DR. AJIBOLA TAIWO is the Chief Medical Officer of Modern Care hospital. With the Lassa fever scourge ravaging some states in Nigeria including: Ondo, Edo, Ebonyi, Enugu, Kano, Borno, Nasarawa, Kogi, Rivers, Abia, Adamawa, Benue, Kaduna, Delta, Taraba, Plateau, Bauchi, Osun and Ogun States, the medical practitioner speaks with JOY NGWOLO on the causes and how best to reduce the spread of the virus. Excepts!
What is Lassa Fever?
Lassa fever is a haemorrhagic viral disease caused by a single stranded RNA virus called Lassa virus. It is a zoonotic disease first discovered in Lassa town in Borno State of Nigeria and is transmitted when an individual comes in contact with the faeces or urine of an infected mouse species known as mastomys natalensis.
What are the symptoms of Lassa fever?
Early symptoms of Lassa fever include fever and general body weakness. Later, the individual begins to experience headache, muscle pain, chest pain, sore throat, vomiting, diarrhoea, cough, and abdominal pain. In severe cases, facial swelling, fluid in the lung cavity, bleeding from the orifices (mouth, nose and anus) may be seen. Others are seizures, tremor, disorientation, deafness and coma may be seen in the later stages. In some cases, deafness, transient hair loss and gait disturbance may occur during recovery.
How is it spread?
It’s spread through contact with the faeces and urine of infected rats. Also through aerosol inhalation
Why has Lassa fever become an annual occurrence in Nigeria?
The disease is spreading in the country because of poor environmental and food hygiene within the country as rats practically live in houses with us. Another issue is the poor disease surveillance system of the country which allows it to be spread before an alert is given. Other contributory factors are lack of adequate testing facilities, ignorance about the disease and poverty.
Is government doing enough to contain the spread of the virus?
Although government should be commended for measures taken so far to contain the spread of the epidemic but there are areas where improvement can be made. These includes improvement in information dissemination about the virus, improvement in disease surveillance systems, provision of diagnostic facilities for the disease, as well as finding ways of improving access to medical care.
What measures can people take to curtail the spread of the virus?
The prevention of Lassa fever spread is dependent on government and individuals. Certain preventive measures such as observing simple hygiene regimes. People should store grains and foodstuff in rodent-proof containers. Another measure is environmental hygiene. Garbage should be disposed of properly to prevent rats from infesting the homes. People should also keep their households clean. Cats should also be kept in houses to help reduce the number of rodents infesting the house
Also, family members should avoid contact with body fluids like blood, saliva and so on while caring for sick persons. Care should also be taken to avoid physical contact when burying dead people who had a febrile or haemorrhagic diseases in endemic areas.
In hospitals, staff should apply standard infection prevention and control measures when caring for patients. These include basic hand washing, use of personal protective equipment, safe injection practices and safe burial practices. Health care staff providing care for patients with suspected or confirmed Lassa fever should take extra precautions to prevent contact with patient’s body fluids, contaminated surfaces and materials. When in close contact with patients with Lassa fever, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown and gloves.
Samples taken from humans for investigation of Lassa virus infection should be handled by trained laboratory workers and processed in suitably equipped laboratories under maximum biological containment conditions.
Do you think Lassa fever can be completely eradicated?
The disease cannot be completely eradicated yet because there is yet no vaccine to prevent infection. One major key used to combat diphtheria, poliomyelitis, whooping cough and so on was the development of a vaccine that was used to combat the disease.
Poor funding of the health sector resulting in poor health facilities, inadequate staffing, inadequate training of health professionals, poor disease surveillance and so on. For instance, when Ebola became a scourge and was assuming alarming proportions of infections, a vaccine was quickly developed. Funds are needed to build isolation centres, hire experts, purchase necessary equipment and drugs. Nigeria’s proposed budget for 2020 is 427.3billion naira which is less than five per cent of the total budget and translates to about N2000 per Nigerian. Where will the money to fund research for Lassa come from?
Another challenge is poverty which makes people live in filthy environments which are easy breeding places for rats. It also prevents people from accessing quality health care at the right time.
There are some cultural practices which aid the spread of the disease. Cultural practices like washing of dead bodies by care givers that help spread the disease if the deceased died of the disease. The disposal of bodies of people who died of the disease needs to be handled by professionals in a way that will not perpetuate the spread of the disease. Unfortunately, the carrier animal- rat is eaten as a delicacy in some communities too.
How can it be treated?
Presently, there is no vaccine for prevention but treatment can be done with ribavirin which is very effective when given in the early stages of the infection. This is why it is important for people to report cases as soon as the disease is detected so that treatment can be administered immediately.
