Monday letter
Lassa fever poses a huge challenge for Nigeria’s health delivery system, evident in the high number of deaths, including of health workers.
Lassa fever was first discovered in Nigeria in 1969 in Lassa Town, Borno State, when some missionary nurses died from it while stationed in Nigeria and also from where the disease derived its name. Lassa fever is a deadly virus that is typically transmitted to humans from rodents which occurs more in the dry season. Every year, Lassa frequently infects people in West Africa and outbreaks of the disease have been observed in Nigeria, Liberia, Sierra Leone, Guinea, and the Central African Republic.
Lassa fever is transmitted to humans through contact with the urine, saliva, faeces and blood of rodents. The disease is endemic in rodent population in parts of West Africa. The reservoir for the virus is the “multi-mammate rat. But unlike Ebola Virus Disease, Lassa fever is treatable although there is no immunization vaccine yet. Early intravenous treatment with Ribavirin showed improved patients’ chances of surviving the disease.
The nation is grappling with another scourge after years of many epidemics. Although this is not the first time or the worst Lassa epidemic in Nigeria, the recent outbreak has spread to nine states and has killed not less than 50 people since the beginning of the year. In 2012, Nigeria recorded 1723 cases of Lassa fever with 112 deaths. Thereafter, Lassa fever cases had increased in Nigeria in 2016, with the highest toll in 2019.
But it becomes disappointing to realise that we did not learn from the past to strengthen our health system through supporting authorities to be able to prevent the disease, support communities and citizens to do the same.
Lassa fever can be prevented by avoiding contact with rodents and putting food away in rodent-proof containers. The government should upscale public awareness and enlightenment on Lassa fever not only through the traditional ways of using print and media but extend to mosques, churches, schools, markets, restaurants, and motor parks to ensure adequate grassroots penetration especially in rural areas.
Last year, the Nigeria Centre for Disease Control had declared Lassa fever a public health emergency, but Nigerians and other health workers have continued to die of the haemorrhagic fever. With the virus already spreading to 10 states, we must scale up measures in place, just like our response to the Ebola epidemic in 2014 which was described by many as “robust and decisive attracting commendations from several international partners”.
We have to do something seriously about our culture of poor response to emergencies. The signs and symptoms of Lassa fever occur two to three weeks after a person comes in contact with the virus. Symptoms during the initial phase are fever, vomiting, chest pain, weakness, headaches, and general malaise which may be non-specific, easily under-diagnosed, and mimic other common ailments such as malaria, yellow fever and typhoid. A doctor was infected as a result of performing a Caesarean section on an infected pregnant woman. It was a very painful and avoidable death as no one should die while trying to save lives.
If Lassa fever, a haemorrhagic disease is spread by rodents in filthy environments then it presupposes that we ensure that our environments are clean and devoid of breeding conditions for the rodents.
We must all play a part, after all we contribute to the generation of waste. Poor sanitation is a predisposing factor to multiplication of these rats.
With proper planning, phased implementation and adequate investment of resources we should have an effective epidemiological surveillance system such that outbreaks of infectious diseases can be detected and controlled.
- Yusuf Hassan Wada, Usmanu Danfodiyo University, Sokoto
