At least, three people are diagnosed of Lassa daily somewhere in the country,” Tomori said. “We abandon disease surveillance and control activities; there was a time people worked together, the laboratories at Ibadan, the Ministry of Health, NIMR, joined forces to protect the country. In the 60s to 80s at Ibadan, we produced every reagent we needed in the country. We did not depend on importation. But now we are lazy and everybody wants to make money from importation.” Sadly, with the new trend of the infectious disease, only few Nigeria laboratories can give accurate results. To Tomori, Six to seven laboratories in the country cannot give proper results due to lack of support.
The only few that function in the country have the support of partner agencies and backing from abroad. The professor of virology also, in a report, described Lassa as an annual recurrent budget of death for poor people of Nigeria, adding: “Because we have lived in a state of denial of the disease, we handle it with characteristic laxity, laissez-faire, negligence, sloppiness, slackness, disregard, triviality and freewheeling abandon. “Lassa lacks the zeal and trepidation that Ebola outbreak inspired and Nigeria still wakes up every year an outbreak is reported, “running like a decapitated chicken in any which direction, and forgetting about the disease till another year another outbreak.”
To another stakeholder, a renown professor of pharmacognosy and President, Bioresources Development Group, Prof. Maurice Iwu, Lassa was more than an embarrassment because the country has the personnel required, knowledge of the fever and how to prevent it, but the disease still claims lives. Iwu argued that unless the country adopts the approach used during the Ebola outbreak, many more people would fall victim. “As long as Lassa fever is anywhere in the country, as long as we have restaurants that don’t keep good hygiene, as long as we have houses that are co-infested with rat and horse, as long as we have dirty environment, we are all vulnerable,” he said. “The only thing we can do is keep track of the virus, and from time to time do research. Our universities should make sure that 80 percent of their research is localized to treat our own diseases, issues and viruses we live with.”
Current burden Findings by Sunday Vanguard show that as far as the average Nigerian is concerned, a confirmation of pockets of the disease across the states is alarming, while an epidemic would be catastrophic. Such fears are well founded. The latest Lassa fever outbreak affected 24 states in Nigeria. Unlike outbreaks of the past, it is spreading in rural and urban areas. In the country today, millions of people are walking around with high fevers and other kinds of symptoms that could confuse diagnosis of Lassa fever. Worse still, Nigeria has been listed among countries that may be threatened by global spread of Zika virus, another terrible, viral disorder caused by mosquitoes. This time, even health workers are not spared. WHO updates Update on the World Health Organisation, WHO, website showed that between August 2015 and 17 May 2016, WHO has been notified of 273 cases of Lassa fever, including 149 deaths in Nigeria. Of these, 165 cases and 89 deaths have been confirmed through laboratory testing (CFR: 53.9 percent). The cases were reported from 23 states. Since August 2015, 10 health care workers (HCW) have been infected with Lassa virus, of which two have died. Of these ten cases, four were nosocomial infections. Just two weeks ago, two medical doctors died from the disease in Anambra and Delta States. As of 17 May 2016, eight states reported Lassa fever cases (suspected, probable, and confirmed), deaths and/or following of contacts for the maximum 21-day incubation period. Currently, 248 contacts are being followed up in the country. The other 15 previously affected states have completed the 42-day period following last known possible transmission. Public health response Currently, two national laboratories are supporting the laboratory confirmation of Lassa cases by polymerase chain reaction (PCR) tests. All the samples were also tested for Ebola, Dengue, Yellow fever and so far have tested negative. The two laboratories that are currently operational are Virology laboratory, Lagos University Teaching Hospital and Lassa fever research and control centre, Irrua specialist hospital. Along with other key partners, WHO is supporting the Federal Ministry of Health in surveillance and response of Lassa outbreaks including contacts tracing, follow up and community mobilisation. Of particular concern since the onset of Lassa fever outbreaks in Nigeria is the high proportion of deaths among the cases that is still under investigation. What it is?
According to WHO, Lassa fever is an acute viral haemorrhagic illness caused by Lassa virus, a member of the arenavirus family of viruses. It is transmitted to humans from contacts with food or household items contaminated with rodent excreta. The disease is endemic in the rodent population in parts of West Africa like Nigeria. Prevention and control Humans usually become infected with Lassa virus from exposure to urine or faeces of infected Mastomys 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.
There is no epidemiological evidence supporting airborne spread between humans. Person-to-person transmission occurs in both community and health-care settings, where the virus may be spread by contaminated medical equipment, such as re-used needles. Sexual transmission of Lassa virus has been reported. It also occurs in all age groups and both sexes. Persons at greatest risk are those living in rural areas where Mastomys are usually found, especially in communities with poor sanitation or crowded living conditions. Symptoms The incubation period of Lassa fever ranges from 2–21 days. 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, diarrhoea, 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 and low blood pressure may develop. Protein may be noted in the urine. Shock, seizures, tremor, disorientation, and coma may be seen in the later stages. Deafness occurs in 25 percent of patients who survive the disease.
