The World Health Organisation (WHO) on Monday urged governments at all levels to intensify public awareness campaigns on Lassa fever in the rural areas.
Mrs. Faith Irehi, WHO Coordinator in Edo, made the call during a sensitisation campaign on Lassa fever in Etsako West Local Government Area of the state.
“Following the recent outbreak of Lassa fever in Etsako West and other parts of the country, governments need to sensitise the public on the need to maintain good personal hygiene, especially in the rural areas.
“What we need to do is to ensure that our people are well informed as everyone needs to know what to do to prevent the disease from affecting them.’’ Irehi said that people living in the rural areas were at greater risk of contracting the disease especially those who lived where rats and rodents are often found.
She also advised communities to improve on their hygiene level and protect their foods from the excreta and urine of rodents, particularly the `Natal Multimammate’ mouse.
The `Natal Multimammate’ specie of mouse was found to be the natural host of the Lassa fever virus.
The WHO coordinator cautioned people against bush burning and spreading `garri’ outside, saying that this was common with people living in the rural areas.
“The key thing is prevention because we are still coming to the peak; February and March are actually the period for bush burning.
“We can actually prevent this; People should stop the practices of bush burning and spreading `garri’ outside.
“They should cook their food well because the things that can cause Lassa fever include contact with the faeces, saliva and secretions from infected people or agents,’’ Irehi advised.
Plateau state government has confirmed that its medical team is battling with two confirmed cases of Lassa Fever at the Jos University Teaching Hospital (JUTH)
The government has also confirmed that the disease has claimed two lives in the state since 8th January when government discovered the first case of the outbreak in the state.
State Commissioner for health, Dr. Kuden Kamshak who stated this while giving update on the spread of the disease in Jos on Sunday said the state government has successfully managed the spread of the disease in the state.
Dr. Kamshak said, “So far the disease has killed two people, not three as earlier reported.
“Out of the two deaths we reported last week, only one of the victims tested positive to Lassa Fever, the blood sample of the second victim tested negative in Benin where we took both sample for confirmation.
“The first death was recorded in a private hospital in Mangu and the second death was the victim that died in JUTH.
“But right now we have two confirmed cases of Lassa Fever and the patients are being managed at the Jos University Teaching Hospital (JUTH)
“Then we have isolated about 70 people whom we suspected had contact with the two people already killed by the disease. They are close relations of the two victims as well as some health workers who had direct contact with victims.
“We are keeping such people under close surveillance so as to curtail the spread of the disease and so far we are happy to report that the virus has not spread. Our medical team are working round the clock to overcome the situation.” Kamshak stated.
The Lagos State Government yesterday confirmed two more cases of Lassa fever in the state with one of the victims already dead.
The development brought the number of Lassa fever cases in the state to three, including the index case at Ahmaddiya Hospital in Ojokoro part of the state.
The Commissioner for Health, Dr Jide Idris, yesterday said the index case was responding to treatment at the Lagos University Teaching Hospital (LUTH).
The second victim, he said, is a 36-year-old lady; an indigene of Kogi State who was first discovered at Naval Reference Hospital, Ojo on January 18 before she was referred to Mainland Hospital the same day and has since been receiving antiviral medication.
Idris said yesterday that her condition was stable and ambulating.
The third case, he said, died because he presented late.
He is said to be a 51-year-old resident of Ilasan Leki and indigene of Edo State where he attended a wedding ceremony on December 28, last year.
He was initially admitted at Divine Medical Centre in Ikoyi on January 12, this year, but died at 2 pm the same day before the result of the laboratory test that confirmed him positive was received.
His corpse has been kept in the morgue in a leakproof body bag.
He was to be buried yesterday, after due consultations with his family.
Idris said there were eight negative cases while three others were pending for confirmation.
He said his ministry had listed 447 contacts of the confirmed cases and 438 (98 per cent) of the contacts were being monitored.
“The three confirmed cases are not related in terms of source of infections,” he stated.
The Commissioner said his ministry had requested for more Ribavirin injection and tablets, personal protective equipments (PPEs) and other items from the Federal Ministry of Health (FMOH), Abuja.
