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Lassa Fever: One Outbreak Too Many

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L-R: Executive Director, National Primary Health Care Development Agency, Dr Ado Muhammed, Director-General, National Orientation Agency, Mr Mike Omeri, Minister of State for Health, Dr Osagie Ehanire, Minister of Health, Prof. Isaac Adewole and Minister of Information and Culture, Alhaji Lai Mohammed, during a joint Ministerial news conference to give update on the outbreak of Lassa Fever in Nigeria, in Abuja, yesterday

L-R: Executive Director, National Primary Health Care Development Agency, Dr Ado Muhammed, Director-General, National Orientation Agency, Mr Mike Omeri, Minister of State for Health, Dr Osagie Ehanire, Minister of Health, Prof. Isaac Adewole and Minister of Information and Culture, Alhaji Lai Mohammed, during a joint Ministerial news conference to give update on the outbreak of Lassa Fever in Nigeria, in Abuja, yesterday

Lassa fever, otherwise called
Lassa Hemorrhagic Fever (LHF), a deadly disease was first diagnosed in 1969 in the town of Lassa in Borno State, Nigeria. Since that discovery, the disease has spread to other West African states such as Liberia, Sierra Leone, Guinea and Central African Republic. Medical experts argue that the re-emergence of this outbreak appears to be spreading faster than the previous ones, and have advised that more effective surveillance and preventive measures should be taken to curb this deadly disease.
Cause
The Lassa virus is a zoonotic disease. It is transmitted from animals and spreads to humans from rodents which are the primary host of the Lassa virus, especially Natal Multimammate mouse (Mastomys natalensis), an animal found in most parts of sub-Saharan Africa popularly known as Rats (i.e animals with a very long mouth and long tail in this part of region).
Lassa Fever or Lassa Hemmorrhagic Fever is a member of Arenaviridae virus family which is an acute viral hemorrhagic fever. The virus is very hard to distinguish from other viral diseases caused by the Lassa virus, especially the Marburg and Ebola as well as such other more common febrile viruses that trigger malaria.
It usually infects people in West Africa, and is estimated to have resulted in 300,000 to 500,000 cases annually over the last few years. In fact, it has caused the death of about 5,000 persons each year. The fever accounts for up to one third of deaths in hospitals within the affected region.
Despite the disease outbreak, rat meat still remains an important source of protein and one of the most enjoyed delicacy by some people in Africa, particularly Nigeria. Yet, it is the carrier of the deadly disease called Lassa fever.
An important message for those that prepare rat meat delicacy, is that there is the need for them to  know that infection takes place during the process of finding and preparing the rat for consumption. Experts say that the virus that causes the disease is excreted in urine and could stay for 3-9 weeks or in semen for three months.
This deadly disease has since 1969 been a cause of major deaths in Nigeria. In April, 2012, it caused the death of over 70 persons officially recorded from 19 out of the 36 states in the country. In 2014, the disease claimed 20 lives across the country. Now, the disease has re-emerged, claiming many more lives, and sending others to hospital beds.
With the present outbreak in Nigeria, citizens have been advised to ensure a high level of personal hygiene to avoid being infected by the virus. This means that the people must keep food stocks and environment clean as well as report as soon as possible any symptoms to the nearest healthcare centre or medical facility for early intervention and treatment.
As at the last count, the Federal Ministry of Health has confirmed the death of 41 people out of 93 reported cases of Lassa fever outbreak in 10 out of the 36 states in the country. According to the Minister of Health, Prof Isaac Adewole, the deaths were recorded in Bauchi, Nasarawa, Niger, Taraba, Kano, Rivers, Edo, Plateau, Oyo and Gombe states.
He said the ministry had ordered for the immediate release of adequate quantities of ‘ribavirin,’ the specific antiviral drug for Lassa fever, to the affected states for immediate treatment of patients. He also directed health facilities in the country to emphasise routine infection prevention and control measures, and ensure that all Lassa fever patients are treated free.
The minister, who said this in Abuja while briefing newsmen on the outbreak of the Lassa Hemorrhagic Fever (LHF), also advised citizens to improve on their personal hygiene, which he said includes food hygiene and food protection practices. He further advised people to avoid contact with rodents and rats as well as food contaminated with rat’s urine and excreta by covering all food while avoiding drying food in open spaces and along roadsides.
The Director, National Centre for Disease Control, Prof. Abdulsalam Nasidi, has also confirmed the death of 41 persons, saying that results of tests on some other cases are still being awaited. He described the fatality rate as high, nothing that the deaths so far were largely because the infected persons did not report early to the nearest healthcare centres for treatment. According to Nasidi, “We are still reviewing the preliminary reports. We have sent teams to Taraba State. We are already working on all the samples collected. We even sent some drugs already,” and described the situation as “really terrible.”
Already, the Federal Government has set up a four-man expert committee, headed by Prof Michael Asuzu to visit the most endemic states, such as Kano, Niger and Bauchi. “The committee will embark on a fact-finding mission, assess the current situation, document response experiences, identify gaps and proffer recommendations on how to prevent future occurrences”, the Health Minister, Prof Isaac Adewole, said. He assured that the committee was not to apportion blame but rather to document lessons learnt for better planning of an effective response, explaining that part of the long-term response is to establish an inter-ministerial committee to deliver a final blow on Lassa fever and other related diseases in the country.
