The incidence of Lassa fever cases in Nigeria continues to increase despite on-going efforts to control the disease.
Recently, The Nigeria Centre for Disease Control (NCDC) revealed that the federal and state governments are providing Ribavirin for treatment of Lassa fever and treatment centres had been provided with other essential drugs required for the prevention, diagnosis and treatment of Lassa fever cases.
This has however been refuted as various people have revealed through their personal experience at the clinics and hospitals.
Despite the conflicting stories, the disease is spreading and new cases are cropping up.
From 1st January to 11th March 2018, a total of 1,386 suspected cases of the disease and 114 deaths have been recorded actively, with at least one confirmed case across 55 local government areas in Edo, Ondo, Bauchi, Nasarawa, Ebonyi, Anambra, Benue, Kogi, Imo, Plateau, Lagos, Taraba, Delta, Osun, Rivers, FCT, Gombe , Etiki and Kaduna states making nineteen states.
Kaduna state reported one new confirmed case for the first time in this outbreak. Seven states have exited the active phase of the outbreak, while 12 States remain active.
This year, 84 per cent of all confirmed cases are from Edo (43%) Ondo (25%) and Ebonyi (16%) States. Sixteen health care workers have been affected since the onset of the outbreak in six states –Ebonyi -9, Nasarawa – 1, Kogi -1, Benue -1, Ondo -1 and Edo -3 with four deaths( Ebonyi 3 and Kogi 1).
A total of 3323 contacts have been identified from 19 active states. Of these 1150 are currently being followed up, 2182 have completed 21 days follow up and 21 of the 54 symptomatic contacts have tested positive from 3 states (Edo-11, Ondo-7 and Ebonyi-3).
“Effective surveillance is clearly important, containment and general precautionary measures will minimise risk of viral transmission. All we need to do is to practise more universal care precautions at all times generally and avoid reverting to old habits. People need to practice more hygiene, which is very important and the environment needs to be cleaner,” Oladoyin Odubanjo, Chair, Association of Public Health Physicians of Nigeria (APHPN), said.
“We have to be very careful with our living condition, in all these cases of outbreaks, simple basic hygiene by washing and cleaning hands would help and the government needs to improve in assisting states with epidemic so as to live well,” Odubajo said.
Speaking on reasons observed as the cause for the recent spread across Nigeria, Jide Idris, Commissioner of health, Lagos State, speaking exclusively in an interview with BusinessDay, said: “All those states where they have high numbers of Lassa fever cases, there are things they do like spreading grains on the floor in open places so they have to find a way around it and because of the species of rats there. Also, there is need for the public to ensure and maintain adequate personal hygiene and environmental sanitation at all times as part of prevention and control measures against the spread of Lassa fever.”
The commissioner stated that when Lagos had one suspected case recorded which was imported, they traced contacts and they got over 60 people. They all tested negative. In his words, “what the State government has done is not relenting in continuous surveillance. I urge people to dispose refuse properly at designated dump sites and not into the drainage system. They must also ensure they store food items in rodent-proof containers,” he said.
On the brighter side, Researchers at the Irrua Specialist Teaching Hospital, Edo State, in collaboration with partners from the Bernhard-Nocht Institute for Tropical Medicine, Germany and others, have deployed real-time sequencing of Lassa fever viruses from the on-going outbreak to learn key lessons to influence control efforts.
The real-time availability of sequencing information for the current 2018 Lassa fever viruses will support the response to the on-going Lassa fever outbreak.
The most important question being investigated at the moment is: What has caused an outbreak of this magnitude, at this time? One of the possible answers to this question is the emergence of a new Lassa virus lineage or strain with increased virulence or transmissibility. Experts have insisted that evidence from this work, although limited to seven viruses at the moment suggests that this is unlikely to be the case.
Experts have said that the viruses circulating in 2018 appear to originate from the pool of lineages and strains known to be circulating in Nigeria and are consistent with previous outbreaks. The most likely route of transmission continues to be spill over of viruses from the rodent reservoir to humans rather than extensive human-to-human transmission.
Lassa fever cases are usually at their peak during the dry season (January to March) while some cases take place during the wet season (May to November). The occurrence might also be partly due to population movements and overcrowding. As the wet season advances, there is progressive difficulty in travelling and may be responsible for the reduction in number of cases soon after in the season.
“Maintaining good hygiene at home such as eliminating rats out of the house and food supplies, ensuring that food is well cooked before eating, disposing all refuse far away from homes, avoiding bodily fluid and blood contact while caring for a sick person and ensuring that all foodstuffs are put in rodent-proof containers are some of the effective preventive measures that can be employed to help prevent the outbreak,” said Oluniyi Olatunde, Medical practitioner at Araba Specialist Hospital.
Kemi Ajumobi, Anthonia Obokoh & Micheal Ani
