Combating the Lassa fever outbreak

The fragility of the nation’s health care system has come to the fore with rising deaths from the recent outbreak of Lassa fever across the country. A few days ago, the Nigeria Centre for Disease Control and Prevention (NCDC) disclosed that Lassa fever had claimed 168 lives across 21 states and 106 local government areas this year. In its epidemiological report for week 38, the NCDC revealed a total of 4,543 suspected cases. Out of this, 897 were confirmed positive, with a case fatality of 18.7 per cent. The epicentres of the disease outbreak, Ondo, Edo, Taraba and Bauchi, accounted for 67 per cent of all confirmed cases.

According to NCDC, Ondo State had the highest burden of the disease and quickly followed by Edo and Bauchi states. The disease also affected Ebonyi, Benue, Kogi, Gombe, Plateau, Kaduna, Nasarawa, Enugu, Delta, Anambra, Rivers, Borno, Oyo, Ogun, Lagos and the Federal Capital Territory (FCT). The NCDC also explained that the majority of the confirmed cases were among people aged 21-40. Both men and women were affected.

The World Health Organisation (WHO) says that Lassa fever is an acute viral illness that is caused by Lassa virus. It reveals that Lassa fever is known to be endemic in Benin, Ghana, Guinea, Liberia, Mali, Nigeria and Sierra Leone, stressing that it probably exists in other West African countries as well. Medical experts say that the Lassa virus is primarily transmitted to humans via contact with food or household items contaminated with rodent urine or faeces. They posit that person-to-person transmission can also occur, particularly in health care settings lacking adequate infection prevention and control measures.

The Lassa virus was first identified in Lassa village, Borno State, Nigeria, in 1969. The Lassa virus belongs to the virus family Arenaviridae. The symptoms of Lassa fever include a gradual onset of fever, malaise and general weakness. It is followed by headache, sore throat, muscle/chest pain, nausea, vomiting, diarrhoea, and cough. In severe cases, patients may experience bleeding, facial/neck swelling, shock and respiratory distress.

Since the disease is spread by rats, it can be prevented by controlling rat population and implementing good hygiene, such as, blocking holes, storing food in covered containers, as well as proper waste disposal. Proper preventive measures should be provided in health care settings. Washing hands regularly with soap and running water after handling food, waste or caring for someone with symptoms will go a long way in preventing the disease. The disease can also be prevented by washing fruits and vegetables with clean water before eating. We enjoin members of the public to cover all cooked food and water to prevent contamination.

We commend the NCDC for deploying rapid response teams, prepositioning medical supplies, providing technical and capacity building support such as training for health workers, and coordinating the national response effort. It is instructive that the NCDC has been timely in the dissemination of crucial guidelines, public health advisories and coordinating surveillance and testing activities across the country. The affected states should ensure that the Lassa fever outbreak is contained and avoid its spread to other states in the country.

The federal and state governments should carry out massive awareness campaign on the Lassa fever outbreak highlighting the causes of the disease, symptoms, treatment options and preventive measures. The awareness campaign messages should be in English, the major Nigerian languages and Pidgin. The government must always be prepared about Lassa fever outbreak since it occurs annually. There is need to prioritise preventive measures against the disease. We call on all tiers of government, stakeholders and donor agencies to work in concert to contain the Lassa fever outbreak across the country.

Beyond Lassa fever outbreak, the government should not ignore malaria, cancer, hypertension, child killer diseases and others that kill many Nigerians. The recent report that Nigeria’s health system is performing at only 45 per cent, below the African regional average of 56 per cent is unacceptable. Also, the report that only 80 heart surgeons are serving over 200 million Nigerians is lamentable.

Apart from increasing our annual budget for health to 20 per cent as recommended by regional and global health agencies, the federal and state governments can introduce health insurance for the citizens at highly subsidized premium. We say this because Nigeria cannot achieve the 2030 target for universal health coverage with the current reliance on out-of-pocket health spending.