Battling Lassa Fever : The Rivers Example

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Since ever the first Lassa Fever case was made public early this year in Rivers State, the disease has continued to make serious in-roads into other parts of the country.

As at last week, figures made available by the Federal Ministry of Health indicate that so far, 40 lives have alaready been lost to the epidemic nationawide.

Just between January and February, the epidemic has crept into 12 states. The states include Edo, Nassarawa,Plateau, Ebonyi, Taraba, Yobe,Ondo Rivers, Gombe, Anambra, Delta and Lagos.

In Rivers State, official sources put the death rate at two, but there are claims that it may have risen to six.State Commisioner for Information and Communication Mrs.Ibim Semenitari after last week State Executive Council Meeting debunked the figures.

She submitted,’’ there are about six cases that are yet to be confirmed. The second case we have currently is on admission and the patient is doing very well because it was caught on time”.

Federal Minister of State for Health, Dr. Mohammed Pate disclosed that the disease was first reported in endemic States of Edo, Nassarawa and Plateau from where it was subsequently exported to Lagos, Port Harcourt and Yobe

.He described Lassa Fever as an acute febrile illnes, with bleeding and death in severe cases caused by Lassa virus. It has an incubation period of between six and 21 days to manifest in patients.

Dr. Pate further stated,’’ The Ministry through its surveillance system started to see cases of this in isolated manner but those cases accumulated. So far, there are 397 suspected cases of which about 40 individuals have lost their lives unfortunately as a result of this viral disease.”

But prior to the announcement by the federal authorities last week, the Rivers State Ministry of Health had commenced efforts in tackling the menace.

It would be recalled that in January a youth corp member serving in Opobo/Nkoro Local Government Area of the state was reported to have died of the disease and since then, the health authorities commenced what they called,’’ tracing’’, but while on the course of tracking the trail of the epidemic news filtered in again of the death of a second victim at the University of Port Harcourt Teaching Hospital(UPTH), where currently a Rapid Response Centre had been set up.

It was against this backdrop that on the 11th of February, the State Commissioner for Health, Dr. Sampson Parker visited the UPTH to see things first hand. Faced with the reality of the situation, Dr. Parker there and then declared that there was Lassa Fever epidemic in the state.

The Commissioner submitted,’’ this is a public health challenge, there is Lassa Fever in Rivers State and we must do all we can to curb the menace”.

His declaration came against the backdrop of poor emergency planning in the country,’’ we really have to look at what we can do now,” Dr Parker observed, ‘’ and a Committee has to be set up to swing into action immediately”.

But prior to the set up of the Committee- made up of both federal and state health officials, a brief study of the situation was done by the Commissioner and the hospital authorites.

Dr. Justina Jumbo a top epidemiologist in the federal hospital first briefed the Commissioner and simulated the situation. First, she recalled that the first case of Lassa Fever was isolated in the Western part of the country in 1969.

She noted that the disease was making its presence in Rivers State for the first time,’’ this is the first time a trace is being made in Rivers State,” she asserted,” and it was a youth corp member who spent three weeks in camp that went to Opobo and died a week later of the disease at her home state.”

Dr. Jumbo expressed worry that some of the symptoms of the fever looks so similar to that of malaria and typhoid hence most infected persons may be treating malaria, while the disease eats deep into their system.

Symptoms include high fever, back pain, abdominal pain, diarrhea and stooling of blood.

The virus is mostly transmitted through direct contact with eating foods contaminated with rat feces and urine or cuts and sores when they may have contact with them

She further stated,’’ 15 percent of patients have hemorrhage and we dont have sufficient Rapid Diagnostic Kits”.

A medical personnel in Opobo/Nkoro where the disease was first reported, Mr. Henry Minimah told The Tide that after the first case no other incident has been recorded.

‘’ For now at the Primary Health Care level once we identify the case we refer it to UPTH.”

Mr. Minimah noted that sometime it can be airborne, emphasising that once a person is close to an infected person, such person was at risk,’’inshort too much contact led to the death of a caregiver in UPTH recently”.

Airborne transmission is when a person inhales particles in the air contaminated with rats excretions. A complication of Lassa fever is deafness. it develops in mild as well as severe cases. As a result the citizenry is advised to report any strange ailment or feverish conditions that has lasted for more than two days to the nearest hospital for tests.

Commissioner for Information and Communications, Mrs. Ibim Semenitari warned the populace,’’ please when you notice any symptom of having a fever that is not going or high temprature that is not going or any sign that have been indicated please go to the nearest health centre.”

He advised people to keep their environment clean, by clearing their drains, and killing rodents and avoid frequent handshake with strange people.

Another medical personnel in the hospital, Dr. Tobin West, who is the Head of Community Health in the hospital called for the set up of a special emergency ward, noting that the major problem was getting infected persons an isolated unit to avert contact with other patients.

He also called for increased staffing anf enlightenment campaign,” we are ready to act as a referral centre for the state…since the outbreak of the epidemic some of our medical staff have become symptomatic,” he added.

Nonetheless, one major challenge at the initial stage was the diagnosing the disease. The earliest patients blood samples was taken to Irua in Edo State for testing.This not only proved a challenge, it gave rise to delays in prompt treatment of cases.

However after hearing the report, The State Commissioner of Health swinged into action. First, he ordered that a Rapid Response Unit be set up in the hospital to assist in taking patients. But before then he inaugurated a Joint Committee for the team made up of officials from the Federal and State Health Ministry of Health.

Dr. Parker also directed the Permanent Secretary, Dr Godwin Mpi to immediately provide logistics. Which include provision of vehicles, diagnostics kits and injectibles. Consequently, a diagnostic centre was set up in UPTH to reduce the time lag of waiting for test results from Irua Centre for Disease Control in far away Edo State.

In his recommendations, Dr. Mpi harped on the need for sensitisation to cover military formations. According to the permanent secretary such areas like barracks and slums were prone to high presence of rodents-the major transmitter of Lassa Fever.

Dr Mpi also said that the team should include core Ministries that oversee the environment since that would aid the coverage of campaigns.

Last week however, the Rivers State Executive Council ordered the mobilisation of Public Health Officers to all parts of the state.

The health officials are expected to boost enlightenment and enforce environmental hygiene in the various neighbourhoods in the state. Already Ministry officials have started raiding dirty nieghbourhoods. Only last week No.23 Ihute Street in Mile III axis of Port Harcourt was thoroughly combed and some of the buildings were closed down due to poor sanitation.

In addition, Commissioner for Health said the 110 Health Centres have been equipped and supplied with necessary medical kits required to check the epidemic.

He assured that Government would not relent in sensitising her citizens and fight the disease mostly transmitted by rats.