Abakaliki – In an effort to prevent further outbreak of Lassa fever, Ebonyi Government is to begin intensive campaigns against rat consumption in rural areas where inhabitants erroneously believe rats have high nutritional value.
Lassa-fever The state Commissioner for Environment, Chief Donatus Njoku, told the News Agency of Nigeria (NAN) on Monday in Abakaliki that the government would explore all avenues to dissuade the citizens from consuming rats. Lassa fever outbreak in the state in January resulted in four deaths. Njoku said:
“Rats are the primary vectors of the disease, and we are vigorously carrying out enlightenment through mass media, workshops, seminars and various ministries’ communication channels. “We will collaborate with traditional rulers and other opinion leaders at the grassroots to educate rural dwellers to shun such a notion and realise that rat is the disease’s primary vector.
“We have also continued to sensitise the populace to urgently report suspected cases to relevant health agencies. “With the total functionality of the state government-owned South-East Virology Centre, such an occurrence can be expeditiously handled.’’ On sanitation, Njoku said that contrary to insinuations, non-observance of the monthly sanitation in the state did not affect effective sanitation. “State and Federal Government functions sometimes fall on the last Saturday of the month, and when this occurs, we have to comply.
“The state government has evolved policies which make the populace to clean their environments on daily basis and not wait for designated days,” he said. Njoku told NAN that the state Ministry of Environment ensured that state government ministries and parastatal-agencies cleaned their environments daily as directed by the governor.
“We assess their performances to ascertain the level of compliance; to show his seriousness toward the directive, the governor visits the ministries for on-the-spot assessments. “We encourage the people to keep their environments clean to improve their health,” he said. (NAN)
Source: Vanguard
From 1 January through 25 February 2018, 1081 suspected cases and 90 deaths have been reported from 18 states (Anambra, Bauchi, Benue, Delta, Ebonyi, Edo, Ekiti, Federal Capital Territory, Gombe, Imo, Kogi, Lagos, Nasarrawa, Ondo, Osun, Plateau, Rivers, and Taraba). During this period, 317 cases have been classified as confirmed and eight as probable, including 72 deaths (case fatality rate for confirmed and probable cases = 22%). A total of 2845 contacts have been identified in 18 states.
Fourteen health care workers have been affected in six states (Benue, Ebonyi, Edo, Kogi, Nasarawa, and Ondo), with four deaths (case fatality rate= 29%). As of 18 February, four out of the 14 health care workers were confirmed positive for Lassa fever.
Lassa fever case management centers are operational in four states (Anambra, Abakaliki, Edo, and Ondo States). The health care workers working in these centers are trained in standard infection control and prevention (IPC) as well as use of personal protective equipment (PPE). In addition, the suspected cases and deaths reported in community settings are being actively investigated by the field teams and contacts are being followed up. Currently, three laboratories are operational and testing samples for Lassa fever by polymerase chain reaction (PCR). WHO continues to support the outbreak response, mainly in the domains of enhanced surveillance, contact tracing, strengthening of diagnostic capacity and risk communication.
Lassa fever is endemic in the West African countries of Ghana, Guinea, Mali, Benin, Liberia, Sierra Leone, Togo and Nigeria. As of 22 February 2018, 10 suspected cases who fell ill in Nigeria were reported in Benin, and confirmed cases have been reported from Beninese states that border Nigeria. The outbreak of Lassa fever is considered active in one Nigerian state that borders Benin and two that border Cameroon. Lassa fever is not considered endemic in Cameroon and no outbreaks of Lassa fever have been reported in recent years.
Public health response
- A national Lassa fever Emergency Operations Centre (EOC) was activated in Abuja on 22 January and continues to coordinate response activities in collaboration with WHO and other partners.
- A team of Nigerian Centre for Disease Control (NCDC) staff and Nigeria Field Epidemiology and Laboratory Training Program (NFELTP) residents were deployed to respond to the Ebonyi, Ondo, and Edo outbreaks.
- The three most affected states of Edo, Ondo and Ebonyi have dedicated Lassa fever treatment units and ribavirin is available for treatment of confirmed cases. NCDC is collaborating with a non-governmental organization, the Alliance for International Medical Action (ALIMA), to conduct an assessment of treatment units.
- Enhanced surveillance is ongoing in states with an active outbreak and state line lists of cases are being uploaded to a national level database, a viral haemorrhagic fever management system.
- NCDC has supplied Irrua Specialist Teaching Hospital and Federal Medical Centre Owo with tents and beds to increase in-patient capacity.
- Staff from Irrua Specialist Teaching Hospital are providing clinical case management advice to other hospitals with suspected cases, and a 24-hour Lassa fever case management call line has been established.
