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Adequate health education necessary to prevent Lassa Fever — Yetunde

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In its situation report, the Nigeria Centre for Disease Control (NCDC) said from February 25 to March 3 2019, 39 new confirmed cases of Lassa fever were reported in six states – Edo, Ondo, Ebonyi, Bauchi, Taraba and Kogi with new deaths in Edo, Ondo and Kogi. The NCDC also said from January 1 to March 3 2019, a total of 1374 suspected cases have been reported from states that have recorded at least one confirmed case (21 states including FCT). Of these, 420 were confirmed positive, 15 probable and 939 negative. Overall, 33 States including FCT have reported a total 1447 suspected cases. Since the onset of the 2019 outbreak, there have been 93 deaths in confirmed cases. To curb the trend, health experts say there is a need to keep sensitising Nigerians on the disease and its health risks. Health safety practitioner and senior registrar in the Department of Community Health at Lagos University Teaching Hospital (LUTH), Dr. Odusolu Yetunde discussed the need to take precaution and ways to avoid the illness. GERALDINE AKUTU reports.

What causes Lassa fever?
Lassa fever is an acute zoonotic viral haemorrhagic illness caused by a single stranded RNA virus called Lassa virus. The virus is found in a rodent (multimammate rat), which acts as its reservoir. The virus is so-called because it is named after Lassa town in Borno State, where it was first discovered.

Exposure to the virus is basically through two main ways: Firstly is rodent to human transmission, whereby there is ingestion of food or materials contaminated by infected rodent excreta or catching and preparing the rat as food. The second is human-to-human transmission, whereby there is direct contact with blood, tissues, secretions or excretions, urine of infected humans and sexual contact. Other modes of transmission can be needle stick or cut injury, transmission through breast milk. Inhalation of aerosolised virus is also reported.

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What are the symptoms after exposure?
Lassa fever can occur in all age groups and sexes. The symptoms of exposure are high-grade fever, headache, malaise, facial swelling, muscle weakness, conjunctivitis and mucosal bleeding. There can also be symptoms arising from affected organs. In the gastrointestinal system we can have nausea, haematemesis (vomiting of blood), dysphagia (inability to eat), diarrhoea, which can be bloody, abdominal pain and constipation.

In the cardiovascular system, it can lead to hypotension and tachycardia.  In the respiratory tract, it can manifest as cough, chest pain, breathlessness and sore throat, while in the central nervous system, it can manifest as hearing loss, seizures and coma. Lassa fever is also known to be severe in pregnancy, especially in the third trimester. The illness may manifest between of five to 21 days, which is the usual incubation period for the disease.

Lassa fever is diagnosed through the use of the case definitions mentioned above, as well as use of laboratory test to isolate /detect the virus. Lassa fever is treated mainly with an antiviral drug known as ribavirin, as well as other adjunct treatments given to treat the infected person, such as fluids and antipyretics, among others.

Prevention of Lassa fever can be ensured by adequate health education to the community. Good community hygiene should be implemented to prevent rodents from entering homes. There should be proper handling and storage of food in rodent-proof containers. Trapping and killing of rodents with proper and safe disposal of the carcasses should be ensured. Rodents should be avoided as source of food. Those who spread food outside for drying e.g. cassava grains or any other food should ensure they are covered and prevented from rodent’s infestation.

Where there are cases of Lassa fever, prevention methods to curtail its spread should also be done, such as promotion of good environmental and frequent/regular hand washing practices, as well as avoiding contact with infected people. Safe burial practices should also be done, where there are incidents of death. This may require professional handling of corpses.
 
In hospital settings where Lassa fever cases are treated, preventive measures should be instituted to avoid nosocomial spread (health worker to patient, and patient to patient spread of the infection). There should be isolation of cases, as well as universal safety precautions, such as strict barrier nursing and good hand washing practice, among others. Protective clothing i.e. personal protective equipment (PPE) should also be worn by health workers. These include gloves, safety mask, gowns/overall, face shield and consistent sterilisation of contaminated equipment.
 
Lassa fever is a disease in which one case is said to be an epidemic, and it may result into death in 50 per cent of cases. Therefore, we need to create more awareness about the disease and ensure that the menace is curbed, particularly at community, state and national levels. The prevention of Lassa fever virus is the key thing we need to ensure, because as Benjamin Franklin said: “An ounce of prevention is worth a pound of cure.”

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