By Ojoma Akor & Francis Arinze Iloani
188 citizens died in 3 months 963 cases in 27 states ‘Disease deserves more attention’ In the wake of the coronavirus (COVID-19) pandemic, Lassa fever has killed at least 188 Nigerians this year, with experts saying the disease has wreaked havoc since its discovery in the country 51 years ago. Health officials have, therefore, called for a corresponding attention to end the Lassa fever, emphasising that it is equally a deadly disease that has taken a toll on the citizens and medical practitioners over the years. It was gathered that from January this year to the first week of April, 963 people have fallen ill with the disease across 27 states of the country.
Lassa fever has also killed 56 people from the last week of February when the first case of coronavirus (COVID-19) was recorded in Nigeria. Minister of Health, Prof Osagie Emmanuel Ehanire As at Tuesday, April 14, Nigeria recorded 373 confirmed cases of coronavirus (COVID-19) and 11 deaths. This is by far below the number of people infected or killed by Lassa fever within the same period. A breakdown showed that within the period, out of the 963 Lassa fever infections, the mortality rate is 19.52 per cent. On the other hand, out of the 373 cases of COVID-19 recorded, the mortality rate is 2.95 per cent. Daily Trust observed that out of the total of 199 mortalities recorded from both Lassa fever and COVID-19 within the period, Lassa fever accounted for 94.5 per cent of the total deaths while COVID-19 accounted for 5.5 per cent of the total deaths. A situation report by the Nigeria Centre for Disease Control (NCDC) also revealed that 985 people were receiving treatment at various centres for Lassa fever, saying 37 health workers have also been affected by the disease this year. According to the Nigerian Association of Resident Doctors (NARD), six doctors have lost their lives to Lassa fever this year alone. This excludes laboratory scientists and technicians, nurses, pharmacists, and other health workers that have lost their lives to the disease. There are growing concerns that while attention is being paid to the coronavirus outbreak with financial interventions from the public and private sector, little or no attention is being paid to Lassa fever, which is wreaking more havoc and has been endemic since the country recorded its first case in 1969. Silent killer in Nigeria Lassa fever is a viral haemorrhagic illness caused by contact with food or household items contaminated with rodent urine or faeces. The virus is carried in multimammate rats (the common soft-furred African rat whose female has a double row of breasts), which normally live in bushes and visit nearby homes for food which they contaminate. The President of the Nigerian Association of Resident Doctors (NARD), Dr. Aliyu Sokomba, said Lassa fever is a very serious outbreak and that Nigeria is experiencing the world’s largest outbreak of the disease. He said available figures point to the fact that the fatality rate of 19. 5% of the disease is very high. “It means that for every 100 people that come in contact with Lassa fever, 20 of them die,” he said. According to him, Lassa fever is more deadly than COVID-19 considering that while the latter has so far killed only 11 people in Nigeria, the former has killed 188 people. He said in spite of this, tackling Lassa fever has been abandoned, probably because of the status of people mostly affected by the disease as compared to those that come down with COVID -19. The NARD president said government and all other stakeholders need to give attention to Lassa fever prevention and control. “Lassa fever is a preventable disease but we have stopped talking about the preventive measures since COVID-19 came up. The disease is highly infectious, it spreads and it kills. So it is high time attention is paid to it because it is killing Nigerians and every life matters.” He said while Lassa fever has been endemic in the country, it has witnessed annual outbreaks consistently in the last five years. A medical practitioner, Dr. Sabo Ibrahim Ali, said it is good to also give Lassa fever treatment the needed attention because it is killing many people in Nigeria especially the poor.
“Of course you cannot compare coronavirus with Lassa fever but Lassa has been with us for decades and should be dealt with seriously. Coronavirus got the traction it got because of many factors, including the fact that it started in the advanced societies and spread like wild fire, killing thousands within a short period to the extent that it has grounded the world,” he said. According to NCDC, Lassa fever may also be spread between humans through direct contact with blood, urine, faeces, or other bodily secretions of a person infected with the disease, saying laboratory transmission can also occur. The illness was discovered in 1969 and is named after the town in Borno State, where the first case occurred. According to the Centres for Disease Control and Prevention, apart from Nigeria, Lassa fever is endemic in parts of West Africa including Sierra Leone, Liberia and Guinea, saying other neighbouring countries were also at risk, as the animal vector for disease is distributed throughout the region.
The centre said an estimated 100,000 to 300,000 infections of Lassa fever occur annually, with approximately 5,000 deaths. It said surveillance for Lassa fever is not standardised; therefore, the estimates were crude and not actual representation of what is happening. “For instance, in some areas of Sierra Leone and Liberia, it is known that 10-16 percent of people admitted to hospitals annually have Lassa fever, demonstrating the serious impact the disease has on the region,” it said. Rising cases of Lassa fever Analysis by the Daily Trust showed that the number of Lassa fever cases recorded from January to April 5 (three months) dwarfs the total number of cases recorded in 2019 which stood 810. Similarly, 633 cases were recorded in 2018, and 308 cases were recorded in 2017. The 188 death recorded this year also exceeded the total number recorded in 2018, which had the highest number of deaths before now at 171. Signs and symptoms The illness is characterised by sudden onset of fever and general weakness. Other symptoms include headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and abdominal pain. In the most severe cases, individuals may bleed from the mouth, nose, eyes or other parts of the body and eventually die.” Sometimes, a large percent of Lassa fever cases may be unnoticed because it has similar symptoms for other common diseases. How to protect yourself from Lassa fever Outbreaks of Lassa fever have resulted to loss of lives among the general public and health workers.
Medical experts have advised people to prevent the spread of the disease by not spreading foods along the road, keeping food in tightly sealed containers, wearing protective clothing such as masks, gloves, gowns and goggles when caring for patients with Lassa fever and avoiding contact with patients’ secretions. Dr. Ogugua Osi-Ogbu, a consultant physician said, “The cover of your pot or water must be ‘rat proof’ so that the rat will not be able to easily displace. “Washing our utensil is very necessary; cups, plates, cutlery must be thoroughly washed before usage. You don’t just pick them and use for the sake that it has earlier been washed not minding if rats had perched on them. When rats have played on them and you don’t wash before use, your food will be contaminated. “We must also know that not every fever is malaria. If you have a fever that has been treated and it’s not going away, you must visit the hospital because there could be other reasons, one of which is Lassa fever. The good thing about it is that it is treatable if we start treatment on time, people do not have to die by it if treatment starts earlier. The incubation period goes between six to 21 days and study has shown that if we start treatment between six days of infection people do not actually need to die. “Many people continue treatment severally thinking they have malaria or typhoid thereby leading them into the late stage of infection. Such people come to the hospital when they are already bleeding or developing multi-organ failure and at that point, there are very little medications would do,” she said. Dr. Ogugua advised health workers to maintain standard procedures and hand washing when managing patients. She also enjoined family members of any victim of the disease to take precaution while attending to their infected relations through avoiding direct body contact with the patients’ fluid, through the use of gloves and also taking the patients to the hospital as soon as sign of ailment is seen.