The Commissioner for Environment, Hon Samuel Adejare, said open defecation and dirty environment should be avoided in order to rid the environment of rodents.
He said: “Cultural change is expected at this point in time. People should learn to live more responsibly.
“The state, through the Ministry of Environment, will step up its game of environmental laws through the police and Kick Against Indiscipline (KAI) Brigade.”
The two commissioners said whenever they notice any symptoms of Lassa fever, particularly persistent high fever that is not responding to standard treatment for malaria and typhoid, members of the public and health workers should report to the nearest health facility or call the following lines: 08037170614, 08022234273, 08022241768 08033065303, 08033086660, 08055281442 and 08023169485.
They enjoined suspected cases or their relatives to report promptly to health facilities because early medical intervention can save lives.
Sanction awaits any health facility that fails to report suspected cases of Lassa fever to appropriate quarters in good time,the Medical and Dental Council of Nigeria (MDCN) warned yesterday.
“It is quite unethical for any doctor to delay any case in his own facility without referral. We have levels of care in this country, in primary level of care there is specific ailment they are suppose to treat for them to refer to the next level,”Dr Abdulmumini Ibrahim, Registrar of the council , told the News Agency of Nigeria (NAN) in Abuja.
Speaking on the first Lassa fever death in the FCT Ibrahim said the council was yet to receive any complaint from the public on factors that led to death of the victim at the National Hospital.
Ibrahim explained that the council does not rely on ‘’hearsay’ in prosecuting any case, but bases its actions on valid complaints by members of the public.
His words: “we do not work on `hearsay’. There has to be valid complaint by anybody and all the information regarding the complaint is in public domain, and we will pick it up from there.
“So, if anybody should complain and against that hospital we will investigate the case and see what went wrong and bring that that doctor to book,” he said.
Describing the delay in referral of patients with any ailment as unethical, the registrar urged medical practitioners to ensure prompt referral of patients to appropriate hospitals for proper medical care or improved services.
The first death recorded in Abuja metropolis as a result of Lassa fever occurred on Jan. 13, after the victim spent about a week at the Kubwa private hospital in the FCT.
The 33-year-old man from Plateau was unconscious before he was referred to the National Hospital Abuja.
He said that private hospitals and clinics are not expected to keep any fever patient unduly,saying: “any fever that is being treated between 48 to 72 hours should vanish, whether it is malaria, typhoid or fever emanating from cancer .
“At your own level if you start treating and investigating any patient and realise that is a case you cannot handle then you refer that case rather than allowing the patient’s condition to deteriorate,” Ibrahim said.
The council is charged with the responsibility of regulating the practice of medicine, dentistry and alternative medicine in the most efficient manner that safeguards best healthcare delivery for the populace.
As the nation continues to battle with the latest health scourge in the country, Lassa fever, the health facility where the first index case in Lagos State was diagnosed remains shut down. The Lagos State government had shut the Ahmaddiyya Muslim Hospital, Ijaiye Ojokoro after a 25-year-old student from Ahmadu Bello University, Zaria, who was on admission at the hospital was diagnosed with Lassa fever.
Findings at the hospital indicate that patients who were on admission at the time the student was admitted have been quarantined together with about 35 health workers of the hospital. In the meantime, no patient can visit the hospital for treatment as part of measures to curtail the disease.
A health worker, who spoke anonymously, expressed reservations at the continued closure of the hospital. “We understand that the government is doing this to stop the disease from spreading but it’s too harsh. The patients and staff quarantined are anxious to leave for their homes and our patients outside want to come in for treatment. Nothing is going on here now and we are not happy about the situation,” he said.
Few workers were seen at the hospital premises with no single patient in sight. The situation may likely stay this way until the 21-day surveillance period expires.
Meanwhile the Medical and Health Workers Union, Lagos State Council, on Saturday said that it would embark on public enlightenment to discourage drinking of garri for now to prevent Lassa fever.
Mr Razak Adefalade, the chairman of the union, who stated this in Lagos, noted that the house rats that cause Lassa fever are mostly in contact with Nigerians’ most staple food, garri, a cassava product.
