•As Disease Cases Decline With Intensive Response
Chioma Umeha
Over the last five weeks, there has been a decline
in the number of new cases of Lassa fever reported in Nigeria. In addition, the
country has witnessed a reduction in the number of people who have died from
the disease, compared to 2018, Dr. Chikwe Ihekweazu, the Director General of
the Nigeria Centre for Disease Control (NCDC), said.
Dr. Chikwe Ihekweazu who said this while
interacting with members of the press at a briefing held on today, revealed
that the NCDC and partners have continued to sustain response activities in
states across the country, despite progress made so far.
According to him; “An outbreak of Lassa fever was
declared in Nigeria on January 21 2019. Since then, 420 confirmed cases and 93
deaths have been reported in 21 States. The national response is being
coordinated by the national, multi-sectoral, multi-partner Emergency Operations
Centre (EOC) led by NCDC.
“In addition, NCDC has supported Ebonyi, Edo,
Ondo, Plateau and Kebbi states in activating sub-national level EOCs for
coordination.
“Following the large Lassa fever outbreak in 2018,
the NCDC together with partners instituted five key measures to ensure improved
preparedness in 2019.
“These include; Trained over one thousand health
care workers in the six zones in the country on Lassa fever management,
diagnosis and surveillance, together with the Irrua Specialist Teaching
Hospital; Prepositioning of treatment and diagnostic supplies to the 21 states
that recorded cases in 2018, treatment centres and laboratories.
“Others are; Publication of Lassa fever messages
on three major newspapers, weekly radio shows on Radio Nigeria, and intensive
community engagement; High level advocacy visits to State Governments,
encouraging them to do more to prevent and respond to cases of Lassa fever.
“The rest are; Developed new case management
guidelines, initiated a Lassa fever Research Consortium and hosted and
International Conference on Lassa Fever to share knowledge.”
Following the declaration of the 2019 outbreak,
the Director General, NCDC said that a Rapid Response Teams (RRTs) comprising
officers from the NCDC, Federal Ministry of Agriculture and Rural Development
and Federal Ministry of Environment have supported the response in the high
burden states of Edo, Ondo, Ebonyi, Plateau, Bauchi and Taraba states.
In these states, NCDC has also supported full
availability of drugs, personal protective equipment, laboratory reagents and
other supplies required for case management and diagnosis of Lassa fever. This
year, there has been no single stock-out reported in any state.
In January 2019, NCDC hosted the first Lassa fever
International Conference. This brought together the largest gathering of
researchers and professionals to discuss progress on Lassa fever. Importantly,
Nigeria introduced her national Lassa fever research plan and has been
recognised as one of the leading stakeholders in global Lassa fever research.
Over the last six months, progress has been made in this area especially in
discussions around Lassa fever vaccines.
In the next one year, Nigeria is expected to be
part of clinical trials towards the development of Lassa fever vaccines.
In 2018, genetic sequencing carried out at the
Irrua Specialist Teaching Hospital showed that the virus circulating originated
from the pool of lineages that have been in Nigeria since the first discovery.
This year, early sequencing result shows similar
findings. The preliminary results of 42 Lassa fever virus sequences indicate
that rodent to human transmission, as observed in 2018, is still the dominant
route of transmission. Therefore, there is a strong need to improve prevention
measures especially around environmental sanitation.
The progress recorded in the response to the 2019
Lassa fever outbreak including an early decline in the number of new cases and
reduced case fatality have been attributed to various factors.
This includes the early deployment of One-Health
national RRTs, improvement of functions in Lassa fever treatment centres,
revision of case management guidelines, enforcement of environmental sanitation
in some states, introduction of the Infection Prevention and Control (IPC) ring
strategy, targeted intensified risk communications activities, high level
advocacy visits, operational research into response activities, among others.
Dr Ihekweazu
said; “We are grateful to our partners including the World Health
Organization, UK Public Health Rapid Support Team, Medecins Sans Frontiers,
World Bank, ALIMA, African Field Epidemiology Network. We also applaud the
efforts of state epidemiologists, treatment centres and laboratories in the
country, especially the Irrua Specialist Teaching Hospital Edo, Federal Medical
Centre Owo, Ondo and Federal Teaching Hospital Abakaliki, Ebonyi.
It is very important that Nigerians continue to
practice preventive measures to avoid infection. Prevention of Lassa fever
relies on promoting good community hygiene to discourage rodents from entering
homes.
Other effective measures include storing grains
and other foodstuff in rodent-proof containers, proper disposal of garbage far
from the home, maintaining clean households and frequent hand hygiene.
All food should be well prepared, and family
members should always be careful to avoid contact with blood and body fluids
while caring for sick persons.
Healthcare workers are urged to maintain a high
index of suspicion for Lassa fever when handling patients, irrespective of
their health status.
Lassa fever should be considered in patients with
fever, headache, sore throat and malaise, in whom Malaria has been ruled out
with a rapid diagnostic test (RDT), especially when patients are not getting
better.
Health workers should adhere to standard
precautions including wearing protective apparels when handling suspected Lassa
fever patients. The revised Lassa fever case management guidelines are
available on the NCDC website, www.ncdc.gov.ng.
Lassa fever is a viral infection caused by the
Lassa fever virus, primarily transmitted to humans through direct contact,
eating food or drinking water contaminated with urine, faeces, saliva or blood
of infected rats.
Person-to-person transmission is through contact
with blood, urine, saliva, throat secretion or semen of an infected person.
The disease can be treated, with early
presentation to a healthcare facility greatly increasing the chances of
survival. Early signs of the disease include sudden fever, sore throat and
general body weakness.
