The yearly scourge of Lassa fever has struck at the heart of the country once again, leaving in its wake the usual trail of deaths and wailing by the bereaved families. At the last count, no fewer than 41 people had been reported dead in about 86 cases of infection in 10 states across the country; and the number is expected to increase.
By any standard, this is quite alarming. But in a country that has become so immune to shock, due to the frequency of mass death from plane crashes, road accidents, communal and sectarian clashes, suicide bombings and other forms of Boko Haram terror attacks, there is the tendency for that number not to stir the right kind of emotion. This is perhaps why Abdulrahman Nasidi, the Project Director, National Centre for Disease Control, was quoted as saying that it had not reached the level “to declare a national emergency.”
But periods such as this demand swift reactions from the health authorities to avert another national disaster, especially since the infection is preventable and treatable if medical intervention is sought early enough. This is where enlightenment is very vital; right from the affected states and beyond, health authorities have a responsibility to tell the citizens what is expected of them to prevent a further spread of the infection and, for individuals who have already been infected, how to access the right medical care.
According to reports so far, the affected states cut across the northern and southern parts of the country. They include Bauchi, Nasarawa, Niger and Taraba states. Others are Kano, Rivers, Edo, Plateau, Gombe, and Oyo states, as well as Abuja. But, being a highly infectious disease, the number could witness a rapid increase if urgent measures are not taken to curb the spread.
Though first described in the 1950s, the virus that causes Lassa fever was not identified until 1969 in a town called Lassa in the present day Borno State. Since then, the disease, seen as endemic in West Africa, has been killing thousands of people every year. According to the World Health Organisation, between 300,000 and 500,000 persons come down with Lassa fever annually, out of which 5,000 deaths are recorded.
Just like the dreaded Ebola Virus Disease, which Nigeria was however able to effectively contain in 2014, to the surprise of a bewildered world, Lassa fever is a highly fatal form of haemorrhagic fever. The incubation period is between six and 21 days, similar to that of Ebola.
Strikingly too, Sierra Leone, Guinea, Liberia and Nigeria, the same countries that were ravaged by the recent EVD epidemic, have been identified as the Lassa fever endemic countries.
The disease is mild or asymptomatic in up to 80 per cent of people infected. Starting with fever, symptoms progress to the weakness of the body and general malaise. Other symptoms include headache, sore throat, nausea, vomiting, diarrhoea, cough, severe facial swelling and, in acute cases, bleeding from the mouth, nose, vagina and gastrointestinal track. There is also a possibility of shock, tremor, seizure, disorientation and coma in the later stages. Death occurs within 14 days of the manifestation of the disease. For 25 per cent of those who survive, there is the possibility of deafness, but hearing could return one to three months later.
Caused by Lassa virus, it is a disease in which secondary transmission could occur from one infected human to another, but primarily transmission is from exposure to infected rodents. Mastomys or multimammate rats, as they are called, are the main vectors that contaminate food, water, utensils or other household items, through faecal discharge and urine.
It is also possible for an infection to take place through direct contact with an infected person’s blood, urine, faeces and other bodily secretions. This is why it is advisable that the sharing of medical equipment such as hypodermic needles and syringes should be avoided. Infection could also occur through inhalation of contaminated dust particles in the air.
Apart from enhancing nationwide surveillance and sensitisation, the Minister of Health, Isaac Adewole, said the Federal Government had dispatched adequate quantities of needed drugs – ribavirin – to the affected areas. This is very important so that those who make it to the hospital early can be sure of a reasonable chance of survival. Fatality rate for such people is put at 15 per cent.
Eminent virologist, Oyewole Tomori, advises that with adequate awareness of the causes of the disease, it is easy to reduce the rate of infection, even if it would be difficult to eliminate it completely. “So, what we need is a lot of awareness, especially among people in the rural areas, to store their foods properly, to protect them from contaminated virus,” he said.
For Lassa fever, what is important is personal hygiene in and around the home. Since rodents scavenge food in rubbish heaps, efforts should be made to ensure that refuse is dumped far away from the house. It is also advisable that, from time to time, homes are fumigated to get rid of rodents that may have taken refuge in kitchens and stores.
Lassa fever is usually common during the dry season – although some outbreaks have in recent times been recorded in rainy seasons. So febrile conditions should not always be assumed to be malaria, but should be subjected to clinical tests to ascertain the nature of ailment. Experts say that even after cure, the virus could remain in the body, especially in the semen, for as long as three months.