He called on members of the public to stop drinking garri at the moment, adding that it was better that the cassava flour be utilised for ‘eba’ because of the use of hot water which kills the virus.
According to Dr. Ejike Orji, a virologist and immediate past chairman of the Guild of Medical Directors, Abuja, Lassa fever is asymptomatic and the process of detecting the virus is complicated. The incubation period is about 6 to 21 days.
“The virus is very acute and can affect all the organs of the body. Carriers might be complaining of fever, muscle pain, fatigue and occasionally muscle swelling. They could also complain that their eyes are red and that is because of itching since Lassa causes haemorrhagic fever”.
Speaking further, Dr Orji said because of the haemorrhagic nature of the virus, it can also affect the gastrointestinal tracts so much so that an affected person might present with cases of nausea and vomiting which may be bloody. He added that apart from a bloody diarrhoea which an infected person is likely to come up with, there might also be some forms of stomach pains and even constipation. There could also be evidence of hepatitis.
Also, Lassa fever can affect the cardiovascular system as it might lead to hypertension or hypotension, causing the blood pressure to be high or low and the victim would have abnormal high range. Another grim picture of the virus is that the brain is not spared. Lassa fever can affect the brain or the nervous system and it might mimic meningitis.
“The respiratory system is also at risk as an infected person can also come down with cough, chest pain and difficulty in breathing”, Dr Orji added.
Treatment
Being a haemorrhagic fever which is viral in nature, the Lassa virus is diagnosed by doing a laboratory test in a test centre.
Dr. Orji said the first step in the treatment of a carrier of the virus is admitting and isolating the person, while also ensuring that the patient’s body fluid and excreta are properly disposed in order to prevent the spread.
“For people to have a chance of survival, there must be early and aggressive treatment with a drug called ribavirin and of course the normal treatment you give to patients. There is also a drug we call interferon which can boost the immune system.
“The normal treatment for people who have such viral infection is you must make sure you test the person and ensure the patient has enough (intravenous) fluids. Also if the person has bled so much, there might be need for some level of transfusion.”
Prevention
Being a viral infection, which can be easily spread, medical practitioners have always harped on prevention as the best form of treatment. Preventive measures in this regard refer to making efforts to control the rat population around the house, while also ensuring that no food is exposed to rodents since the urine and body fluid of rodents are the key things which cause Lassa fever transmission.
“Some people eat rats; those people should be discouraged because transmission could happen when it is being prepared. It is just like we told people not to eat bats and bush meat during the Ebola period so people must make sure that they prevent contacts with rats and then they should cover their food very well”.
For those who also like to gulp down canned drinks without running a careful check, there could also be a grim picture as using a tissue paper to clean the opening is not enough to safeguard against the virus. For it to be safe for drinking, there would be need to use soap and water, the medic added.
“I always tell people not to drink directly from a canned drink. It can be dangerous because you don’t know whether rodents have urinated on them in the process of storage. It is important that we use soap and water to clean the openings of those things before they are served to people”, Dr Orji submitted.
He added that another way of treating the virus is to get a person who has survived it since the anti-body can be used to treat someone that has the disease.
Dr Lazarus Eze
Also commenting on the issue, Dr Lazurus Eze, an Abuja-based public health physician, canvassed for government to ensure a safer environment by ensuring a timely and regular waste disposal and management in order to curb the spread of the virus.
For him, Lassa fever can be prevented by keeping a clean environment and practising good personal hygiene. He harped on the need for individuals to ensure proper refuse disposal and avoid dumping of refuse in drainages and indiscriminately.
“Lassa Fever is a viral haemorrhagic fever caused by multimammates rats (Mastomy natalensis). The rats may transmit the virus to our uncooked food. Government at all levels should provide leadership and coordinate efforts to prevent further spread of Lassa fever. Health education at the community level, behavioural change, communication and proper waste management are effective primary prevention measures,” he asserted.
Furthering, Dr Eze called on government at all levels to provide leadership and coordinate efforts to prevent further spread of Lassa fever.
“Health education at the community level, behavioural change, communication and proper waste management are effective primary prevention measures”, Dr Eze said.
