Last year, the Special Aviser to Governor Rotimi Akeredolu on Health and Acting Commissioner for Health, Dr Jibayo Adeyeye, while on a Lassa Fever sensitization drive in Owo, disclosed that the state has the highest number of Lassa fever deaths in the country.
With 1,163 cases reported in 130 local governments in 27 states, Ondo State had 81 of the 242 deaths in the country in 2020.
In fact , he made it known that Lassa fever killed more people in the state than COVID 19.
This is certainly no cheering news for the state. The image of the sunshine state has been dimmed by this dark news.
Lassa fever is prevalent during the dry season , infecting health care givers, with huge deaths annually.
Lassa fever is an acute viral haemorrhagic illness caused by Lassa virus, a member of the arena virus family.
The annual peak of human cases is usually observed during the dry season (December–April), following the reproduction cycle of the mastromy rats in the wet season (May–June).
Humans are infected with Lassa virus through exposure to food or household items contaminated with urine or faeces of infected mastomys (carrier rats).
Evidently, the disease is endemic in the rodent population in parts of West Africa.
Lassa fever is endemic in Benin, Ghana, Guinea, Liberia, Mali, Sierra Leone, Togo and Nigeria, to mention a few in the African and West African sub regions.
Person-to-person infections and laboratory transmission can also occur, particularly in health care settings, in the absence of adequate infection prevention and control measures.
To this end, there is need for prompt diagnosis and treatment, which is essential for quick recovery.
Medical records confirmed that overall case-fatality rate is one per cent.
Nonetheless, among patients who are hospitalised with severe clinical presentation of Lassa fever, case-fatality is estimated at around 15 per cent, while early supportive care with rehydration and symptomatic treatment improves survival. Surprisingly, about 80 per cent of people who become infected with Lassa virus display no known symptoms, thus aiding community transmission of the virus.
However, one in five infections result in severe disease, particularly when the virus has affected several vital organs such as the liver, spleen and kidneys.
Epidemiology report for the 51st week of 2020 (December 14 to 20) as released by the Nigeria Centre for Disease Control (NCDC) indicated that number of new confirmed Lassa fever cases increased from five in week 50, 2020 to 12 cases in week 51.
The cases were reported from Edo and Ondo states. Cumulatively in 2020 (from week one to 51), the epidemiology report revealed that there were 6,668 suspected cases of Lassa fever, out of which 1,175 cases were confirmed with 242 deaths.
Three states, Ondo, Edo and Ebonyi, account for the high number of deaths with 81,40 and 23 deaths, respectively. In total for 2020, 27 states recorded at least one confirmed case of Lassa Fever across 130 Local Government Areas (LGAs). Of all confirmed cases, Ondo state had 36 per cent, Edo 32 per cent and Ebonyi states seven per cent, even as number of suspected cases significantly increased compared to reported cases for the same period in 2019.
Similarly, factsheet from the World Health Organization (WHO) revealed that 15 confirmed cases were reported among health care workers with one death among a confirmed case and one among a probable case.
There are fears that confirmed cases and casualties may rise due to the devastating effect of COVID-19, which has greatly taken the attention of the public health officials.
It suggested that country’s capacity to detect and respond to Lassa fever outbreaks should be improved , especially in areas of surveillance, laboratory, case management and coordination, as well as infection prevention and control.
In past years, NCDC responded to Lassa fever outbreaks through the activation of a National Emergency Operations Centre (NEOC) with an inter-disciplinary, multi-partner technical team to ensure a well-coordinated response and swift control of Lassa fever outbreaks in affected states.
Confirmed cases were referred to designated treatment centres in the affected states following optimised standard of care protocols.
NCDC in its previous epidemiology reports confirmed that National Lassa fever multi-partner, multi-sectoral Technical Working Group (TWG), strongly engaged in the coordination of the response activities at all levels. It also confirmed a strong cross border collaboration with Benin Republic as regards the newly reported Lassa fever cases, as well as the implementation of targeted risk communication activities in most affected states
It, however, planned to continue community mobilisation of resources and manpower, in response to the fever, as well as the finalisation of Lassa fever five-year strategic plan.
A senior NCDC officer who pleaded anonymity confirmed that guidelines for appropriate case management and infection prevention and control measures for 2020/2021 season have been disseminated to the different states, while surveillance activities have been enhanced in the affected states with enhanced active case finding.
Since this disease is caused by infection from rodents, rats, it is obvious that the State Government steps up its public health strategies.
Basic hygiene must be intensified through mass public awareness.
Public Sanitary Officers, should be deployed across the state, to undertake House to house assessment of environmental sanitation and enforce such appropriately.
More public awareness and sensitization on the causes of the virus and other public health diseases should be undertaken, using both traditional and new media.
Senior government officials should use every opportunity to draw attention to the disease and others and what to do to avert such.
Members of the public should join hands with the government by doing what is right in terms of basic hygiene and environmental sanitation.
Furthermore, the government should prioritise the resuscitation and training of Epidemic Preparedness and Response (EPR) Committee and Rapid Response Teams (RRT), intensify risk communication activities by airing radio jingles and other public awareness measures, and allocate a dedicated budget line for disease surveillance.
More Isolation/treatment centres for clinical management of infectious disease cases should be established while surveillance activities, including active case search and contact tracing, should be intensified.
Government should in the same vein, provide comprehensive aftercare services for survivors and activate Emergency Operation Centres (EOCs) based on the protocol to declare an emergency, in addition to supporting their respective epidemiology units.
Members of the public should take preventive measures to prevent the disease, through regular hand washing with soap and water, proper storage of food, ensuring clean environment to prevent breeding of rats among others.
In health-care settings, staff should always apply standard infection prevention hand control precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment to block splashes or other contact with infected materials and safe injection practices.
Health-care workers caring for patients with suspected or confirmed Lassa fever should strictly apply extra infection control measures to prevent contact with the patient’s blood, body fluids and contaminated surfaces or materials such as clothing and bedding.
When in close contact, within one metre, of patients with Lassa fever, health care workers should wear face protection, which could be a face shield or a medical mask and goggles, a clean, non-sterile long-sleeved gown, and sterile gloves for some procedures.