WITH the reported case of one Lassa fever victim in the federal capital territory, Abuja, following the breakout in more than 10 other states of the federation, the Federal Government should declare a state of emergency on the disease. Indeed, the position of the Minister of Health, Isaac Adewole, that the disease has not reached such magnitude as to declare a national emergency is a tard insensitive. The Ebola epidemic, in 2014, claimed just about three casualties in Lagos when a national emergency was declared, in quick and sensible anticipation of the danger the nation faced. This helped to contain the spread and the same quick response should be deployed against Lassa fever.
Already the haemorrhagic Lassa fever has, within two weeks, spread to 14 states and the Abuja FCT, with 43 people confirmed dead, out of the reported 76 victims. So far, the states affected include Taraba (where the disease started), Bauchi, Nassarawa, Niger, Kano, Rivers, Edo, Plateau, Gombe, Oyo, Ondo, Lagos, Edo and Imo.
Given the speed of spread and the lack of capacity in most states to contain the disease, a national emergency declaration is imperative to stem further spread and all the affected states need federal support to deal with what has become a public health bedlam. Needed, at this juncture is not panic but precautionary hygienic measures by members of the public. All persons suspected of Lassa fever symptoms should be reported immediately to the nearest health facility and put in isolation, especially as, unlike Ebola fever, Lassa fever is curable if reported on time.
According to experts, the disease is asymptomatic in 80 per cent of cases, while the remaining 20 per cent takes a complicated course. It incubates for between six to 21 days before presenting symptoms. Like Ebola, the symptoms include persistent high fever with multi-organ complications, stooling, vomiting, and bleeding from the nose, mouth and anus. Other symptoms are stomachache, constipation, cough, chest pain and seizures.
The Federal Government in collaboration with the state Ministries of Health should immediately develop a comprehensive and vibrant information dissemination mechanism to constantly educate members of the public. Such information sharing, including daily updates, would help track the trajectory of the disease and the level of impact and containment.
Lassa fever is a zoonotic disease transmitted by animals, specifically, rodents of the species Mastomys natalensi, a common mouse found in Equatorial Africa. The mouse is ubiquitous in homes and eaten as delicacy in many areas. The rodents excrete the virus through urine and feces, which could be aerosolized (airborne).
Humans are infected when exposed to the rodent excrement through the respiratory or gastrointestinal tracts. It is, therefore, important that people should avoid contact with these rats through food.
Simple precautionary steps should be taken at homes to store food items properly, away from rats. Inhalation of infected tiny airborne particles is believed to be the most potent means of exposure. Person to person transmission has also been established, which poses danger to health workers and everyone who comes in contact with infected persons.
Whereas, healthcare personnel are urged to be very careful, the solution is not in abandoning victims to their fate, as reported at the Lagos State University Teaching Hospital (LASUTH), Ikeja, where health workers fled at the sight of a suspected victim brought to the facility, who then turned out not to be infected.
Early supportive care through rehydration and blood transfusion improves survival and case fatality rate of the disease is 1 to 20 per cent. Unlike Ebola fever, Lassa fever is treatable using ribavirin, administered intravenously or orally. A potent vaccine, already showing positive results on animals, is still in the making.
Lassa fever was first described in 1969 in Lassa town in Borno State, Nigeria and outbreaks of the disease have been reported in Liberia, Sierra Leon, Guinea and the Central African Republic.
Across West Africa, statistics shows that on annual basis, about 300,000 to 500,000 cases are reported out of which some 5,000 deaths occur. The episodic outbreak of Lassa fever over the decades shows that not much research has been done to establish the kind of response to stop it. That explains why a preventive vaccine is still being worked on.
Quite often, diagnosis is mistaken for other illnesses such as malaria, thereby, delaying treatment and allowing spread of the disease. Most health facilities in rural areas lack proper equipment for diagnosing the disease. Though, researchers at the United States Army Medical Research Institute of Infectious Diseases (USAMARIID) in Fort Detrick, Maryland, are making a headway in developing a vaccine, there should be more research on the virology of the disease.
What kind of virus are we dealing with? How do we control it, especially, considering that rodents are freely eaten as delicacy in many areas in West Africa without people getting infected?
This is a challenge to Nigeria’s universities and research organization. It is possible that there is a different vector that is yet unknown and the Nigerian Centre for Disease Control (NCDC) as well as other medical research institutes should buckle up to find a solution to the danger Lassa fever poses.