WHO risk assessment
Lassa fever is a viral haemorrhagic fever that is transmitted to humans via contact with food or household items contaminated with rodent urine or faeces. Person-to-person infections and laboratory transmission can also occur. The overall case fatality rate is 1%; it is 15% among patients hospitalized with severe illness. Early supportive care with rehydration and symptomatic treatment improves survival. The antiviral drug ribavirin seems to be an effective treatment for Lassa fever if given early on in the course of clinical illness. There is no evidence to support the role of ribavirin as post-exposure prophylactic treatment for Lassa fever. Lassa fever is known to be endemic in Benin, Guinea, Ghana, Liberia, Mali, Sierra Leone, Togo and Nigeria, and most likely exists in other West African countries.
The current Lassa fever outbreak in Nigeria shows an increasing trend in the number of cases and deaths in recent weeks with 317 confirmed cases reported in 2018 so far. This is the largest outbreak of Lassa fever ever reported in Nigeria.
The infection of 14 health care workers that were not working in Lassa fever case management centers highlights the urgent need to strengthen infection prevention and control practices in all health care setting for all patients, regardless of their presumed diagnosis. Given the high number of states affected, the clinical management will likely happen in health centers that are not appropriately prepared to care for patients affected by Lassa fever and the risk of infection in health care workers will increase.
The reporting of confirmed cases in different parts of the country and porous borders with neighbouring countries indicate a risk of spread nationally and to neighbouring countries. An overall moderate level of risk remains at the regional level. Public health actions should be focused on enhancing ongoing activities including surveillance, contact tracing, laboratory testing, and case management. Greater coordination and information sharing regarding Lassa fever cases and contacts with Benin would also contribute to rapid detection and response to cross-border spread of the outbreak.
WHO advice
Prevention of Lassa fever relies on community engagement and promoting hygienic conditions to discourage rodents from entering homes. In healthcare settings, staff should consistently implement standard infection prevention and control measures when caring for patients to prevent nosocomial infections.
Travellers from areas where Lassa fever is endemic can export the disease to other countries, although this rarely occurs. The diagnosis of Lassa fever should be considered in febrile patients returning from West Africa, especially if they have been in rural areas or hospitals in countries where Lassa fever is endemic. Health care workers seeing a patient suspected to have Lassa fever should immediately contact local and national experts for guidance and to arrange for laboratory testing.
Source: WHO
Lagos, Nigeria (CNN)
Nigeria is facing its worst Lassa fever outbreak on record, with 72 people confirmed to be dead from the virus and 317 infected, according to the World Health Organization.
A further 764 are suspected to be infected, and 2,845 contacts have been identified.
On average, Lassa fever is deadly in 1% of all individuals infected, with higher rates of 15% morbidity among people hospitalized for the illness. As of Sunday, the case fatality ratio was 22%, according to the Nigeria Centre for Disease Control.
Although it’s endemic to the country, Lassa fever numbers have never reached this proportion before, according to the WHO.
Nigeria’s Centre for Disease Control said Wednesday that it was facing an “unprecedented outbreak” that has spread to 18 states since it began in January.
The disease can cause fever and hemorrhaging of various parts of the body — including the eyes and nose — and can be spread through contact with an infected rat.
Person-to-person transmission is low but has been seen in Nigerian hospital settings this year. Fourteen health workers were infected, of whom four died within eight weeks.
The WHO said Wednesday that health facilities were overstretched in the southern states of Edo, Ondo and Ebonyi, and it is working with national reference hospitals and the Alliance for International Medical Action to rapidly expand and better equip treatment centers.
It also hopes to reduce further infections to hospital staff.
“The ability to rapidly detect cases of infection in the community and refer them early for treatment improves patients’ chances of survival and is critical to this response,” said Dr. Wondimagegnehu Alemu, the WHO representative to Nigeria.
State health authorities are mobilizing doctors and nurses to work in treatment centers. Four UK researchers have also been deployed to Nigeria to help control the unusually large outbreak.
“Given the large number of states affected, many people will seek treatment in health facilities that are not appropriately prepared to care for Lassa fever,” Alemu said.”The risk of infection to health care workers is likely to increase.”
Lassa fever is endemic in most of West Africa, especially Nigeria, where it was discovered in 1969.
Edo, Ondo and Ebonyi states account for 85% of cases, said Dr. Chikwe Ihekweazu, director of the Nigeria Centre for Disease Control, in a statement.
According to the US Centers for Disease Control and Prevention, touching, eating or sniffing foods and other household items that have been contaminated by multimammate rat feces or urine can aid transmission.
Nigerians, especially in those three states, should “continue focusing on prevention by ensuring they prevent access to their foodstuff by rodents,” Ihekweazu said.
There is risk of the virus spreading to other West African countries due to increased migration, said Dr. Oyewale Tomori, professor of virology at Redeemer’s University in Nigeria and the former regional virologist for the WHO’s Africa Region.
“There is always cause for alarm in West Africa, where the rodent host of can be found in virtually all countries of West Africa,” he said.
Benin, Liberia and Sierra Leone have all reported cases of Lassa fever over the past month, according to the WHO, but risk of further international transmission is low for now.
Source: CNN
