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Containing current Lassa fever outbreaks in Nigeria

By Chukwuma Muanya (Lagos), Hendrix Oliomogbe (Asaba) and Tunji Omofoye (Osogbo)
15 February 2018   |   4:27 am
As part of efforts to contain an outbreak of Lassa fever in Nigeria that has infected up to 450 people in 17 states within five weeks, the World Health Organisation (WHO), on Tuesday, announced it is scaling up its response to the outbreak.

FG reports 450 suspected cases, 43 deaths in 17 states within five weeks
Lagos, Osun advocate personal, environmental hygiene as control measures
Delta scientists call for more public laboratories for infectious diseases

As part of efforts to contain an outbreak of Lassa fever in Nigeria that has infected up to 450 people in 17 states within five weeks, the World Health Organisation (WHO), on Tuesday, announced it is scaling up its response to the outbreak.

The WHO, in a statement, said between January 1 and February 4, nearly 450 suspected cases were reported, of which 132 are laboratory confirmed Lassa fever. Of these, 43 deaths were reported, including 37 that were lab confirmed.

From the onset of the outbreak, WHO Nigeria deployed staff from the national and state levels to support the Federal Government’s National Lassa fever Emergency Operations Centre and state surveillance activities. WHO is helping to coordinate health actors and is joining rapid risk assessment teams travelling to hot spots to investigate the outbreak.

The acute viral haemorrhagic fever is endemic in Nigeria but for the current outbreak the hot spots are the southern states of Edo, Ondo and Ebonyi.

WHO Representative to Nigeria, Dr. Wondimagegnehu Alemu, said: “The high number of Lassa fever cases is concerning. We are observing an unusually high number of cases for this time of year.”

Among those infected are 11 health workers, four of whom have died. WHO is advising national authorities on strengthening infection, prevention and control practices in healthcare settings. Healthcare workers caring for Lassa fever patients require extra infection and control measures, including the use of personal protective equipment to prevent contact with patients’ bodily fluids.

With the increase in the number of cases, WHO initially donated personal protective equipment to the Nigeria Center for Disease Control (NCDC) and to the affected states and procured laboratory reagents to support the prompt diagnosis of Lassa fever. WHO is deploying international experts to coordinate the response, strengthen surveillance, provide treatment guidelines, and engage with communities to raise awareness on prevention and treatment.

Lassa fever is endemic to several West African countries. Benin, Liberia and Sierra Leone have all reported cases in the past month. WHO is working with countries in the region to strengthen coordination and cross-border cooperation.

Also, the Lagos State Government has again reiterated the need for members of the public to ensure and maintain adequate personal hygiene and environmental sanitation at all times as part of prevention and control measures against the spread of the Lassa Fever disease in the State

In a statement signed by the Commissioner for Health, Dr. Jide Idris, the government noted that that the prevention and control of the disease remains a shared responsibility of all citizens through observance of the highest possible standards of personal and community hygiene as well as environmental sanitation.

Idris enjoined residents to store house-hold refuse in sanitary refuse bags or dust bins with tight-fitting covers to avoid infestation by rats and rodents; dispose refuse properly at designated dump sites and not into the drainage system and store food items in rodent-proof containers adding that it is by so doing that a habitable and conducive environment, and a disease-free State can be achieved.

“Members of the public are further advised to avoid contact with rats, to always cover their food and water properly, cook all their food thoroughly, as well as block all holes in the septic tanks and holes through which rats can enter the house and clear rat hideouts within the premises”, he said.

While outlining strategies put in place by the State government to control the disease, the Commissioner explained that the Lagos State is maintaining relevant surveillance activities through its disease surveillance unit to prevent the spread of the disease in Lagos.

“Isolation wards have been prepared to manage suspected and confirmed cases, health workers have been placed on red alert and community sensitization activities intensified,” Idris noted.

Idris explained that Lassa fever is an acute viral infection caused by the Lassa virus that is associated with symptoms such as persistent high fever, general weakness of the body, malaise headache, sore throat, nausea, diarrhea, and vomiting.

He added that the disease can progress into a severe form in which case the patient develops facial swelling, fluid in the chest, bleeding from the mouth, nose, and the gut; low blood pressure, shock, disorientation, coma and kidney and liver failure.

The Commissioner advised health workers, both in the public and private hospitals in the State to ensure that they observe universal safety precautions and comply with infection prevention and control measures when dealing with patients, stressing that appropriate personal protective equipment like hand gloves, facemasks, goggles and overalls must be worn when attending to cases.