Even as the Ministry of Health is working hard to contain the spread of the disease, and prevent further infections, the Senate yesterday, summoned the minister to appear before it to explain further what the government was doing to curb the epidemic, and save Nigeria from the Lassa fever shame.
Here in Rivers State, the Chairman, Nigeria Medical Association (NMA), Dr Briggs Furo, has confirmed the outbreak of Lassa fever, corroborating the statement by the state Commissioner for Health, Theophilus Ndagme that two persons have died as a result of the infection of Lassa virus in Rivers State.
Following that confirmation, the state Deputy Governor, Dr Ipalibo Harry Banigo, has called on residents of the state to maintain a high level of hygiene to check new cases and spread of the disease in the state. She charged the Ministry of Health in collaboration with the Ministry of Information and Communications, to embark on sensitization and enlightenment programmes to ensure that residents of the state are better prepared to battle the spread of the disease.
Indeed, there is no reason why residents of the state should not key into the appeal of the Chief Nyesom Wike-led Rivers State Government to exhibit high level of hygiene habits and be cautious of what they eat to avoid being caught in the web of the Lassa fever net. This same appeal goes to all Nigerians, especially those in states where some persons have already died as a result of the epidemic. Every Nigerian must exercise high level of caution in this matter.
Mode of Transmission
A fact sheet of the World Health Organisation (WHO), also says that: “Person-to-person transmission occurs through direct contact with the sick person. Laboratory transmission occurs as well, particularly in hospitals lacking adequate infection prevention and control measures.” This “Person-to-Person transmission occurs in both community and healthcare settings, where the virus may be spread by exposure to infected rodents, or contaminated medical equipment such as re-used needles. Sexual transmission of Lassa virus has been also reported.”
What Are Its Signs and Symptoms
According to WHO, “The incubation period of Lassa fever ranges from six to 21 days before an acute illness with multi-organ involvement can develop. The onset of the disease, when it is symptomatic, is usually gradual, starting with fever, general weakness, and malaise. After a few days, headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhea, cough, and abdominal pain may follow.
“In severe cases facial swelling, fluid in the lung cavity, bleeding from the mouth, nose, vagina or gastrointestinal tract which include Nausea, Vomiting (bloody), Diarrhea (bloody), stomach ache, constipation, dysphagia  (difficulty swallowing), hepatitis. Others are cardiovascular system which includes pericarditis, hypertension and tachycardic (abnormally high heartnrate). It also includes Respiratory tract which manifests in cough, chest pain, dysphoea, phyryngitis, and pleufitis. Within the same period, low blood pressure may develop. Low protein may also be noted in the urine.
Another is the Nervous system, which includes Encephalitis, meningitis, unilateral or bilateral hearing deficit shocks, seizures, tremor, disorientation, and coma. This may be seen in the later stages. Deafness occurs in 25 per cent of patients who survive the disease. In half of these cases, hearing returns partially after 1 to 3 months. Transient hair loss and gait disturbance may occur during recovery.
“Death usually occurs within 14 days of onset in fatal cases. Humans usually become infected with Lassa virus from exposure to urine or faeces of infected Mastomy rats. Lassa virus may also be spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of a person infected with Lassa fever.”
Research shows that there is no epidemiological evidence supporting airborne spread between humans. It also reveals patients infected have shown some symptoms similar to those of malaria.
WHO admits that the overall case fatality rate stands at 1 per cent. It insists that the observed case-fatality rate among patients hospitalized with severe cases is 15 per cent, and argues that early supportive care with rehydration and symptomatic treatment improves chances of survival.
Major challenges
Emerging and re-emerging epidemic diseases such as this pose an on-going threat to global health security. The major challenges are the on-going security risks in the country, limiting access to some areas as well as the jeopardizing availability of resources to respond to the escalating outbreak.
WHO does not advise or recommend any restrictions on travel to Nigeria, and it is expected that no state government should. Travelers returning from affected areas who develop the symptoms of fever should seek medical advice. That is the right way to go to check the spread.
Prevention
The government, its partners and other stakeholders should ensure that they work tirelessly to address the outbreak and bring it to timely end.
It is already established that those at greatest risk are persons living in rural areas and slums where mastomys are found. There is no injection or vaccine to prevent Lassa fever, but the Federal Government has already distributed drugs to states to help curb the spread and impact of the disease. Therefore, we must prevent its spread by non-contact with rats. We must ensure that we avoid the faeces and urine of animals accessing grain stores in residences or market places where grains are stored. Given its high incidence rate, Lassa fever is a major problem in affected countries. Avoid exposure to infectious materials.
It is important to advise that we maintain an effective personal hygiene by ensuring that gloves, masks, laboratory coats and goggles worn while in contact with an infected person. The various Departments of Public Health personnel must ensure that there is proper monitoring and sensitization campaign programme, so as to effectively control the outbreak of this deadly disease.
All borders of states in Nigeria should activate their surveillance mechanisms, so that anybody with fever, severe headache, swallows and breathing difficulty should be treated with dispatch. And in all cases, Nigerians are encouraged to access recommended drugs for early treatment, if symptoms are noticed. At this time in Nigeria’s history, Lassa fever should not be an issue of national concern. Nigeria is supposed to have outgrown this pandemic by now!

