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Lassa fever again!

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• Kills 35, 76 cases reported in 8 states in fresh outbreak

Prof. Isaac Adewole Nigeria's Health Minister
Prof. Isaac Adewole
Nigeria’s Health Minister

Nigeria has again been hit with the deadly Lassa fever outbreak now raging in eight states of the Federation.
A statement from the Minister of Health, Wednesday, said 35 people have died in the outbreak out of the 76 cases reported in the eight states. The states which, according to him, have been experiencing the outbreak in the past six weeks, include Bauchi, Nasarawa, Niger, Taraba, Kano, Rivers, Edo and Oyo.
The Minister said the Federal Government had put some measures in place to curtail further spread and reduce mortality among those affected. He however, ruled out placing travel restrictions from and to areas currently affected.
The Government, he further said, had directed the Nigeria Centre for Disease Control to coordinate the response and provide support to the affected states to fight and prevent the spread of the outbreak, as well as establishing case management centres in tertiary institutions in the states.
Adewole said he had also ordered immediate release of adequate quantities of ribavirin, the specific antiviral drug for Lassa Fever to all the affected states for prompt and adequate treatment of cases; and deployment of rapid response teams from the Federal Health Ministry to all the affected states to assist in investigating and verifying the cases and tracing of contacts.
Urging the public to be calm, the minister assured that Nigeria had the capability to diagnose Lassa Fever, saying all the cases reported so far were confirmed by “our” laboratories.
“However, because the symptoms of Lassa Fever are so varied and non-specific, clinical diagnosis is often difficult, especially early in the course of the disease,” he warned.
The minister also said he had directed all health facilities in the country to emphasise routine infection prevention and control measures and ensure all patients were treated free.
“Family members and healthcare workers are advised to always be careful to avoid contact with blood and body fluids while caring for sick persons. No travel restrictions will be imposed from and to areas currently affected.
“Healthcare workers seeing a patient suspected to have Lassa Fever should immediately contact the epidemiologist in the State Ministry of Health or call the Federal Ministry of Health using the following numbers: 08093810105,08163215251, 08031571667 and 08135050005.”
The minister further assured that the Government had also trained and sensitized clinicians, lab scientist and other health workers on viral hemorrhagic fevers and emergency medicine, as well provided specific drugs and injection for its treatment to the states’ Ministries of Health and in addition case management drugs, Personal Protective Equipment and Information, Education and Communication materials have been supplied to the affected states.
Prof. Adewole urged the public to prevent the spread of Lassa fever by taking the following precautions
• Avoid spreading of foods along the road.
• Keep food in tightly sealed containers.
• Cover all food and water properly.
• Set few traps in and around the house to reduce rat populations
• Isolate infected patients from contact with unprotected persons until the disease has run its course.
• Wearing protective clothing such as masks, gloves, gowns and goggles when caring for patients with Lassa fever.
• Avoid contact with Lassa fever patients secretions.
• If you have a bad infestation and they are in the walls, leave a few exit points so they can get out and not die inside the house and after they are all gone, seal up the holes.
Lassa fever is an acute viral hemorrhagic fever caused by the Lassa virus. The Lassa virus is transmitted to humans via contact with food or household items contaminated with rodent urine or faeces. Person-to-person infections and laboratory transmission can also occur, particularly in hospitals lacking adequate infection prevent and control measures.
About 80% of people who become infected with Lassa virus have no symptoms. One in five infections result in severe disease, where the virus affects several organs such as the liver, spleen and kidneys.
Lassa fever is a zoonotic disease, meaning that humans become infected from contact with infected animals. The animal reservoir, or host, of Lassa virus is a rodent of the genus Mastomys, commonly known as the “multimammate rat.” Mastomys rats infected with Lassa virus do not become ill, but they can shed the virus in their urine and faeces.
The incubation period of Lassa fever ranges from 6-21 days. The onset of the disease, when it is symptomatic, is usually gradual, starting with fever, general weakness, and malaise. After a few days, headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and abdominal pain may follow.
In severe cases facial swelling, fluid in the lung cavity, bleeding from the mouth, nose, vagina or gastrointestinal tract and low blood pressure may develop. Protein may be noted in the urine. Shock, seizures, tremor, disorientation, and coma may be seen in the later stages.
Deafness occurs in 25% of patients who survive the disease. In half of these cases, hearing returns partially after 1-3 months. Transient hair loss and gait disturbance may occur during recovery.
Death usually occurs within 14 days of onset in fatal cases. The disease is especially severe late in pregnancy, with maternal death and/or fetal loss occurring in greater than 80% of cases during the third trimester.
Humans usually become infected with Lassa virus from exposure to urine or faeces of infected Mastomys rats. Lassa virus may also be spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of a person infected with Lassa fever. There is no epidemiological evidence supporting airborne spread between humans. Person-to-person transmission occurs in both community and health-care settings, where the virus may be spread by contaminated medical equipment, such as re-used needles. Sexual transmission of Lassa virus has been reported.
Lassa fever occurs in all age groups and both sexes. Persons at greatest risk are those living in rural areas where Mastomys are usually found, especially in communities with poor sanitation or crowded living conditions. Health workers are at risk if caring for Lassa fever patients in the absence of proper barrier nursing and infection control practices.
There is currently no vaccine that protects against Lassa fever.
Background information: Courtesy WHO

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