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Thursday, April 18, 2024
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Lassa-fever

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The World Health Organisation has identified late diagnosis of Lassa fever patients as the reason for the high mortality rate of the disease in Nigeria.

In a statement on Monday, the health agency gave an official breakdown of the number of Lassa fever cases in Africa and called on governments and stakeholders in affected countries to commit more resources to early diagnosis of the viral disease.

It stated, “Lassa fever has killed more than 160 people in West Africa, most of them in Nigeria, since November 2015. Nigeria, Benin, Sierra Leone, Liberia and Togo have reported more than 300 cases of Lassa fever and 167 deaths.

“Nigeria accounts for the majority of the cases with 266 cases and 138 deaths reported in 22 of the country’s 34 provinces as at 21 March 2016. Benin has recorded 51 cases and 25 deaths. Many of these lives could have been saved if a rapid diagnostic test were available so that people could receive treatment early.”

An expert in haemorrhagic fevers at WHO, Dr. Pieere Formenty, stated that late diagnosis would lead to the death of 60 per cent of patients that have contracted the virus.

Formenty said, “Without early diagnosis and treatment, one in five infections result in severe disease, where the virus affects several organs such as the liver, spleen and kidneys.

“We need resources to invest in diagnostics to easily, accurately and safely test for Lassa fever as we do for malaria and HIV. Without a proper diagnosis, many people do not receive the correct treatment and that is why we see so many people with Lassa fever dying each year.”

PUNCH.

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Cat owners are less likely to contract the Lassa fever virus from rats because cats can kill rats, thus reducing the spread of the disease from animals to man.

However, if the primary reason for purchasing a cat is based on the outbreak of the disease, you are making a right choice for the wrong reasons because pets should never be purchased on impulse.

Pets should be kept primarily for companionship and to share your love.

Cats are beautiful, intelligent and sensitive creatures. They are born hunters with superb hunting instincts that are not dulled even if they are domesticated.

Cats are very playful and can be the perfect buddies for children. But, ensure that you teach your children the act of responsible pet ownership and do not leave them unsupervised when they are playing with a cat.

An interesting study showed that children who live with pets during their first year of life have a lower risk of respiratory tract infection and need fewer antibiotics than children in non-pet homes. This is because pets track more dirt and bacteria into homes and this increased exposure to germs, help to develop a more stable immune system, particularly in children between the ages of five and eight years.

Also, children who own pets or share in pet care responsibilities are often less self-centered and more likely to develop humane attitudes, such as empathy and good nurturing abilities, than children who do not own pets. The reason is that pets help to stimulate better social integration and competence. For example, cleaning a dog’s kennel, grooming or feeding a pet are often multi-step processes that make them more adept at following multi-task instructions.

Individuals and families thinking of getting a cat should research, prepare and then, when the time is right, seek a cat that realistically complements your lifestyle, schedule and energy level.

Keeping a cat is like having a new person that lives in your home. So, you need to evaluate your level of commitment because cats can live up to 15 years. It is highly irresponsible to have a cat and not take good care of it.

I advise that you make a budget before you buy a cat. Your budget will include an estimate for the cost of food, veterinary bills, toys, grooming brushes, combs, and other accessories. Also, you will need to consider the cost of purchase or building a cat condo (an artificial structure for a cat to play, exercise and relax on).

Routine veterinary care is required to prevent cats from falling sick. You also need to realize that there are some diseases a sick cat can transmit to its owner.

For example, you need to be cautious of scratches from a sick cat, as this may result in a disease known as cat scratch fever or Teeny’s disease (Infectious disease caused by an inter-cellular bacterium known as Bartonella henselae). This infection shows clinical signs, such as swelling of lymph nodes, fever and fatigue in humans.

Another disease that can be transmitted by sick cats is known as Toxoplasmosis (Infectious disease caused a bacterium known as Toxoplasma gondii). This bacterium resides in the urine of infected birds and rats. The disease can be transmitted to cats whenever they kill such infected animals.

A cat that is infected with toxoplasmosis can transmit the bacterium to a human being and this is a major cause for concern if the individual becomes infected during the third trimester of pregnancy. It may result in severe foetal abnormalities or an abortion. This is why obstetricians advise pregnant women not to change cat litter boxes.

To prevent you or your cat from getting infected with toxoplasmosis, wash your hands after scooping the litter box and don’t let your cat outside to hunt.

These diseases are not found in healthy cats. So you must ensure that your veterinary doctor carries out a general check-up on your cat, at least once in four months. During this visit, he will update your pet’s medical records by administering any required prophylactic medication or vaccination.