 

Susan Serekara-Nwikhana

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APC, PDP Bandy Words Over Buhari’s Fresh Loan Request

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The ruling All Progressives Party (APC) and the opposition Peoples Democratic Party (PDP) have argued over President Muhammadu Buhari’s request for approval to borrow $4 billion and €710 million to fund the deficit in the 2021 budget.
Recall that the president made the request in a letter he addressed to the National Assembly on Tuesday.
The Peoples Democratic Party (PDP), in reaction to the development, cautioned the NASS against approving the request, saying it could set the country’s debt profile skyrocketing without a feasible repayment plan.
With the approval to borrow $8.3 billion and €490 million loans by its legislative body barely two months ago, Nigeria’s debt profile risks reaching over N40 trillion.
“More alarming is that the debts that APC is hanging on Nigerians are for nebulous projects whose scopes, utilities, locations and contractors are largely vague; a development that validates apprehensions of a huge swindle on our nation at the expense of innocent Nigerians, including generation yet unborn. 
“Our party holds it as an act of wickedness that individuals who know that they will be leaving office in less than two years will be accumulating debts instead of seeking ways to reduce the liability they have brought upon our nation.
“The APC knows it will not be around after May 29, 2023. That is why it is pushing our nation into a deeper economic quagmire with foreign loans, which are largely diverted to the personal pockets of their corrupt leaders,” the opposition PDP said in a statement signed by its spokesperson, Kola Ologbondiyan, on Tuesday.
But responding to the PDP’s criticism, the All Progressives Congress (APC) on Wednesday, said the loans are for “the good of the country” and well-being of the citizenry.
The ruling party also accused the opposition party of looting foreign loans obtained during its 16 years rule rather than spending on infrastructure and economic growth as, according to it, Mr Buhari-led government is doing.
“It was in PDP’s era that loans to fund power generation, purchase arms and ammunition to fight a raging insurgency were misappropriated and diverted to fund PDP activities; and the borrowed money ultimately found its way to the pockets of cronies, friends and family members of administration officials. Nigeria is still servicing a $460 million loan taken from China to fund a phoney Abuja Closed-Circuit Television (CCTV) contract awarded in August 2010.
“Nigerians should also reflect and recall that the PDP had in its 16 years of misrule pushed the country into a dark ditch of insolvency, and a period in which most state governments could not pay workers salaries, not even the minimum wage, or settle contractors’ bills and cater for patients in hospitals, to name a few,” the APC interim National Secretary, John Akpanudoedehe, said.

