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Lassa Fever will be defeated like Ebola-Says LUTH CMD

…Urges Nigerians not to panic
Following the anxiety that greeted the deaths of two patients resulting from Lassa fever disease at the Lagos University Teaching Hospital(LUTH), Idi-Araba, Lagos recently, the hospital authorities have urged Nigerians not to panic as the situation was under control.

Chief Medical Director of LUTH, Prof. Chris Bode, who gave the assurance in Lagos, assured that the disease will be defeated in a similar manner as Ebola was curtailed.

The LUTH CMD had on Tuesday told journalists that two Lassa Fever patients died at the hospital within few days of admission where they were being treated.

He said that it was more important for everybody, including the health workers, to observe good hygiene and environmental practices, such as hand washing with soap and ensuring that foods are properly covered against rats .

His words:“ If we defeated Ebola fever that is 100 times deadlier than Lassa fever, we can effectively defeat the disease and other hemorrhagic fever. There is no need to panic. We only need to control it .

It also occurs in other West African countries like Ghana; and it is not the first time we are having cases of Lassa fever in the country.

We however, should correctly inform the public about steps to take as individuals , families in homes and stakeholders in the control of this endemic ailment in our country. ”

On the steps to follow to curb the further spread of the disease, he explained : “Prevention of Lassa fever relies on promoting good “community hygiene” to discourage rodents from entering homes.”

Bode confirmed that the three LUTH workers who were confirmed to have Lassa fever as result of their contact with the index case-the two dead patients were doing well and are responding well to treatment.

According to him, the other 100 different hospital workers exposed to this index case are currently being monitored and were all given thermometer to report any elevation of temperature to the hospital immediately.

He affirmed that there were adequate materials for containment of the disease, while drugs have been made available to treat anyone confirmed with the disease, adding that the Centre for Disease Control (CDC) in Nigeria has also been contacted.

“ The LUTH personnel who came in contact directly with the first patient were close to 100; and they were swiftly informed and each one is still being followed up for any early signs of Lassa Fever. Of the 100, three persons who developed symptoms tested positive; and have been on admission and receiving treatment in our Isolation Ward here in LUTH”, he said.

He noted that with early diagnosis, Lassa fever can be well treated, because there were available drugs for it.

He reiterated that LUTH was working with officials of the Lagos State Ministry of Health and the Federal Ministry of Health to contain the present Lassa fever cases by mobilising human and material resources to trace the sources and extent of the disease; follow up on potential contacts, identify early and test suspected cases.

Below are further information provided by LUTH that would help Nigerians understand the ailment better and know how to protect themselves against it.

Lassa fever
Lassa fever is an acute febrile illness, with bleeding and death in severe cases, caused by the Lassa fever virus with an incubation period of 6-21 days. The virus, a member of the virus family Arenaviridae, is zoonotic, or animal-borne.

About 80% of human infections are without symptoms; the remaining cases have severe multiple organ disease, where the virus affects several organs in the body, such as the liver, spleen and kidneys. Lassa fever is a significant cause of severe illness and death.

Where Lassa fever is found
It is an acute viral haemorrhagic illness caused by Lassa virus, first identified in 1969 in Nigeria. It is endemic in Benin, Guinea, Liberia, Mali, Sierra Leone, and Nigeria, with peaks in incidence closely related to seasonal patterns.

However, because the rat species, which carry the virus are found throughout West Africa, the actual geographic range of the disease may extend to other countries in the region.

Transmission
The reservoir or host of the Lassa virus is the “multimammate rat” called Mastomys natalensis, which has many breasts and lives in the bush and around residential areas.

The virus is shed in the urine and droppings of the rats, hence can be transmitted through direct contact, touching objects or eating food contaminated with these materials or through cuts or sores .

Transmission also occurs in health facilities where infection prevention and control practices are not observed.

The person at risk
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 Lassa fever is not suspected or while caring for Lassa fever patients in the absence of proper barrier nursing and infection control practices.

Signs and symptoms
The onset of the disease, when it is symptomatic, is usually gradual, starting with fever, general weakness, muscle and joint pains, prostration 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. Patients may die from shock.

Laboratory diagnosis
Lassa virus infections can only be diagnosed definitively in a Virologylaboratory .These tests can be done at Virology Reference Laboratory at Lagos University Teaching Hospital, Idi-Araba, Lagos.

Management
The only known specific treatment for Lassa fever is Ribavirin which may be effective if given within the first six days of illness. It should be given intravenously for ten (10) days.

Supportive treatment should include; Paracetamol, Vitamin K (Phytamenadione), Heamacel, Ringers lactate, antimalaria and antibiotics- start by I.V. If patient is severely anaemic, consider transfusion.

There is currently no vaccine that protects against Lassa fever.

Prevention of Lassa fever
Prevention of Lassa fever relies on promoting good “community hygiene” to discourage rodents from entering homes. Effective measures include storing grain and other foodstuffs in rodent-proof containers, disposing of garbage far from the home, maintaining clean households.

In healthcare settings, prevention is by standard precautions where all blood and body fluids are considered potentially infectious. Standard precautions are applied to all patients at all times and in all health care settings.

These include hand hygiene, use of appropriate personal protective equipment (PPE), waste disposal, cleaning and disinfection of medical equipment and environment, safe injection practices.

In case of any suspected case of Lassa fever, notify the response team in LUTH on 08058019466, 08058744780, 07035521015 and 08023299445.

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