A healthy cat has no disease. All it can spread is to you is “pure unconditional love.”

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Pest control providers and hawkers are laughing all the way to the bank following the recent outbreak of Lassa fever in the country, BUKOLA ADEBAYO writes

The outbreak of Lassa fever has opened new vistas of business opportunities for fumigators, hawkers and other pest control providers in the country. Indeed, calls by experts and government officials urging Nigerians to take precautionary measures to ensure that rats, the major host of the Lassa virus, do not enter their homes, are gaining momentum and acceptance.

For the Managing Director, PestOFF, Lekki, Lagos, Mr. Tunde Aderinto, it is a boom time for the pest control outfit as no less than 10 companies have, in the past three days, contracted the firm to fumigate their facilities and offices.

According to Aderinto, the news of the outbreak of the virus as well as the accompanying commentaries has resulted in increased business for his firm.

“Before, if we submitted 20 proposals to organisations seeking to fumigate their offices, maybe only one will respond. In fact, at a time in 2014, we offered fumigation services free just to sensitise the citizens.

“But in the last three days, more than 10 companies have sent their officials to us, requesting the fumigation of their offices and facilities. I have had to sublet some jobs to my other colleagues because I am running out of chemicals to meet people’s demands,” he told our correspondent on Tuesday.

Beyond the awareness, Aderinto noted that many pest control firms in the country were currently laughing all the way to the bank. For instance, he stated that the fumigation of a plot of land, which hitherto was N20,000, had increased to N30, 000 because of high demand and cost of the chemicals.

Aderinto is however not alone in reaping the “benefits” of the Lassa fever syndrome.

Another pest control expert, Mr. Olumide Lawal, confirmed to our correspondent that demand for fumigation services had tripled.

Lawal, whose business is based in Ikeja, Lagos, said he worked on weekends to meet the demands of some his clients.

He said, “I did not rest this week because we were fumigating some hotels and offices. Many of the firms needed the exercise done before work started on Monday and so this got us all engaged. The Lassa fever outbreak has raised Nigerians’ consciousness concerning the importance of a rodent-free environment.

“Sales go up during Lassa fever outbreak but this time, the demand has tripled. It has been a blessing for my company. But, I don’t think people should wait for another outbreak before they take pest control seriously. Communities should come together to keep their environment clean.

“If I fumigate my house and my neighbour’s house has rats, they will return and invade my house. The business of keeping an environment rodent-free demands communal efforts. We need to dispose your refuse quickly and neatly. We also need to block holes and keep our drainage channels covered.”

He also warned Nigerians to be wary of fake pest control practitioners, who might seek to exploit the increasing demand by offering sub-standard services.

Lawal said, “There is a concentration of chemicals we must use for the cleansing exercise to be effective. If we go lower than that quantity, it will not be effective. It is just like spraying some air freshener or deodorants around the home.

“Again, if we go beyond the specification, it will be poisonous to the residents, who may be exposed to some respiratory diseases.”

Aside from the perspective of experts, hawkers of pesticides, especially rat killers, are having a good time. A petty trader in the Abule-Oja area of Yaba, told our correspondent on Monday that he ordered more local rat traps due to increasing requests from his customers.

“I sell at least 50 pieces of rat poison each day since last week compared to 20 I sold the previous week. What I used to sell for N50 per sachet is now N100. Customers now request the big traps for rats and they are willing to pay double, especially when I create the impression that the products came from the village.

“Before now, it was the chemical rat poison that was in demand but now, you can recommend anything that kills rats and customers will buy it without hesitation. They will only ask if it works.”

Schools, hospitals and establishments are also rolling out environmental sanitation programmes to keep rats out of their environments.

So far, more than 40 persons have died of Lassa fever, a hemorrhagic viral disease since its recent outbreak in the country.

More than 500 Nigerians are currently under observation for the disease.

PUNCH.

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Unknown to many Nigerians, the Lassa fever virus has so far claimed the lives of 41 people in the country. The death toll has exceeded the figure recorded during the outbreak of the Ebola Virus Disease in the country two years ago.

One may wonder why there are so many causalities. The answer is simple: Lassa fever is a highly infectious disease and many people are not even aware of its mode of infection, transmission and how it can be prevented. It is so contagious that you can contract it in the comfort of your home.

To understand how to prevent more deaths from Lassa fever infection, experts say one must learn its history, symptoms and simple ways to avoid it.

