before eating. According to a nutritionist, Mr. Olaolu

Olusina, 43 years, women should avoid tasting of dry garri by chewing them for starch in the market. All garri soakers should let go for now. The problem is that most garri sellers in the market buy their garri from rural markets that are not hygienically conscious. Nigerians were indeed jolted when the news of a fresh outbreak of Lassa fever was broken by the Federal Ministry of Health, few months ago. Many were worried at the revelation that the disease, which had spread to 12 States including Edo, Taraba, Borno, Gombe, Yobe, Plateau, Nassarawa, Ebonyi, Ondo, Rivers, Anambra and Lagos States, was being transmitted through a species of bush rats.

Meanwhile, in its quest to prevent this killer disease in Ogun State, state government has not only embarked on enlightenment campaign to alert its citizens on the symptoms of Lassa fever, but also put in place surveillance measures across the 20 Local Government areas of the State to prevent the disease from spreading among the people as well as engaging on personal hygiene and clean environment.

According to the Ogun State Commissioner for Health, Dr. Babatunde Ipaye, the Government “would do everything possible within its power to guard against the spread of the disease from neighboring States”. He advised members of the public to report cases of any unusual symptoms that normal malaria drugs could not be easily treated which include bleeding from the nose and other parts of the body, muscle pain, chest pain and low blood pressure to the state Ministry of Health or the nearest General Hospital for quick intervention.

•Kowo writes from Abeokuta, Ogun State.

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