In this report, TOPE SUNDAY, chronicles the havoc the resurgence of Lassa fever is wrecking in some major parts of the country, and the steps being taken by governments to put it under control.
Nigeria, in the recent times, has been experiencing the outbreak of contagious diseases like Ebola, and lately the Lassa fever. In 2014, Ebola broke out, and according to the World Health Organisation (WHO), 20 cases and eight deaths were confirmed, along with the imported case, who also died. However, almost six years after its ‘strange’ visitation on the Nigerian soil, Ebola has not resurfaced yet.
But another killer disease, Lassa fever, is now a regular caller on the territory of the most populous black nation on earth.
In 2019, according to an available record, 170 Nigerians lost their lives to Lassa fever.
The 2020 experience
In less than 29 days, the death toll from the outbreak of Lassa fever in Nigeria in the early part of 2020 has risen to 41. The Nigeria Centre for Disease Control (NCDC) in its weekly situation update for week, which captures January 20 to 26, revealed that the number of newly confirmed cases and deaths is gradually on the rise.
According to the Centre, between January 1 and 26, a total of 689 suspected cases were recorded, out of which 258 confirmed cases were reported with 41 deaths.
A breakdown of the report by the NCDC shows that between January 1 and 26, 19 states had been ravaged by the contagious disease. A further analysis of the report revealed that states like Ondo, Edo, Ebonyi, Enugu, Kano, Borno, Nasarawa, Kogi, Rivers, Abia, Adamawa, Benue, Kaduna, Delta, Taraba, Plateau, Bauchi, Osun and Ogun have been hit by the disease.
In two states of Taraba, Borno and Kano, five health workers were among the victims.
Comparisons
The Lassa fever outbreak by this time last year recorded 42 deaths, while the 2020 experience has a record of 41 deaths.
However, a report published by reliefweb on November 24, 2019, which quoted the NCDC situation report for week 47, which captured November 18 – 24, 2019, said eight new confirmed cases were reported from Ondo and Edo states with no new death.
The report said from January 1 to November24, 2019, a total of 4, 681 suspected cases were reported from 23 states. Of these, it stated further that 785 were confirmed positive, 19 probable and 3877 negative (not a case).
“Since the onset of the 2019 outbreak, there have been 160 deaths in confirmed cases. Case fatality ratio in confirmed cases is 20.4%. Twenty-three states of Edo, Ondo, Bauchi, Nasarawa, Ebonyi, Plateau, Taraba, Adamawa, Gombe, Kaduna, Kwara, Benue, Rivers, Kogi, Enugu, Imo, Delta, Oyo, Kebbi, Cross River, Zamfara, Lagos and Abia recorded at least one confirmed case across 86 local government areas.
“93 per cent of all confirmed cases are from Edo (38%), Ondo (32%), Ebonyi (7%), Bauchi (7%), Taraba (5%), and Plateau (5%) states. Predominant age-group affected is 21-40 years. The male to female ratio for confirmed cases is 1:1.
“In the reporting week 47, no new health care worker was affected. A total of nineteen health care workers have been infected since the onset of the outbreak in 10 states – Edo (06), Ondo (04), Ebonyi (02), Enugu (01), Rivers (01), Bauchi (01), Benue (01), Delta (01), Plateau (01) and Kebbi (01) with two deaths in Enugu and Edo states,” the report revealed.
A detailed comparison of the outbreak of Lassa fever in Nigeria in 2019 and 2020 shows that 23 states were affected in 2019, while 19 are being affected in January 2020.
Also, in the year under review, 15 states of Ondo, Edo, Bauchi, Nasarawa,Enugu, Kogi, Rivers, Adamawa, Delta, Ebonyi, Taraba, Plateau, Benue, Kaduna and Abia, are having the resurgence of the outbreak having experienced same in 2019.
Blueprint Weekend’s investigations also revealed that Osun and Ogun states are experiencing the outbreaks this year having escaped it in 2019, while Gombe, Kwara, Imo, Oyo, Kebbi, Cross River, Zamfara and Lagos states that encountered it last year as at the time of filing in this report were freed from its havoc.
State by state experience
In the year under review, some states are worse hit. In Ondo state, at least 16 people had lost their lives to the fresh outbreak of the disease.
As at the time of filing in this report, four local government areas of the state, namely – Akoko South West, Akure South, Ondo West, and Owo had been hit by the virus.
In Asaba, the Delta state capital, a single mother was confirmed dead as a result of the outbreak of the disease. There were three cases of Lassa fever recorded at Federal Medical Centre (FMC), Asaba, but a casualty was recorded.
The situation is the same in Ogun state as a 26-year-old woman, Titilayo Akinsola, died of Lassa fever. Blueprint Weekend gathered that the victim was rushed to the Federal Medical Centre (FMC), Idi-aba in Abeokuta, the state capital.
According to the spokesman of FMC, Segun Orisajo, who confirmed the incident to this medium, Akinsola was admitted to the hospital and after series of tests she was diagnosed of Lassa fever.