According to them, a species of rodents, known as the Multi mammate rat, which breeds in Nigeria and can be found in many homes, especially in the kitchen, is the major harbinger of the disease.

A virologist, Dr. Olumide Abunbarin, says that the animal host are tenants in many communities in Nigeria. This explains why many Nigerians are at the risk of contracting the disease.

He says, “The reservoir, or host, of the Lassa virus is a rodent known as the Multimammate rat of the genus Mastomys. Mastomys rodents are sometimes used as a food source. The infection may occur via a direct contact with it, its urine, faeces, blood or consumption of contaminated food.”

Another public health physician, Dr. Segun Adeboye, notes that another way in which one can contract the deadly virus in the home is through poor hygiene.

Adeboye notes that these rats scavenge on left-over food and they breed better in a dirty environment, especially where there is a lot of refuse.

He says, “If rats are fond of coming into your house for their breakfast, lunch and dinner, then you should know you are at a higher risk of getting infected. They will live in your home and leave all the viruses they carry behind.

“If you eat food items contaminated with urine and droppings from an infected rat then you can be infected. The best thing is to store all food items in sealed containers.”

They say that there is no better time for Nigerians to take environmental sanitation and community management of refuse more seriously as these rats hide and breed better in dirty places and open refuse dumps.

They warn, “There is an air-borne transmission of Lassa virus. One can be exposed to the virus if one inhales tiny particles in the air contaminated with rodent excretions. That is why there is the need for a proper personal and household management of refuse to keep rodents away from our homes and environment.

“Indiscriminate dumping of refuse should be avoided as these are potential breeding grounds for rats. Clearing of bushes and refuse to reduce hiding and breeding spaces for rats is also important.”

Like Ebola, you can also contract the virus by touching the body fluids of an infected person. It is called person-to-person transmission.

But, as infectious and deadly as it is, Lassa fever infection can be prevented if one observes simple rules of hygiene to reduce the risk of contracting the disease directly from the host or through the secondary form of infection or person-to-person transmission.

One of them is hand washing with soap. Adeboye notes that the importance of washing one’s hands with soap and water to get rid of germs, bacteria and other viruses cannot be overemphasised during the period. According to him, this age long habit has been proven to reduce the risk of infection by more than 60 per cent.

Adeboye says, “ Many people are aware of the need to wash their hands, but what we are saying is that you should use soap or a disinfectant when you are washing those hands. That is what will kill the bacteria or virus. The hand is the means by which most infections are contracted. And the average person touches his/her mouth at least 10 times a day.

“If you touch an infected person with your hand unknowingly and you don’t wash your hand before eating, you have introduced a virus into your body just by being negligent. Science has proved that 70 per cent of infections are contracted via the mouth through the hands.”

Access to portable water is still a challenge in most cities in Nigeria. However, you can always improvise with hand sanitisers. They are portable, which means you can carry one in your bag, car and in your office.

Adeboye notes that organisations with a staff strength of more than 50 should have hand sanitisers installed in major entry points in their offices.

“People should promote the use of hand sanitisers, which have been chemically designed with natural disinfectants. Sanitisers are potent but not poisonous. They are also user-friendly and easily absorbed into the skin, unlike when you use water and you have to clean up with a piece of cloth again, which may now contaminate the hand you just washed. We must encourage more people to key into hygiene. Insist that the restaurants where you eat have it. Install it in your homes.”Adeboye adds.

Also, any hospital that has the safety of its patients and health workers at heart would have installed sanitisers in each of their wards and facilities, including toilets, by now.

Experts note that the hospital environment remains the easiest place to contract infections and health workers must ensure that they do not become the carrier of the virus, thereby endangering their lives and that of other patients.

They insist that hospital owners must sensitise their workforce on the importance of decontamination as a means of infection control.

Adeboye says,“The standard practice is that a doctor or nurse must wash his/her hands or use sanitisers before examining a patient and after examining the patient. There is no room for compromise now. We should not be seen as people that are careless again. These are times for drastic measures especially if you live in any of the states where some cases have been confirmed.”

However, beyond Lassa fever, hand-washing with soap has been proved to prevent one from contracting diarrhoea and pneumonia infections, which kill more than 100,000 children annually in Africa.

Use this period of the outbreak to look at ways you can make your home cleaner and safer for you, your family and your community.

PUNCH.

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Lassa fever was first discovered in 1969 after two nurses died of a strange illness in the town of Lassa, Borno State, Nigeria. The condition is characterised by an acute viral hemorrhagic fever caused by a microorganism called “Lassa virus”.