Measures for health care workers
Both medical practitioners also harped on the need for health workers treating the virus to be careful by observing universal precautionary methods and treating every fever with suspicion.
“We know that in Nigeria, a lot of illnesses are due to Malaria, but now we have had Ebola and now we have Lassa so any health care personnel should manage feverish conditions with a lot of suspicion and maintain all universal precautions in terms of protecting themselves and then the other thing is making sure the patient is properly isolated, said Dr Orji.
Dr Eze on his own part urged that personal protective equipment must be provided for health workers who are expected to observe universal precautions and best practices.
Lassa fever and garri consumption
Speaking on the likelihood of being infected with the virus through garri, fruits and other uncooked food items, Prof Oyewole Tomori, a former regional virologist for the World Health Organisation (WHO) and president of the Nigeria Academy of Science, confirmed that any food eaten raw or uncooked and contaminated with urine, blood, etc of a Lassa virus infected rodents can be a source of infection.
“Our food can get contaminated and if you eat without cooking, the possibility of getting infected is high. Once you cook the food items, you destroy the virus, so people smoking garri and all those kind of things are at risk. If the rodents urinate on the fruits and you pick up banana or carrot and you just start chewing it without washing, that could be dangerous, so it boils down to hygiene and cleanliness”.
The Lagos State Government Friday confirmed two more cases of Lassa fever in the state with one of the victims already dead.
The development brought the number of Lassa fever cases in the state to three, including the index case at Ahmaddiya Hospital in Ojokoro part of the state.
The Commissioner for Health, Dr Jide Idris, Friday said the index case was responding to treatment at the Lagos University Teaching Hospital (LUTH).
The second victim, he said, is a 36-year-old lady; an indigene of Kogi State who was first discovered at Naval Reference Hospital, Ojo on January 18 before she was referred to Mainland Hospital the same day and has since been receiving antiviral medication.
Idris said Friday that her condition was stable and ambulating.
The third case, he said, died because he presented late.
He is said to be a 51-year-old resident of Ilasan Leki and indigene of Edo State.
He was initially admitted at Divine Medical Centre in Ikoyi on January 12, this year, but died at 2 pm the same day before the result of the laboratory test that confirmed him positive was received.
His corpse has been kept in the morgue in a leak proof body bag.
He was to be buried Friday, after due consultations with his family.
Idris said there were eight negative cases while three others were pending for confirmation.
He said his ministry had listed 447 contacts of the confirmed cases and 438 (98 per cent) of the contacts were being monitored.
“The three confirmed cases are not related in terms of source of infections,” he stated.
The Commissioner said his ministry had requested for more Ribavirin injection and tablets, personal protective equipments (PPEs) and other items from the Federal Ministry of Health (FMOH), Abuja.
The Commissioner for Environment, Hon Samuel Adejare, said open defecation and dirty environment should be avoided in order to rid the environment of rodents.
He said: “Cultural change is expected at this point in time. People should learn to live more responsibly.
“The state, through the Ministry of Environment, will step up its game of environmental laws through the police and Kick Against Indiscipline (KAI) Brigade.”
The two commissioners said whenever they notice any symptoms of Lassa fever, particularly persistent high fever that is not responding to standard treatment for malaria and typhoid, members of the public and health workers should report to the nearest health facility or call the following lines: 08037170614, 08022234273, 08022241768 08033065303, 08033086660, 08055281442 and 08023169485.
They enjoined suspected cases or their relatives to report promptly to health facilities because early medical intervention can save lives.
The Federal Government has launched a public call centre at the Nigeria Centre for Disease Control (NCDC) to serve the country on all public health emergencies.
While launching the call centre, the Minister of Health, Prof. Isaac Adewole, reiterated the determination of the present administration to provide access to health care information that will keep diseases away from Nigeria.
He urged Nigerians to avail themselves of the opportunity provided by the centre to help government prevent diseases, especially the current Lassa fever outbreak.
The minister called on citizens who have symptoms of Lassa fever to call any of the 10 numbers 097000010—19 from anywhere in the country, and such would be directed to the appropriate state epidemiologist or referred to the nearest health facility.
