…Lassa fever killed 92 Nigerians in 2021- Report
…Prepare for fresh, deadlier outbreaks, NMA warns
…No coordinated effort to reduce casualties – Expert
…Nigeria currently experiencing fourth wave – NCDC
Nigeria is currently witnessing a resurgence of Lassa fever amidst the fourth wave of Covid-19 pandemic occasioned by the Omicron variants. BENJAMIN SAMSON in this report examines the current outbreak.
The Nigeria Centre for Disease Control (NCDC) recently disclosed that 16 states have recorded at least one confirmed case of Lassa fever across 66 local government areas in the country. This was disclosed in the agency’s latest Lassa fever situation report for week 49 spanning from December 6-20.
The report also indicated that Lassa fever has killed 92 people in the country in 2021.The confirmed figures resulting from Lassa fever were recorded in Ondo -45, Edo -14, Taraba -12, Kaduna -4, Bauchi -3, Ebonyi -2, Nasarawa -2, and Enugu -1.
NCDC also noted that eight health workers have been infected with the viral disease. It added that the number of new confirmed cases increased from 4 in week 48, 2021 to 10 cases -These were reported from Ondo, Edo, and Nasarawa states.
“Cumulatively from week 1 to week 49, 2021, 92 deaths have been reported with a case fatality rate (CFR) of 18.7 per cent which is lower than the CFR for the same period in 2020 (20.7 per cent). In total for 2021, 16 states have recorded at least one confirmed case across 64 local government areas.
“Of all confirmed cases, 84 per cent are from Edo (44 per cent), Ondo (35 per cent) and Taraba (five per cent) states,” the Centre stated.
Similarly, two senior consultant gynecologists have reportedly died of Lassa fever at the Dalhatu Arafat Specialist Hospital (DASH) in Lafia, Nasarawa state.
Blueprint weekend learnt that they contracted the disease during an emergency caesarian operation conducted on a woman, who was bleeding and admitted at the hospital, but unknown to the doctors that she had Lassa fever.
A source at the hospital confirmed that the pregnant woman was rushed to the hospital over complications arising from Lassa fever, but the consultants, who attended to her, thought it was pregnancy-related complications. The woman and the baby died some hours after the surgery.
It was further learnt that the test result showed that she had Lassa fever, which actually led to complications that resulted in premature labour that necessitated her being rushed to the hospital on emergency.
The source also disclosed that one of the doctors, who performed the operation, died last week and that the test result confirmed that he died of Lassa fever, while the second doctor has died.
The hospital’s Public Relations Officer (PRO), Mrs. Ruth Namo, confirmed that the two gynecologists died of Lassa fever.
NMA’s warnings
Meanwhile, the Nigerian Medical Association (NMA) has advised the country to prepare for possibly fresh and deadlier Lassa fever outbreaks.
Its president, Prof. Innocent Ujah, at the opening of the December National Executive Council (NEC) meeting (Caliphate City 2021) recently in Sokoto, expressed concerns over emerging and re-emerging infections.
He stressed the need to continually put together effective outbreak prevention and control measures that were culturally appropriate, relevant and feasible for communities to check unnecessary loss of life and minimise disruptions to essential services.
The obstetrician and gynaecologist canvassed uninterrupted community engagement, social mobilisation and communication for effective prevention and control of these emerging diseases.
Ujah said “this is on the premise that every outbreak is unique and community understanding of diseases and their spread are complex, context-dependent and culturally mediated; hence the need for effective coordination.”
The NMA boss said Nigeria “has the opportunity of applying the World Health Organisation (WHO) outbreak communication principles geared at preventing exposure, stopping transmission and providing relevant public health information for an overarching goal before, during and after epidemics.”
“This will help in building and maintaining public trust in the prevention and control of outbreaks,” he said.
Ujah said Nigerian medical doctors and other frontline health workers “have been at risk of contracting these infectious diseases, adding that many had been infected and survived, while some lost their lives in the course of discharging their duties.”
Omicron
Sadly, Nigeria is witnessing resurgence in Lassa fever infections amidst the fourth wave of Covid-19 pandemic. Also, the NCDC also announced the fourth wave of the coronavirus pandemic in Nigeria on December 20, 2021.
It stated that the country has recorded a 500 per cent increase in the number of confirmed cases within the past two weeks.
The director-general of the Centre, IfedayoAdefila, in a statement, noted that the rise in infections had been linked to both the Delta and Omicron variants of the rampaging virus.
However, the latest statistics by the NCDC showed that Nigeria’s infection toll had increased to 233,353, while the fatality toll stands at 2,991.
As of Wednesday, December 15, the number of active cases increased from 12,547 to 16,569 cases, while the number of discharged cases now stands at 212,040. The data also shows that Nigeria has so far tested 3,751,696 samples.
Community transmission
Likewise, the NCDC confirmed the community transmission of the Covid-19 Omicron variant even as it disclosed that “Nigeria has not recorded any death from the variant.”
Making the disclosure during a webinar on the surge in Covid-19 cases across the country, Dr. Adetifa said additional 39 cases of the Omicron variant had been discovered bringing the total to 45. He added that the Omicron had pushed up the number of cases of coronavirus in the country, and that “the variant is gradually becoming dominant.”
“The six earlier detected Omicron cases were detected in persons with recent travel history to South Africa. It is important for Nigerians to maintain physical distance and avoid contact with anyone showing symptoms of respiratory illness.
“We are counting on you to celebrate responsibly and take responsibility to keep yourself and your loved ones safe from Covid-19.”
Lassa fever
A consultant virologist at University of Abuja Teaching Hospital, FunshoIdrisu, in a chat with Blueprint Weekend shed more light on the disease.