Idris added that safety boxes should be used for collection of used needles and syringes and general medical waste must be properly sorted out in colour-coded bags and disposed in line with international standards.

“Hands must be washed often with soap and running water or application of hand sanitizers after each contact with patients or contaminated materials and instruments must be autoclaved. Also hospital mattresses must be covered with plastic sheets to prevent contamination. The plastic sheets must be large enough to cover the entire mattress, be waterproof, and be thoroughly disinfected after discharge of patients,” Idris added.

The Commissioner also enjoined residents to report suspected case or cases of the disease to the nearest government approved health facility or the Ministry of Health.

He stated that a case of Lassa fever should be suspected in any person with persistent high fever not responding to standard treatment for malaria and typhoid fever or bleeding from body orifices and such cases should be reported to the nearest health facility.

Meanwhile, worried by the increasing rate of emerging and re-emergence of infectious diseases such as Lassa fever, monkey pox and Ebola fever among others in, the Delta State branch of the Association of Medical Laboratory Scientists of Nigeria (AMLSN), has appealed to the state government to urgently establish a public health laboratory in the state.

Chairman of the Association, Mr. Kingsley Amaihunwa, who spoke in Asaba, Tuesday during association’s investiture of patrons and annual lecture said that such a public laboratory public health laboratory, when established, would ensure the provision of diagnostic supports to curative and preventive public health services.

Besides, he noted that it would also help in health promotion activities, researches and generation of formative data to guide appropriate treatments and enhance surveillance and control of diseases of public health concern.

While calling for the establishment of Department of Medical Laboratory Services in the State Ministry of Health, the Chairman of the Association, also, stressed the need for the creation of Medical Laboratory Science Department in Delta State University, even as he passionately appealed to the state government to recall the seven Medical Laboratory Scientists at Delta State University Teaching Hospital, Oghara, that were, according to him, unlawfully sacked.

In his remarks, Prof. Dennis Edo Agbonlahor who presided over the ceremony, applauded members of AMLSN for their giant strides in positioning the association in the state for enhanced productivity, just as he joined hands with the association in calling for the creation of Medical Laboratory Science Department in Delta State University, pointing out that there are so many benefits accruing from the establishment of such academic programme.

Also speaking during the ceremony, the National President of the Association, Dr. Bassey Enya Bassey, who was represented by Prof. Felix Emelike, stressed the need for the state government to employ more medical laboratory scientists in the state owned health facilities across the state, adding that adequate attention should be paid to different professionals in the health care sector of the nation’s economy.

In his contribution, the Chairman of Delta State Hospitals Management Board, Dr. Chris Ononye, who represented Governor Ifeanyi Okowa at the ceremony, harped on the need for a robust synergy among different professionals in the health sector of the state, adding that there should be no rivalry among them.

The ceremony witnessed the investiture of the Obi of Owa, HRM (Dr.) Emmanuel Efeizomor II; former Minister of Information, Prof. Sam Oyovbaire; Barr. Ijatuyi Kasali Olawale; and member of the Delta State House of Assembly, Mrs. Princess Pat Ada Ajudua (Oshimili North) as patrons and patroness of the Association respectively.

Meanwhile, the state government of Osun has assured the citizens that there is no outbreak of Lassa fever in any part of the state.

The government said there has not been any report on the spread of the disease by medical personnel who are observing patients in hospitals.

“There is no reason for anybody to panic on the report of a suspected Lassa fever case in the state. What was reported is an isolated death case of a young man who came from a neighbouring state.

“The young man who was suspected of carrying Lassa fever disease from the neighbouring state died at the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife.

As a proactive measure, the medical personnel had to quarantine those who had contact with the strayed deceased for observation.

“This is a normal medical procedure, and does not mean the quarantined people are possibly carrying lassa fever disease. As at today, there has not been any other confirmed Lassa fever case except that of the young man from a neighbouring state that died at the OAUTHC.

“All necessary steps to prevent the outbreak of this disease or any other one in Osun had been pro actively taken. Filth and dirt’s are been regularly taken care of, while medical personnel had been on red alert to ensure any unexpected disease outbreak is contained.

“As far as prevention is concerned, Osun government has been proactive while all curative efforts are already set in place.
We urge people to make sure that their environment is clean and keep their foodstuffs away from rodents…”

“The government urges the people not to panic, as there is no spread of Lassa fever in the state.”