The Minister also said where possible, patients could be picked up from their locations and taken to the nearest health facility.
He assured the public that anyone who uses the call facility will receive help.
Sanction awaits any health facility that fails to report suspected cases of Lassa fever to appropriate quarters in good time, the Medical and Dental Council of Nigeria (MDCN) warned Friday.
“It is quite unethical for any doctor to delay any case in his own facility without referral. We have levels of care in this country, in primary level of care there is specific ailment they are suppose to treat for them to refer to the next level,” Dr Abdulmumini Ibrahim, Registrar of the council , told the News Agency of Nigeria (NAN) in Abuja.
Speaking on the first Lassa fever death in the FCT Ibrahim said the council was yet to receive any complaint from the public on factors that led to death of the victim at the National Hospital.
Ibrahim explained that the council does not rely on `’hearsay’ in prosecuting any case, but bases its actions on valid complaints by members of the public.
His words: “we do not work on `hearsay’. There has to be valid complaint by anybody and all the information regarding the complaint is in public domain, and we will pick it up from there.
“So, if anybody should complain and against that hospital we will investigate the case and see what went wrong and bring that that doctor to book,” he said.
Describing the delay in referral of patients with any ailment as unethical, the registrar urged medical practitioners to ensure prompt referral of patients to appropriate hospitals for proper medical care or improved services.
The first death recorded in Abuja metropolis as a result of Lassa fever occurred on Jan. 13, after the victim spent about a week at the Kubwa private hospital in the FCT.
The 33-year-old man from Plateau was unconscious before he was referred to the National Hospital Abuja.
He said that private hospitals and clinics are not expected to keep any fever patient unduly, saying: “any fever that is being treated between 48 to 72 hours should vanish, whether it is malaria, typhoid or fever emanating from cancer.
“At your own level if you start treating and investigating any patient and realise that is a case you cannot handle then you refer that case rather than allowing the patient’s condition to deteriorate,” Ibrahim said.
The council is charged with the responsibility of regulating the practice of medicine, dentistry and alternative medicine in the most efficient manner that safeguards best healthcare delivery for the populace.
Fifty-five contacts traced to the doctor that died of Lassa fever on Monday at the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) Ife, have been placed under surveillance in Osun State.
Briefing reporters in Osogbo, the state capital yesterday, the Permanent Secretary, Ministry of Health, Dr. Temitope Oladele, said none of those under surveillance showed symptoms of the disease.
Oladele, who assured residents of the state’s capacity to curtail the disease, added that the government was in contact with the hospital where the doctor died for any development on the matter.
He said with the index case of Lassa fever in the state, the confirmation test could not be done after the first test.
“Therefore, it makes it difficult to conclude the victim’s health status,” he said.
The permanent secretary added that the doctor died on the day his blood sample was sent to the laboratory.
His words: “The victim was a resident in a neighbouring state capital and normally shuttled between that state and OAUTHC, Ife. He is now the ‘imported’ index case of Lassa hemorrhagic fever in Osun.”
He said a monitoring room was set up in the Ministry of Health with mobile lines giving out to report any suspicious case.
Doctors and other health workers in the 30 local governments have been put on the alert in case of any incident of Lassa fever, he added.
Also yesterday, the Pharmaceutical Society of Nigeria (PSN) called on pharmacists and other health care team to support the Health Minister, Prof Isaac Adewole, in the quest to curtail Lassa fever.
Its President, Ahmed I. Yakasai, said the call was in tandem with the society’s slogan: “As men of honour, we join hands”.
A statement by the PSN Secretary, Mr. Gbolagade Iyiola, called on governors to cooperate with the Federal Government by starting public enlightenment in local languages, strengthening their surveillance and activating their response mechanisms.
Ebonyi State government yesterday denied reports that the state recorded five suspected cases of Lassa fever.
Commissioner for Health Dr. Daniel Umezurike, said there had been no a case of Lassa fever in the state since 2014.
The Federal Road Safety Corps (FRSC) yesterday appealed to its officers to report any symptoms of Lassa fever to the nearest hospital or health centre.