The virus is shed in the urine and feaces of Mastomys natalensis (A rat that causes Lassa fever). A ‘Lassa fever causing rat’ can easily be identified because they have a total of 24 ‘nipples’ instead of 12 (normal number of nipples in rats).

The key to controlling this virus that causes 5,000 deaths annually is by elimination of rats and proper sanitisation of the environment. The incubation period (Time it takes for the disease to develop) is about 21 days.

In 80 per cent of cases, Lassa fever is asymptomatic (A carrier of the disease fails to show the noticeable symptoms with which the disease is usually associated). Nonspecific symptoms include fever, facial swelling, and muscle fatigue, as well as conjunctivitis and mucosal bleeding. Early symptom can be similar to malaria.

Lassa fever is a zoonotic disease (a disease that can be passed between animals and humans.) Transmission from human to human has been established, presenting a disease risk for healthcare workers.

Humans can get infected by eating food or drinking water that has been contaminated with feaces or urine that contains the virus. In addition, the Lassa fever virus can get into the body if contaminated substance is inhaled or touches broken skin or mucous membranes (a biological membrane that lines various cavities in the body and surrounds internal organs). Mucous membranes can be found in our eyes, nose and mouth.

Like earlier reiterated, elimination of rats is key to controlling Lassa fever virus. However, please exercise caution and do not use toxic chemicals in rat control. Keep babies, toddlers and pets away when applying rat poisons and be careful to avoid food and water sources because rat poisons can harm the rat and pets or human beings that come in contact with the poison or poisoned rat. For example, a rat that consumes poison becomes weak and slow. As such, it is an easy catch for a cat. If a cat consumes such a rat, the cat will get poisoned.

I recall responding to a distress call in which a client’s dog was in comma. On getting to the house, I found the dog had vomited before passing out. Further observation of the vomitus revealed four dark objects. A closer look at these objects revealed partially digested rats. Apparently, the client had previously placed highly toxic rat bait in the environment and the dog had consumed the poisoned rats.

A safe way to eliminate rats is by adding some bait (food) to a human drug known as Indomethacin (popularly known as In-do-cid).

Indomethacin is a non-steroidal anti-inflammatory drug (NSAID) commonly used as a human prescription medication to reduce fever, pain, stiffness, and swelling. However, in rats and mice, Indomethacin has gastroulcerogenic effects (It destroys the inner lining of the stomach of rats and this result in death of the rat or mice.

Beyond eliminating rats, it is also important that you ensure your house is not condusive for rats. This can be achieved by clearing the environment and getting rid of wood piles, tyres, bowls, buckets, and other objects that they can hide in.

In addition, pick up and dispose old newspapers, magazines, cardboards, and other objects that can be food them.

Store provision in sealed plastic containers and place ripe fruits, rice and long-term storage items in the refrigerator. Wash dishes daily or, at least, submerge in soapy water until you can get to them. Dispose garbage in air-tight plastic containers that are inaccessible to rats.

Keep bathroom and kitchen areas as dry as possible. Fix leaky faucets and don’t let standing water accumulate. This is necessary because many insects and rats are attracted to moist areas.

Clean counter tops and tables regularly with disinfectant containing antiviral agents. A good and readily homemade anti-viral solution is “bleach” because it contains sodium hypochlorite (an anti-viral agent). Sodium hypochlorite would help to disinfect surfaces and also destroy the Lassa fever virus.

Also at this time, ensure you wash your hands frequently and thoroughly because hand washing is one of the most effective ways to prevent the spread of many types of infection.

Wash your hands before, during, and after preparing food. Wash your hands before and after caring for someone who is sick, after using the toilet, after changing diapers or cleaning up a child who has used the toilet, after blowing your nose, coughing, or sneezing.

Wash your hands before and after treating a cut or open wound, after touching an animal, animal feed, or animal waste. Don’t forget to wash your hands after touching garbage. Clean hands saves lives.

In conclusion, the Minister of Health, Prof. Isaac Adewole, in a statement issued in Abuja in response to the outbreak of disease in the country has advised that healthcare workers attending a patient suspected to have Lassa fever should immediately contact the State Epidemiologist in the state ministry of health or call the Nigeria Centre for Disease Control and Federal Ministry of Health using the following numbers: 08093810105, 08163215251, 08031571667and 08135050005.

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The Lagos State Government, yesterday, disclosed that there is no new case of Lassa fever recorded in the state.

Lassa-feverIt also said that the index case, a 25-year-old male undergraduate of the Ahmadu Bello University, Zaria, Kaduna State, is presently responding to treatment in the hospital.