Orisajo further said Akinsola died after failed attempts by the medical team of the hospital to save her.
In what appears like raising the alarm, the Rivers state government stated that it had received four suspected cases of Lassa fever in the state. The government stated that the cases have received prompt and adequate attention.
“Two rumours have been investigated and discarded. Two samples have been collected and sent to the national reference laboratories for virology. All two cases are still suspected, unconfirmed and results are being awaited.
“However, the state was notified of a resident of Rivers state who was diagnosed in Edo state as a case of Lassa fever on January 22, 2020.
“Together with the management of the hospital, the family and National Commission for Disease Control, NCDC, are working assiduously to ensure Public Health Safety in the exposed clusters, especially among health care Personnel and the first responders,” the government disclosed in a statement from the Ministry of Health.
On it part, the Plateau state government confirmed five cases of Lassa fever, saying that the victims had been hospitalised.
The Commissioner for Health, Dr. Nimkong Ndam, who disclosed this in Jos, the state capital, said the patients of the ailment had been admitted to two hospitals in the state, adding that three of them were undergoing treatment; one had completed treatment, while the fifth one had been discharged.
He said Lassa fever was not new in the state because the area had experienced the disease in the past.
In Enugu state, the state government declared that it had deployed protective equipment to protect health care workers in Enugu State Teaching Hospital (ESUTH), Park Lane.
The permanent secretary in the ministry, Dr. Ifeanyi Agujiobi, told the News Agency of Nigeria (NAN) that the equipment was to protect the workers and assuage their fears of contamination.
According to him, arrangements have been concluded for the immediate burial of the patient who died at the teaching hospital. The permanent secretary had earlier confirmed the case of Lassa fever which reportedly killed a 75-year-old woman.
According to the statement, the case was presented to ESUTH, Park Lane, about 10 days ago with symptoms similar to malaria. He said the deceased’s sample was taken to Virology Centre at Abakaliki, Ebonyi state, and it was confirmed to be Lassa fever positive.
With Lassa fever hitting some states in the country, the Oyo state government warned bush meat lovers to be cautious by ensuring such meat is well-cooked before consumption.
The Commissioner for Health, Dr. Bashir Bello, who sounded the warnings during a press conference held at state secretariat, on the outbreak of the virus, enjoined residents of the state to properly keep their food items in their homes and prevent rats and other rodents from feasting on them.
Though he pointed out that there was no outbreak of Lassa fever in the state, he said the state had set health facilities and medical personnel on the alert to be able to carry out a quick diagnostic evaluation of Lassa.
Proactive measures
While proffering solution to the disease, an Abuja- based public health expert, Dr. Gabriel Adakole, said proactive measures, rather than curative, must be taken to check its spread.
He noted that “there is an urgent need for government to educate people in high-risk areas about ways to eradicate or reduce the populations of rodents in their homes,” adding that “such a step will aid in the control and prevention of Lassa fever.”
He advised the federal government to sensitise rural dwellers on the resurgence of the disease and ways of curbing its spread. Adakole said the current awareness, which was mostly on the social media, is not getting to people in the rural areas.
According to him, past outbreaks mainly hit rural areas with just a few cases detected in cities. He said further that the lack of awareness on outbreaks in the rural areas is a major factor that contributes to undetected spread of diseases.
He urged the Nigeria Centre for Disease Control (NCDC), and other relevant agencies to reach out to Nigerians in the rural areas to avoid the entrenchment of the virus in such places.
He called on government to also ensure the development of more rapid diagnostic tests and to increase its availability across the nation.
Speaking further on ways to prevent the disease, he said the prevention of Lassa fever relied greatly on promoting good environmental hygiene to discourage rodents from entering homes.
He also said other effective measures include storing grains and other foodstuff in rodent-proof containers, disposing of garbage far from the home and maintaining clean environments.
“Trapping in and around homes can help reduce rodent populations, however, the wide distribution of Mastomys in Nigeria and also in Africa, makes complete control of this rodent reservoir impractical,” he said.
Govt’s efforts
On his part, a Lassa fever expert and virologist, Oyewale Tomori, lamented that the government “is not doing enough in finding a lasting solution to the yearly outbreaks.”
He said the country’s leaders seemed to be less concerned about the disease because most of the people contacting the disease were the masses.
Tomori, however, called on the government to take more responsibility in combating the disease and find a lasting solution to curbing it.
NMA’s take
For the Nigerian Medical Association (NMA), the frequent outbreaks underscored the deplorable state of health care delivery in the country.
The association, in a statement by its president, Dr. Francis Faduyile, appealed to health authorities at all levels to prioritise capacity-building of health care professionals on standard infection prevention and control measures.
The group also described the recent outbreak of Lassa fever across the country as a reflection of the abysmally low level of preparedness in handling infectious diseases, especially viral haemorrhagic fever, at all levels of health care delivery.
