THE LASSA FEVER EPIDEMIC

The authorities could do more to contain the viral disease

The numbers are becoming frightening by the day, giving credence that the latest outbreak of Lassa fever is the most virulent in its history. Last week, the Nigeria Centre for Disease Control (NCDC) confirmed the death of 101 patients from the viral disease and nine others in “probable cases” since January this year. Some 22 health care workers across seven states were among the dead. What is also worrying is the grave danger in its rapid spread: at the last count some 20 states are affected with Edo, Ondo and Ebonyi presently saddled with the highest burden. But what happens when it spreads to states like Lagos and Kano with high population density?

What is even worse, Nigerians will likely live with the deadly disease for quite a while. “We have had the largest outbreak of Lassa fever in Nigeria’s history in the first quarter of this year,” said Dr Chikwe Ihekweazu, Chief Executive Officer of the NCDC. “It is endemic in our environment and as long as there is rat, we will always have cases of Lassa.” Thus, unlike Ebola whose spread could be halted once the chain of infection is broken, Lassa, according to Ihekweazu, has multiple channels of infections.

However, experts in the health sector believe that the country has not done enough in tackling the haemorrhagic fever, giving room for Lassa epidemics to recur nearly every year since it first emerged in 1969 at Lassa, the town after which it was named. “Our lack of commitment, not owning our problems, bad governance is what’s responsible,” said Professor Oyewale Tomori, chairperson of the National Lassa fever steering committee. “Until we change governance, we will remain where we are. Over the years, infrastructure for managing and containing infectious disease outbreaks has folded, leaving only a couple of labs and the Irrua Specialist Hospital to deal with viral haemorrhagic fever outbreaks.”

It is noteworthy that Lassa fever has been a serious challenge for Nigeria’s health authorities since it was first diagnosed in Lassa, Borno State. But there seems to be no deliberate effort to build capacity to contain the disease once and for all or indeed to prevent, detect and respond timely to outbreaks. The vaccine for the viral disease is still “being developed” 50 years after it was diagnosed. There are no well-equipped laboratories and other vital equipment across the states. Almost everything is done on ad hoc basis resulting in grave danger to many. The situation is so bad that many hospitals could not even provide the right equipment including hand gloves to health workers, leading to their constant infections and deaths. Indeed, Dr Mike O.Ogirima, President of the Nigeria Medical Association (NMA) warned last week that doctors may stop attending to Lassa patients unless there was significant improvement in equipment for the treatment of patients.

The symptoms of Lassa include fever, sore throat, vomiting, back pain, cough, abdominal pain, restlessness, and general body weakness. It usually manifests six to 21 days after contact with the virus. However, because the symptoms of Lassa could be varied and non-specific, clinical diagnosis is often difficult, especially early in the course of the disease. For that reason, experts advise steps should be taken by all health facilities to emphasise routine infection prevention and control measures. The observance of adequate personal hygiene and environmental sanitation at all times could help in preventing the spread of Lassa fever. These are significant for avoiding contacts with rats, dead or alive.

While we believe that with effective coordination, the virus could be contained, the real challenge is for all stakeholders to work towards its total eradication from our country.