He said, “Lassa fever is a severe and often-fatal hemorrhagic illness caused by Lassa virus. Since it was originally discovered in 1969 in the village of Lassa in Borno state, there have been countless outbreaks of various magnitude and severity across West Africa.
“The Lassa virus is a member of the Arenaviridae virus family. Humans contract the virus primarily through contact with the contaminated excreta of Mastomysnatalensis rodents commonly known as the multi-mammate rats, which are the natural reservoirs for the virus.
“The rodents live in bushes, but because of dry season, they run to houses for protection and live with humans and deposit excreta on floors, tables, beds and foods.
“The foods that can be contaminated by the rodents include garri, yam, rice and beans, among others. So, people should cover their foods properly, avoid taking soaked garri that was not covered. While feeding on the foods, the rodents defecate and urinate on them, which is not good for human consumption. So, people should not eat leftover foods without properly warming them.
“The virus is transmitted to humans through cuts and scratches. In some regions, mastomys rodents are consumed as food, but it is better for people to avoid contact with rodents.
“In the early stages, Lassa fever is often misdiagnosed as influenza, typhoid or malaria, and as a result many patients fail to receive appropriate medical treatment. Making a correct diagnosis of Lassa fever is made difficult by the wide spectrum of clinical effects that manifest, ranging from asymptomatic to multi-organ system failure and death. The onset of the illness is typically indolent, with no specific symptoms to distinguish it from other febrile illnesses.”
What we eat
Speaking with this reporter, a public health consultant, Dr. Uche Okolie, urged Nigerians to be wary of buying snacks wrapped in newspapers or other unhygienic means.
He said, “It is also important to bring to the attention of Nigerians that we should be wary of smoked meat slices (suya), bean cake (popularly called akara in local parlance), roasted corn and other food items or snacks that are usually sold by wrapping them in old newspapers or other paper materials where rodents might have excreted on them.
“That paper-wrapped food item may not be washed or rinsed before consumption so it becomes unhealthy to eat. It is therefore not hygienic to keep food items in used papers. These papers may not, by mere visual inspection, reveal rodents’ urine or excreta, so difficulty may arise in discerning which ones are contaminated or not. One never can tell if these papers have come in contact with excreta from rats. When an individual then consumes food items wrapped in these contaminated papers, such a one may be at high risk of contracting Lassa fever. It is, therefore, advisable to play safe by taking your container to receive the food items at the point of sales or requesting them to be sold in a safe and healthy wrapper.”
He also warned Nigerians against the consumption of cassava flakes (garri) to avoid contracting Lassa fever. He said the rats that caused the disease were mostly in contact with the most popular Nigerian staple food, garri.
“When garri is soaked in ordinary water and consumed, one is exposed to the risk of contracting Lassa fever. But if the water is boiled to make eba, it could go a long way to kill the bacteria caused by pests or rodents in garri.”
An expert’s view
Also, a virologist, Dr. Chris Osakwe, of Doctors without Borders in an interview with Blueprint Weekend queried Nigeria’s poor handling of the disease over the years.
He said, “The rash of deaths recorded across the country in the wake of the ongoing Lassa fever outbreak is evidence that not much has changed over the years in the management and control of the disease in Nigeria. If any lessons have been learnt at all from previous experiences, they are obviously not being put to proper use to contain the high incidence of the deadly disease. Instead of witnessing a decline in yearly infection rates, Lassa fever cases appear to have become more widespread in the country.
“More cases are still being recorded on a daily basis. For a disease that is not so strange to the country’s health authorities, there should be better ways of handling it to reasonably bring down the casualty figures. In particular, health care workers, as professionals, should take their self-protection more seriously to reduce the soaring number of casualties among them.
“Despite the annual harvest of deaths, there has not been a well-coordinated, determined and focused effort to reduce the casualty rate and, possibly, eradicate the disease. For a disease that is both curable, if early medical intervention is sought, and preventable through observance of adequate personal hygiene, this is not good enough. Indeed, the figures are alarming and it is getting to a stage where the government can ill afford to continue to ignore them.”
Preventive measures
On how not to contract the disease, an environmental health scientist Mustapha Haruna, said hygiene is critical in the prevention of the disease.
“There are many things Nigeria can do to halt the spread of the deadly Lassa fever. The fever has caused devastation in the lives of Nigerians for 51 years, with the virus not prompting changes in the way and manner Africa’s largest economy responds to outbreaks and other health emergencies. Many years down the line, the virus has continued to stage a comeback, with outbreaks already reported in different states of the country.
“In prevention of Lassa fever, it is critical to maintain a high level of hygiene around the home, which could help to keep rats at bay.
“Apart from keeping the home clean, it is also important for the environment to be kept clean and refuse dumpsites to be far away from residences. This falls under the purview of the local government which, in the past, had sanitary inspectors that moved from house-to-house to enforce compliance with accepted standards of cleanliness. Those whose duty it is to clean the drains should be made to do their job to reduce the breeding ground for rodents,” he said.
Health workers
Meanwhile, Dr. Osakwe advised health care practitioners to always observe safety precautions whenever attending to patients. He also advised the general public to store food items, especially grains, garri and powdered food in air-tight containers.
“The general public should endeavour to quickly report any case of high grade fever not responding to anti-malarial treatment to the nearest hospital, so that quick diagnosis and treatment can be instituted. Early presentation has a good prognosis,” he said.
He appealed to relevant governments and stakeholders to be serious with the welfare of health personnel. He noted that health personnel risk their lives under a very poor remuneration.
“Can you imagine that the hazard allowance for a doctor is just N5, 000, while those who are not exposed to any risk are being paid allowances running into millions of Naira?”
