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ν WHO, other experts warn of more infections this dry season
By Cosmas Omegoh
Lassa fever is on the march again. This time, its pace fast and unrestrained.
Experts had earlier suggested that wide spread of tropical diseases such as Lassa fever is rampant in the dry season. And now, that is happening as the disease threatens, killing people in their numbers.
In January this year, the Nigeria Centre for Disease Control and Prevention (NCDC) reported an additional 77 confirmed Lassa fever cases, thus “bringing the cumulative confirmed cases to 105 in 2023.”
NCDC reported: “In total for 2023, 10 states have recorded at least one confirmed case across 30 local government areas.
“The cases were reported from the following states: Ondo (33), Edo (25), Ebonyi (6), Bauchi (5), Benue (4), Kogi (1), Imo (1), Oyo (1) and Nasarawa (1).”
The agency noted that six deaths were reported in that week in January.
It was gathered that between mid January and now, more and more Lassa fever infections and deaths had occurred across the country.
In the first weeks of February, for instance, Edo State Commissioner for Health, Prof Akoria Obehi, confirmed four new deaths from Lassa fever, adding that the latest brought the fatality figure in the state to 20.
According to Prof Obehi, the deaths occurred in Etsako West, Etako Central and Owan East local governments of the state.
He disclosed that the state’s Lassa fever fatality cases had increased to 13 per cent. It now has a total of 155 confirmed cases in 11 LGAs.
Other states too have been having their own shares of Lassa fever infestions. Often, such deaths are neither reported nor recorded.
WHO warnings
WHO reckoned that “Lassa fever is endemic in Nigeria, and the annual peak of Lassa fever cases is typically observed during the dry season (December–April).”
The global-health body warned that “the number of infections is expected to rise further until the end of the dry season.”
To those who know, WHO’s advisory is a call to war against those miniature rats running riot in homes, desperately searching for food. They need to be got rooted out quickly as they might be harbingers of death.
Possible ways to contract Lassa fever
Our correspondent learnt that about this time each year, many rural folks contract Lassa fever when the disease-bearing rats sneak into their homes, or storage facilities searching for food.
Once the harvest season is over, such rats have less food to eat. So, some of them go for greener pastures, looking for food in and around the homes.
It was also learnt that rural dwellers who dry their foodstuff by the road side or at vantage spots in village risk infection.
Experts told our correspondent that when rats come into contact with exposed food, they eat out of it. Sometimes, they even urinate on the food or leave their droppings on it. By so doing, they leave the lethal Lassa fever virus on their trail.
Now, it is against this drop that everyone is warned that those tiny rats around the home are potential enemies to every family. Some of them are harbingers of disease and death. Not minding their size, they can spread sorrow and sadness. With their urine and feaces alone – harmless as they may seem – they sustain a relentless biological war against humanity, doing incalculable harm.
Now, as the dry season gets underway, Lassa fever has been rebounding, gaining pace and power as it spreads.
For a fact, the fever kills within a short period. Anyone so infected has a grim chance of survival.
Health workers over the years have succumbed to its power trying to save others, but not knowing that they were up against such a formidable foe until it was too late.
Late last year, NCDC in one of its situation reports raised the alarm that Lassa fever cases had increased to 933, revealing that it killed 173 people in the country in 2022.
In Week 44 of last year, it said, the number of new confirmed cases of the scourge increased from 10 in Week 43, 2022 to 17 cases. These were reported especially from Ondo, Edo, Benue, Kogi, Oyo states.
NCDC said that in addition that 25 states and 102 local government areas were affected by the disease.
“The number of suspected cases has increased compared to that reported for the same period in 2021.
“Cumulatively, from Week 1 to Week 44, 2022, 177 deaths have been reported with a case fatality rate (CFR) of 18.2 per cent, which is lower than the CFR for the same period in 2021 (21.7 per cent).
“In total for 2022, 26 states had recorded at least one confirmed case across 106 local government areas.
“Of all confirmed cases, 71 per cent are from Ondo (33 per cent), Edo (25 per cent), and Bauchi (13 per cent) states.”
The Nigerian heath body added that “the predominant age group affected is 21-30 years (Range: 0 to 90 years, Median Age: 30 years).
“The number of suspected cases has increased compared to that reported for the same period in 2021.”
Analysts now believe that the said mortality figure could be much higher given the difficulty in obtaining accurate data in the country.
What is Lassa fever?
Dr Ifedayo Adetifa, NCDC’s Director General in one of his recent pronouncements admitted that: “Lassa fever is one of the recurrent and concurrent disease outbreaks Nigeria contends with.
“It is responsible for significant morbidity and mortality and has significant impact on healthcare delivery in affected regions given the deaths caused in healthcare workers.”
Similarly, a medical missionary, Rev. Sister (Dr) Luciana Agba described Lassa fever as “one of those hemorrhagic diseases in the family of Ebola. But it is less virulent than Ebola.
“It is deadly, and has killed many, including medical workers in areas of the country where it is endemic.”
While providing more insight, Dr Laz Eze, a public health physician and sustainable development consultant based in Abuja, described Lassa fever as “an acute viral haemorrhagic illness caused by the Lassa virus.”
According to him, “it is a zoonotic disease, carried mainly by multi-mammate Mastomys rats and transmitted to humans.”
Symptoms of Lassa fever
Quoting WHO, Dr Eze recalled that Lassa fever can sometimes deceive health worker because “about 80 per cent of infected persons may not have symptoms,” while “about one out of every five infected persons may have severe disease symptoms.”
But how can an infected person be identified? Dr Eze who is the CEO of TalkHealth 9ja and founder MakeOurHospitalWork Campaign said: “Such signs are usually the same as those of other common infections. So, there must be a high index of suspicion.
“Lassa fever may present with high-grade fever, tiredness, vomiting, headache, body pains, and in severe cases, difficulty in breathing, bleeding gums, nose, eyes, etc.”
Other ways one can get infected
Also speaking on other ways one can contract Lassa fever, Dr Eze said: “It is possible to get infected when there is consumption of food, or one comes in contact with objects or household items contaminated with faeces or urine of the Mastomys rats.”
A medical microbiologist, Mr Oladayo Ibukun, told our correspondent that overland travellers who buy foodstuff such as garri or purchase exposed, leftover foods on the road are also at risk.
“People also run the risk of being infected with Lassa fever especially when they buy foodstuff such as garri or elubo (ground cassava or ground yam) sold by the road side.
“Sun foodstuff may have been visited days before by rats which ate out of it without the seller knowing it.
“Unfortunately, anyone who buys a portion of such infected food, one could be in trouble. That could also mean a lot of trouble for an entire household.
“Now, what about people who buy edibles that were visited by an infected rat without any signs that they ate of it? They too may be in trouble.”
NCDC’s ray of hope
In the face of the challenge, Dr Adetifa assured that “the country has made progress over the years in the management of Lassa fever.”
He, however, admitted that “many gaps still exist, for example (there are) limited options for therapeutics and vaccines, and the absence of evidence-informed interventions for vector control.”
More that needs to be done
But despite the assurances given by Dr Adetifa, Dr Eze insisted that “communities and the government are not doing enough to prevent Lassa fever.”
Dr Eze believes that “there is now a need for massive awareness – especially during this dry seasons– on prevention practices such as good environmental and personal hygiene.
“Every community should have a health committee, which shall be responsible for health promotion and education on common infectious diseases like Lassa fever.”
He also advised that the “government should ensure proper training of health personnel on personal protection, universal precautions, and effective management strategies.”