The state Commissioner for Health, Dr. Jide Idris while briefing newsmen at the weekend, urged residents to remain calm over the outbreak of Lassa fever, saying everything possible was being done to curtail the spread of the virus in the state.

Confirming the occurrence of the first case of Lassa fever in the state, Idris explained that the patient was reported to have fallen ill after he arrived Lagos and “was taken to Ahmadiyyah Hospital, Ojokoro on January 9, 2016 with complaint of fever, sore throats and difficulty in swallowing before he was later taken to Lagos University Teaching Hospital, LUTH, where he is currently been isolated for treatment.

“The patient is presently being managed at the Lagos University Teaching Hospital (LUTH) and his condition is stable”, he added.

Besides, he said that “Ahmmadiyyah Hospital, where the first case of the disease in Lagos was reported, is now under surveillance and there will be no service delivery in the facility until further notice. The 15 in-patients as well as 25 health workers in the facility are being monitored for the next 21 days. Contacts tracing is ongoing; and currently we have 92 contacts and all are being followed up.”

However, when contacted yesterday, a source at the state Ministry of Health, who preferred anonymity, said, “As I speak, there is no fresh case of Lassa in Lagos, the only index case is responding to treatment under stable condition and contacts are all under strict surveillance while facilities; and isolation centres have been prepared to manage suspected and confirmed cases.”

Though, Lassa fever and Ebola Virus Disease are said to belong to the same Viral Haemorrhagic Fever group, Lassa Fever is milder and can be treated and cured if detected early. Therefore, any persistent fever should be reported to the nearest public health facility.

Idris however, urged members of the public and health workers to report any case or symptoms of persistent high fever not responding to standard treatment for malaria and typhoid fever to the nearest health facility or call the following lines:, 08037170614, 08022234273, 08022241768 08033065303, 08033086660, 08055281442 and 08023169485.

Assuring the Lagosians, Idris said “Government is fully prepared to manage the situation and as such people should not panic for whatever reasons.

The Lagos State Government as part of its mandate remains committed to ensuring that the well being of the people is assured. We will not compromise on our commitment to a healthy and happy state.”

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Lassa fever is endemic in parts of west Africa including Sierra Leone, Liberia, Guinea and Nigeria; however, other neighboring countries are also at risk, as the animal vector for Lassa virus, the “multimammate rat” (Mastomys natalensis) is distributed throughout the region. In 2009, the first case from Mali was reported in a traveler living in southern Mali; Ghana reported its first cases in late 2011. Isolated cases have also been reported in Côte d’Ivoire and Burkina Faso and there is serologic evidence of Lassa virus infection in Togo and Benin.

The number of Lassa virus infections per year in west Africa is estimated at 100,000 to 300,000, with approximately 5,000 deaths. Unfortunately, such estimates are crude, because surveillance for cases of the disease is not uniformly performed. In some areas of Sierra Leone and Liberia, it is known that 10 -16 per cent of people admitted to hospitals every year have Lassa fever, which indicates the serious impact of the disease on the population of this region.

Individuals at greatest risk of Lassa virus infection are those who live in or visit endemic regions, including Sierra Leone, Liberia, Guinea, and Nigeria and have exposure to the multimammate rat. Risk of exposure may also exist in other west African countries where Mastomys rodents exist. Hospital staff are not at great risk for infection as long as protective measures and proper sterilization methods are used.

Primary transmission of the Lassa virus from its host to humans can be prevented by avoiding contact with Mastomys rodents, especially in the geographic regions where outbreaks occur. Putting food away in rodent-proof containers and keeping the home clean help to discourage rodents from entering homes. Using these rodents as a food source is not recommended. Trapping in and around homes can help reduce rodent populations; however, the wide distribution of Mastomys in Africa makes complete control of this rodent reservoir impractical.

When caring for patients with Lassa fever, further transmission of the disease through person-to-person contact or nosocomial routes can be avoided by taking preventive precautions against contact with patient secretions (called VHF isolation precautions or barrier nursing methods). Such precautions include wearing protective clothing, such as masks, gloves, gowns, and goggles; using infection control measures, such as complete equipment sterilization; and isolating infected patients from contact with unprotected persons until the disease has run its course.

Further, educating people in high-risk areas about ways to decrease rodent populations in their homes will aid in the control and prevention of Lassa fever. Other challenges include developing more rapid diagnostic tests and increasing the availability of the only known drug treatment, ribavirin. Research is presently under way to develop a vaccine for Lassa fever.

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