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A’Ibom Gov Signs Anti-Open Grazing Law

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Akwa lbom State Governor, Udom Emmanuel, has signed into law a bill to prohibit open rearing and grazing of livestock and provide for the establishment of ranches in the state.
The Speaker, Aniekan Bassey, with the Attorney General and Commissioner for Justice, Mr Uko Udom (SAN), presented the bill for signing on Wednesday at the State Executive Chambers, in the Governor’s Office, Uyo.
The governor, after signing the bill into law, stated that the new law was no respecter of persons irrespective of status or calibre.
He instructed relevant authorities of government to ensure that the law was implemented and enforced to the letter with strict compliance, stressing that, culprits must be brought to book accordingly.
The new law will promote modern techniques in animal husbandry, prevent the destruction of farms by wandering cattle while reducing clashes and killings between herders and farmers in the state.
It will also promote international best practices in livestock administration, regulation and control in the state, among other things.
The state Assembly passed the bill on Tuesday, and the Speaker, Aniekan Bassey, directed the Clerk of the House, Mrs Mandu Umoren, to communicate the decision of the House to the Governor for his assent.
Also at the Executive Chambers, the Speaker who was accompanied by the Leader of the House, Udo Kierian Akpan, and the Clerk of the Assembly, Mrs Mandu Umoren, to the signing ceremony witnessed the inauguration of two C\committees by the Governor.
The committees are the Akwa Ibom State Gender Based Violence Management Committee, chaired by the First Lady, Mrs.  Martha Udom Emmanuel, and Akwa Ibom State Road Safety Management Committee, chaired by the Deputy Governor, Mr. Moses Ekpo.

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NASS S’East Caucus Moves To Reconstruct Federal System

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Members of the South East Caucus of the National Assembly have resolved to join hands with other patriotic Nigerians across regional, religious, political, and ethnic divides to reconstruct a federal system where the rights, happiness, and prosperity and those of unborn generations are guaranteed. 
Making their feelings known in a communique issued at the end of an extraordinary meeting held at the Apo Legislative Quarters, Abuja last Wednesday, the law makers said the topic of the meeting centered on review of developments in the South East, particularly the security situation in the region vis-à-vis the sit-at-home orders by members of the proscribed Indigenous People of Biafra(IPOB) and  the detention of Mazi Nnamdi Kanu.
  “We expressed solidarity with our people of the South East over the marginalisation of the region in the scheme of things within the Nigerian commonwealth. The Caucus feels the pains of our people and their quest for equity, justice, and protection of their lives and property in every part of the country. The Caucus, therefore, resolved to continue to fight for a level-playing ground and an enabling federal system where Ndigbo are able to develop their homeland at their own pace and equally pursue their happiness and actaulise their enormous potentials in every part of the country, unmolested.
 Reviewing the sit-at-home orders by the IPOB and the mayhem some nefarious elements have seized the opportunity to visit on the lives, properties, and psyche of the people, the Caucus equally reviewed and rued the incalculable economic losses and hardships these have brought upon the region.
They, however, condemned in strongest terms the disruption of the ongoing Senior Secondary School Certificate Examination in some parts of the South East, particularly the incident at Comprehensive Secondary School, Nkume, Njaba Local Government Area of Imo State, where the English examination organised by the West Africa Examination Council, WAEC, on Monday, September 13, 2021, was ruthlessly scuttled by armed men, who chased away the students, teachers, and examiners before setting ablaze motorcycles belonging to the teachers. 
“This is certainly not who we are as a people. On the contrary, we are a people, who have always cherished and encouraged learning from the ages. We are a people that fully appreciate the place of education in the liberation and enlightenment of the human mind and the socio-economic and political emancipation of a people”.
The South East legislators equally condemned in strongest terms the incessant killings in the South East, adding “This must stop immediately. We call on the security agencies to unravel the culprits behind these wicked acts and ensure that they are brought to book to serve as a deterrent to others.
“ Noted with delight that IPOB has called off the Monday sit-at-home order and resolved to ensure that nobody uses them as façades to bring ruination on Igbo land.
“ Call on our people to go about their lawful businesses and enjoin our governors and the security agencies to rebuild confidence in our people by not only ensuring the security of their lives and properties, but also ensuring that our people feel safe as they undertake their legitimate businesses.
 ”Elaborately discussed the issue of Mazi Nnamdi and resolved to intervene. To this end we resolved to set up a committee to constructively interface with relevant stakeholders, the Federal Government and its relevant agencies towards finding a political solution. We will keep Ndigbo abreast of developments in regard.
 “Appeal to our people not to allow anyone to destroy the South East region. The post-war South East was not built through government patronage, but largely by the sheer determination and sacrifices of our people, who refused to resign to fate or bow their heads in defeat. 
“It is in Igbo land that you easily find hospitals, schools, roads, and other social amenities built by individual or communal efforts of the people, home and abroad, through the instruments of the town unions and other community organisations such as the age grades, Umuada, etc. 

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