Lassa Fever Labs Are Grossly Inadequate, Says Raheem

The National President of the Association of Medical Laboratory Scientists of Nigeria (AMLSN), Mr. Toyosi Raheem, has said that Nigeria needs biosafety level 4 (BSL-4) laboratories across the federation to be able to effectively tackle Lassa fever.
What is the place of diagnostic laboratories for Lassa fever patients who are asymptomatic?
WE are all aware that Lassa fever is one of the hemorrhagic fevers, and it is transmitted by rodents to human beings through contaminated foods and other consumables.

We also know that once someone is infected through food or from human-to-human means, within a specified period of time, usually between six to 21 days, the infected person will begin to show signs and symptoms of Lassa fever. These ranges from muscle, chest pain, high-grade fever, cough, and in extreme cases, bleeding through the mouth, nose, eyes, anus and other openings in the body. When bleeding occurs, it becomes extremely difficult to control.

Of the infected people, it has been reported that 80 per cent of them will be asymptomatic (that is signs of Lassa fever will be absent in them), where as it is only about 20 per cent of them who will manifest the symptoms I have listed.

It means by extension that about 20 per cent of the infected people will present either in clinics or hospitals, where as 80 per cent, because they are not sick, will not present at all in any clinic or hospital, even though they still have the infection.

In the same manner, the rat that is transmitting this infection through urine or faecal droppings is not sick, but it is transmitting the infection through foods to other people. In the same manner, the person that is asymptomatic has the chance of transmitting infection through one means or another to others too.

So, the focus should not only be on the 20 per cent of those that are symptomatic. But we should also think about the 80 per cent of those who are asymptomatic, because if they are not trapped, the possibility of them spreading the virus through either faeca droppings or from body secretion is also there.

What should be done?
Our position as an association is that government should put in place capacity to detect as many people as possible, whether asymptomatic or asymptomatic, of Lassa fever. We do not need to wait for people to develop symptoms before we track them.

We feel that the laboratories in Nigeria now, about seven of them, are grossly inadequate for a country like Nigeria. We are glad that the Health Minister has set up the National Lassa Lassa Fever Action Committee. We feel that committee should look at the possibility of scaling up diagnostic centres in Nigeria, because Nigeria is too big a country that we cannot rely on only seven laboratories; we know that it is not all laboratories that can carry out investigations on Lassa fever.

We should build at least two laboratories in each of the zones of the country, so that people can easily be referred to those centres for proper diagnosis and follow up action.

It is not only Lassa fever that we should focus on. If walked down the memory line, in the last 10 years, there have been one issue or the other. We at a time discussed bird flu and later Ebola virus. But today we are discussing Lassa fever. So, we should establish should laboratories that will be on hand to respond appropriately to these emerging and re-emerging diseases.

We have so many laboratory scientists in this country and who should be integrated appropriately to fight all these diseases. But it requires proper funding for those laboratories. For instance, to effectively diagnose Lassa fever or any other hemorrhagic fever, we need a laboratory that is not less than biosafety level (BSL-4). And in this country, we can hardly see a biosafety level 4 laboratories; the maximum you can see may be biosafety 3 laboratories.

We appeal to government to build as much as possible laboratories that will be equipped with facilities that can be rated as biosafety level 4. That is when we can easily track symptomatic and asymptomatic infected individuals.