Danger Next Door …As Lassa Fever Claims Casualty In Rivers

Since 1969, when two nurses on a mission in Nigeria were killed by the very deadly disease known as Lassa Fever to date, not many ever imagined that a danger perceived to be far far away from home could be such a health emergency in Rivers State. But State Commissioner of Health, Dr Sampson Parker confirmed last Friday, that Lassa Fever might just be next door and called for caution, better hygienic living and total avoidance of self-medication when any feveral symptoms are observed.

Addressing newsmen in his office, at the state Secretariat complex, Port Harcourt, a worried Health Commissioner announced that so so close, Lassa Fever had already claimed its first casualty in the state, while six other cases have been confirmed.

To tackle the epidemic, he said the more than 110 primary health care centres have been equipped to face the challenge, and adequate medical personnel trained and  dispatched accordingly, while aggressive enlightenment has been launched to alert the citizenry, particularly rural dwellers of the lethal nature of the viral threat.

Dr Parker explained that a Rapid Response Team is already at work, pushing Rapid Diagnosis test kits for use by the various healthcare centres, in order to institutionalize them so that no more medical staff is taken unawares. Headed by the Chief Medical Director of the University of Port Harcourt Teaching Hospital (UPTH), Prof A .C Ojule, the quick response team had been inaugurated Monday, last week, in a swift reaction to curb the viral scourge. It is made-up of state health officials, their counterparts from the Federal Health Ministry and the UPTH and are already on top of the situation.

While that is on, the Public Health Department of the state Ministry of Health has designed, published and started circulating flyers on facts of Lassa Fever, for the proper understanding of the public.

So, what exactly is Lassa Fever? Where from? What are the signs and symptoms? How are Human beings infected? How can  Lassa Fever be prevented?

All these questions are answered in My Agony today, as a public service contribution of The Tide Newspapers.

History

Lassa Fever, as stated earlier is a highly infectious disease caused by a virus that is native to West Africa. Lassa Fever was first diagnosed in 1969, in a community called Lassa, when two nurses on mission in Nigeria died from it. The newly discovered Lassa Virus takes its name after that same Nigerian town The Tide research revealed to be in Borno State, where the first diagnosis occurred. The Lassa Virus comes from the family of viruses called Arenaviridae. Carried by animals, it is a zoonotic RNA virus with a single strand.

Lassa Fever is endemic to areas of West Africa. Cases have been reported in Nigeria, Guinea, Sierra Leone, and Liberia. As the virus is carried by various species of rodents throughout West Africa, Lassa Fever has a geographic range all throughout the region and potentially beyond.

It is estimated that there are anywhere between 100,000 to 300,000 individuals infected by the Lassa Virus each year. Approximately 5,000 of such cases result in death. Parts of Liberia and Sierra Leone report that nearly 16% of the population in hospitals have Lassa Fever, which gives a crude picture of the severity of the disease in the region.

The reservoir of the Lassa Virus is the multimmammate rat from the genus Mastomys. At least two species of such rodents act as hosts to the virus in Sierra Leone. The rodents reproduce very quickly and often, creating large populations that populate the forests and the savannas of East, Central, and West Africa. Mastomys rodents can colonize human establishments. Such factors make the transmission of the Lassa Virus to humans relatively easy.

Human’s Infection

Mastomys rodents excrete the virus in their droppings and urine. The virus is transmitted to humans when an individual comes in direct contact with the contaminated waste. Alternately, a person may touch objects or consume food that have been contaminated with rodent waste. The virus could also enter through open wounds or sores. Inhalation of the virus is possible when a person breathes in minute particles of contaminated air and is known as airborne or aerosol transmission. In some parts of Africa, Mastomys rodents are eaten as a food source so infection may happen when they are captured and prepared for consumption.

Transmission may occur from person to person when an individual makes contact with any tissue, blood, excretions or secretions of an infected person, but casual contact will not spread the virus. Nosocomial transmission can also occur with contaminated needles or other medical equipment.

Symptoms To Watch

The symptoms of Lassa Fever begin approximately one to three weeks after the initial infection. Symptoms may include pain in the chest wall, fever, back pain, abdominal pain, sore throat, conjunctivitis, swelling in the face, diarrhea, mucosal bleeding and proteinuria. There have been reports of neurological issues such as tremors, encephalitis, and hearing loss. The symptoms of Lassa Fever are so diverse that diagnosis can be challenging.

Clinical Diagnosis

The diagnosis of Lassa Fever requires laboratory testing. Enzyme-linked immunosorbent serologic assays are used to find Lassa antigen as well as IgG and IgM antibodies. It takes about a week to culture the virus. In post-mortem examination, immunohistochemistry is used on tissue specimens. Reverse transcription-polymerase chain reaction can be used to detect the virus as well, but this method is typically reserved for research work rather than clinical.

Likely Complication

Deafness is a standard complication of Lassa Fever and can occur in varying degrees in approximately a third of all cases. Permanent loss of hearing is typical and seems to have no correlation to the severity of the case. Another grave complication of Lassa Fever is sudden abortion.

Fatality Level

Approximately 20% of hospitalized Lassa Fever patients die from the disease. Approximately one percent of infection cases without disease results in death. The death rate for Lassa Fever is especially high for pregnant women in their third trimester. Approximately 95% of unborn fetuses die if the mother is infected.

Treatment And Control

Treatment for Lassa Fever requires an antiviral medication called Ribavirin. Ribavirin is especially effective during the early stages of Lassa Fever. Supportive treatment such as maintaining blood pressure, oxygenation, and electrolyte and fluid levels are required for a full recovery. Any secondary infections that arise should be treated.

High Risk Areas

People living in areas with Mastomys rodents are at high risk. Medical care workers in such areas should take care to wear protective gear when treating any patient. Preventive measures include avoiding contact with rodents, keeping food in rodent-proof receptacles, and practicing excellent hygiene of the person and the household. Do not consume rodents; pest control and extermination is recommended. When nursing a person with Lassa Fever, wear protective clothing, gloves, and masks and take care not to come in contact with any bodily fluids. Practice proper equipment sterilization and keep infected individuals isolated from others until full recovery.

So, for Emphasis, How can Lassa Fever be prevented?

•By avoiding contact with rats (mastomys Rodents) especially in the regions where outbreak occurs

• Put away food in Rats proof containers

• Keep the surrounding clean. It helps drive rats from entering your homes. .

• Use rat traps in and around your homes

• When caring for patients with lassa fever, apply Isolation precaution methods. Eg (1) wearing of mask, Gloves, Gowns and Goggles (2) Use infection control measures eg Sterilization and Isolating infected patients from contact with unprotected persons until the disease has run its course

• Carry out effective health Education especially in high-risk areas about ways to  decreasing rat population in their homes.

Here in Rivers State all necessary steps have been taken to ensure that the scourage is curtailed and medical personnel free from infection, with the urgent training of medical staff, provision of required drugs and an aggressive public enlightenment of the public. But all these would not achieve the desired ends unless other neighbouring states take similar urgent proactive measures.

More importantly, the relevant social institutions must make necessary arrangement to remove from the streets destitutes and others with all manner of contagious afflictions and be quarantined so that society may be spared the agony of suffering for being a neighbour’s keeper.

My Agony is that while Rivers is still battling population explosion on account of its cosmopolitan pedigree and being heart of the  nation’s oil and gas production, even rodents, hitherto unknown to our culture and clime, not only seek to be part of the population, but a deadly one.

With additional information from on-line research

Soye Wilson Jamabo