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Lassa fever: Lagos gives update


… records 14 suspected cases

Dr. Jide Idris Lagos Health Commissioner
Dr. Jide Idris
Lagos Health Commissioner

I. Preamble
Lagos State has recorded 14 suspected cases of Lassa Fever as at January 21, 2016, since the outbreak of the disease in the Country in November, 2015.

Three (3) of the suspected cases were confirmed positive of Lasssa Fever. One (1) case was confirmed on the 15th January 2016 and two (2) cases were confirmed on 18th January 2016. Eight (8) suspected cases tested negative, while we are awaiting results for the remaining three (3) suspected cases.
The Ministry has line
listed 447 contacts of the confirmed cases and 438 (98%) of the contacts are currently being monitored.

II. Suspected cases
Orile GH 1 1 negative

Ahmaddiya Hospital 2 1 positive
1 negative
Alimosho 2 2 pending.
Mushin 2 1 negative
1 pending
Amuwo 5 1 positive
4 negative
Eti Osa 1 1 positive
Mainland 1 1 negative

TOTAL 14 3 positive, 8 negative,
3 pending.

III. Confirmed cases
The three confirmed cases are not related in terms of source of infections.
Case 1
The patient, a 25 year old, male, undergraduate of Ahmadu Bello University, Zaria, Kaduna was first admitted at State was reported to Ahmmadiyyah Hospital, Ojokoro on the 9th of January, 2016 and later referred to the Lagos University Teaching Hospital (LUTH) on the 14th of January, 2016. He was confirmed as a case of Lassa fever on the 15th of January, 2016 at LUTH.
Present condition
The patient is presently being managed at the Lagos University Teaching Hospital (LUTH), has had antiviral medication for 7 days and his condition is stable and he is ambulating.
Case 2
A 51 year old man who lived in Ilasan Lekki came back from Edo where he attended a wedding ceremony on December 28, 2015. He was initially admitted at Divine Medical Centre in Ikoyi on January 12, 2016 and referred to Mainland Hospital Yaba early January 18, 2016. The patient died at 2pm same day before the result of the laboratory test that confirmed him positive of Lassa Fever was received.
Present condition
The patient has been kept in the morgue in leak proof body bag. He is to be buried today after due consultation with his family.

Case 3
A 36 year old Lady a native of Kogi State, first presented at Naval Reference Hospital, Ojo, on January 18, 2016 and referred to Mainland Hospital later same day.
Present Condition
The patient is being managed at Mainland Hospital and has received antivral medication for 5 days. Her condition is stable and she is ambulating.
IV. Contacts Line Listed and Being Monitored.
A total of 447 cases have been line listed out of which 438 are being monitored.
V. Other Prevention and Control Interventions by the Ministry
In view of the confirmation of cases of Lassa Fever, the Lagos State Government has called on residents of the State to be calm assuring them that both the State and Federal Governments are doing everything possible to control the spread of the Lassa virus. In line with international standards, the contacts of the patient are being tracked for follow-up. Meanwhile, drugs and other materials have also been prepositioned at our designated facilities; and isolation centres have been prepared to manage suspected and confirmed cases.
In addition, the government is implementing the following:
• Establishment of an Emergency Operations Centre (EOC) at the Ministry of Health (Conference Room). Holding of debriefing meeting daily at 6pm.
• Constitute teams to embark on intensive contact tracing.
• Request for more Ribavirin Injection & Tablets, PPEs and other items from FMOH.
• Step up community sensitization interventions.
• Tae stock of all infection prevention commodities lie PPEs, Lea Proof Body Bags etc.
• Redistribute Fact Sheets and protocols for managing Viral Haemorrhagic Fevers to all facilities (public and private)
• Redesign template for Data Management.
• Intensify Disease Surveillance activities for prompt detection of any new case.
• Pacing the Lagos State Ambulance Services on stand-by.
• Mobilise professional from the Lagos State Ministry of Health (LSMH) and its agencies, Federal Ministry of Health (FMOH), Lagos University Teaching Hospital (LUTH), Lagos State University Teaching Hospital (LASUTH), Association of Public Health Physician
• The Mainland Hospital and all other General Hospitals to continue to be on high alert.
• The Anti-viral drugs for the management of cases are available
• Ambulances have been dedicated to respond to referral and transportation of cases
• Airing of jingles on Lassa fever on electronic media to continue.
• of the Ministry and AGPMPN for circulation to all health workers in their facilities.
• Reactivation of isolation wards in LASUTH and 26 General Hospitals in Lagos State for isolation of any suspected case.
• Continue collaboration with Federal Ministry of Health, Virology Reference Laboratory, College of Medicine University of Lagos and World Health Organisation, Lagos in prevention and control of the disease.

