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On January 7, 2020, the Abia State Commissioner for Health issued a press release, to notify abians about the outbreak of Lassa fever. The commissioner wrote, and I quote: “To this end, Abians are advised to get rid of rodents within their environment, wash their hands regularly, keep their environment clean, avoid soaking and drinking of raw garri, warm their food before eating and report to the hospitals and primary health care centres, in case of any emergency.”
Do you know the funny thing? Here in Gregory University Uturu, staff, students and other Abians who consulted me, were more concerned about how to survive without soaking and drinking raw garri, than the symptoms of yellow fever. God have mercy.
According to our revered Chinua Achebe, Eneke the bird was asked why he was always on the wing and he replied “Men have learned to shoot without missing their mark, and I have learned to fly without perching on a twig.” Yes since Lassa fever has learned to be pernicious and perfidious, I have learned to be persistent and preventive in discussing it. I shall keep on educating Abians, nay Nigerians.
I got a text last week, from my former patient in Lagos and I quote “Doc, I heard over the radio, that Lassa fever is back again in some states. Does that mean I should start using my hand-sanitizers again?”
I fired back – “Did you stop using it before, do you need Lassa fever to remind you of personal hygiene?”
Yes, Lassa fever is back. No thanks to our negligence, and we know that Lassa fever can only be killed with cleanliness. I thought it is said that “cleanliness is next to godliness,” and we are all very religious. So even from the spiritual angle, we should go clean.
Lassa fever had recently resurfaced in 10 states and still counting. I want everybody to err on the side of caution. Assume that Lassa fever is now in your state. Go back to the preventive-mode of three years ago. Assume the worst, and brush-up all you need to know about Lassa fever. Educate every member of your family, lest any of them should become the weak link. In case you have forgotten, let me re-cap.
How do we define Lassa fever?
• Lassa fever also known as Lassa Haemorrhagic Fever (LHF), is a type of viral Haemorrhagic fever caused by Lassa virus. Many of those infected by the virus do not develop symptoms.
• Lassa fever was discovered in 1969 in Lassa town in the present Borno State, when a white missionary nurse, Ms Laura Wine, posted by the Church of the Brethren in USA, to the local hospital in Lassa town, purportedly contracted the disease there.
• Lassa fever is distributed by “multimammate rat” – multiple-breasted-rat (Mastomys natalensis).
How is Lassa fever transmitted?
a) Transmission of Lassa virus to humans most commonly occurs through ingestion and inhalation.
b) Through contamination of food that is taken raw (drinking garri, salad condiments, carrot, cucumber, etc), which the rats excrete or urinate on or by exposure of open cuts or sores to the viruses, which can also lead to infection.
c) Mastomys rodents often live in, and around homes, and scavenge on left-over human food items, or poorly stored foodstuff, contamination is quite often.
d). Person-to-person transmission is common especially after exposure in the blood, tissue, secretions or excretion of Lassa viruses in infected individuals. Also, person-to-person transmission can occur in healthcare settings, where protective measures are not adequately employed.
e) Lassa virus may be spread through contaminated medical equipment, such as re-use of needles.
f) All manicure, pedicure, barbing and shaving instruments must be properly sterilised.
Signs and symptoms of Lassa fever.
1) Incubation is 1 to 3 weeks after the patient comes in contact with the virus.
2) Fever, weakness, headache, loss of appetite and nausea.
3) Cough, sore, ulcerated, throat, chest and abdominal pain and diarrhoea.
4) The patient is restless, confused, with conjuctivitis and has enlarged lymph nodes.
5) Bleeding gums, eyes or nose. Respiratory distress, repeated vomiting, facial swelling, pain in the chest, back and abdomen.
6) Neurological problems have also been described, including hearing loss, tremors and encephalitis.
7) Death may occur within two weeks, after onset of symptoms, due to multiple-organ failure.
How to diagnose Lassa fever
a) Through Enzyme-Linked-Immunosorbent-Serologic-Assays (ELISA) to detect Immunoglobulin M & G (IgM & IgG).
b) Also Reverse-Transcription-Polymmerase-Chain-Reaction (RT – PCR), also used to detect antibodies and immunoglobulins.
c) Electron Microscope (EM), serology and immunofluorescence are also employed.
How do we treat Lassa fever?
1) There is no specific treatment for Lassa fever, but symptomatic treatment is advised.
2) Anti-viral drugs like ribavirin has been found to be effective in management of Lassa fever.
Prevention of Lassa fever
• Rigid isolation of any suspected case is essential, but the clinical spectrum is wide.
• All contacts should be traced, and paired sera for complement fixing antibodies should be sent to the Nigerian Centre for Disease Control (CDC).
• Of course we should continue our handwashing, use of hand-sanitizers, and we should be very wary of the hands we shake.
• Meanwhile remain medically guided.
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