VI. Information for the Public

Members of the public are being sensitized to note that Lassa fever can be contacted through:
• Ingestion of foods and drinks contaminated by the saliva, urine and faeces of infected rats
• Catching and preparing infected rats as food
• Inhaling tiny particles in the air contaminated with infected rat urine or droppings.
• Direct contact with a sick person’s blood or body fluids, through mucous membranes, like eyes, nose or mouth.
Those at highest risk include health workers, families and friends of an infected person in the course of feeding, holding and caring for them.

Residents are urged to watch out for the signs and symptoms of Lassa fever which typically occur within 1-3 weeks after the patient comes into contact with the virus. Early symptoms of the disease include fever, headache, chills, diarrhea, nausea, vomiting, sore throat, backache, and joint pains. Late symptoms include bleeding from the eyes, ears and nose, bleeding from the mouth and rectum, eye swelling, swelling of the genitals and rashes all over the body that often contain blood. It could progress to coma, shock and death.
The citizens have been informed that though Lassa Fever and Ebola Virus Disease belong to the same Viral Haemorrhagic Fever group, Lassa Fever is milder and can be treated and cured if detected early and that any persistent fever should be reported to the nearest public health facility.
They are also advised to suspect Lassa fever in persons with the above symptoms and positive history of contact with an infected person or health worker who had treated either suspected or confirmed cases. Residents are enjoined to observe a high level of personal and environmental hygiene and take note of the following:

• Avoid contact between rats and human beings.
• Ensure proper collection and disposal of waste.
• Cover all foods (including left-overs) and water properly.
• Wash hands properly before and after cooking of foods.
• Block all rat hideouts.
• Store food items in rodent-proof containers.

VII. Information for Health Workers (Public and Private).
Health workers are also advised to:

• Be at alert and have high index of suspicion for Lassa fever and other viral hemorrhagic fever.
• Report any suspect case to the Primary Health Department of LGAs or the Ministry of Health.
• Observe universal safety precautions when attending to all patients.
• Wear appropriate PPEs when attending to suspected/confirmed cases.

VIII. Conclusion
Members of the public and health workers are to report any case or symptoms of persistent high fever not responding to standard treatment for malaria and typhoid fever to the nearest health facility or call the following lines:, 08037170614, 08022234273, 08022241768 08033065303, 08033086660, 08055281442 and 08023169485.

In conclusion, we wish to emphasize the need for the citizenry to follow the general health promotion and disease prevention measures highlighted below:
1. Basic environmental sanitation, including proper disposal of refuse, avoiding open defecation etc.
2. Regular hand washing with soap and water
3. Maintaining personal hygiene.
4. Adequate nutrition
5. Antenatal care for pregnant women.
6. Immunization of children against deadly vaccine preventable childhood diseases.
7. Regular medical check-ups towards ensuring early diagnosis and prompt treatment of both communicable and non-communicable diseases.

In addition, all health workers are enjoined to comply strictly with infection control measures and processes while providing health care to the people.

The Lagos State Government, under the proactive leadership of the Governor, His Excellency, Mr. Akinwunmi Ambode is determined to continue provision of quality, affordable and accessible health care to the good people of the State.

Thank you for your attention.

Itesiwaju Ipinle Eko lo je wa logun!

Dr Jide Idris Dr. Olufemi Onanuga
Honorable Commissioner (Health) Special Adviser on PHC.

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