Lassa Hemorrhagic Fever (LHF) In Nigeria: The War So Far


Lassa fever or Lassa hemorrhagic fever (LHF) is an acute viral hemorrhagic fever caused by the Lassa virus and first described in 1969 in the town of Lassa, in Borno State, Nigeria. Outbreaks of the disease have been observed in Nigeria, Liberia, Sierra Leone, Guinea, and the Central African Republic. The primary animal host of the Lassa virus is the Natal Multimammate mouse (Mastomys natalensis), which has many breasts and lives in the bush and peri-residential areas, found in most of sub-Saharan Africa. Lassa fever is an acute febrile illness, with bleeding and death in severe cases, caused by the Lassa fever virus with an incubation period of 6-21 days. The virus is probably transmitted by contact with the feaces or urine of animals accessing grain stores in residences and is excreted in urine for 3-9 weeks and in semen for three months.

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Lassa fever was first detected in Nigeria in 1969. The number of recorded cases peaked in 2012 when 1,723 cases with 112 fatalities were recorded. It has continued to decline since then. In the last 6 weeks, Nigeria has been experiencing Lassa fever (LF) outbreak which has so far affected 10 states. The states affected include Bauchi, Nassarawa, Niger, Taraba, Kano, Rivers, Edo, Plateau, Gombe and Oyo States. The total number so far reported is 81 and 35 deaths, with a mortality rate of 43.2%.

About 80% of human infections are asymptomatic; the remaining cases have severe multi-system disease, where the virus affects several organs in the body, such as the liver, spleen and kidneys. The onset of the disease is usually gradual, starting with fever, general weakness, and malaise followed by headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and bleeding from mouth, nose, vagina or gastrointestinal tract, and low blood pressure.

The virus is shed in the urine and droppings of the rats and can be transmitted through direct contact, touching objects or eating food contaminated with these materials or through cuts or sores. Nosocomial transmission also occurs in health facilities where infection prevention and control practices are not observed. Person to person transmission also occurs most especially when a person comes in contact with the virus in the blood, tissue, secretions or excrements of an infected individual.

The Minister of Health , Professor Isaac Adewole, in a statement issued in Abuja in response to the outbreak of disease in the country, said “the total number of suspected cases so far reported is 76 with 35 deaths, and a Case Fatality Rate of 46 per cent.”
But the Federal Government yesterday said the impact had not reached the magnitude which the disease could be declared a ‘National Emergency.’

Prof. Adewole, has however assured Nigerians of government’s readiness to stem further spread of the haemorrhagic fever now confirmed by laboratories to be Lassa Fever Viral Disease.

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According to him, “the public is hereby assured that the government and its partners (such as The Nigeria Centre for Disease Control NCDC), and other stakeholders are working tirelessly to address the outbreak and bring it to timely end.”

He stressed that “in response to these reported outbreaks, the Federal Ministry of Health under my leadership has taken the following measures to curtail further spread and reduce mortality among those affected: Immediate release of adequate quantities of ribavirin, the specific antiviral drug for Lassa fever to all the affected states for prompt and adequate treatment of cases.”

He said it also included deployment of rapid response teams from the Ministry to all the affected states to assist in investigating and verifying the cases as well as tracing of contacts, clinicians and relevant healthcare workers had been sensitized and mobilized in areas of patient management and care in the affected states.
Meanwhile, affected states have been advised to intensify awareness creation on the signs and symptoms including preventive measures such as general hygiene.

More so, Adewole stated that “It is important to note that Nigeria has the capability to diagnose Lassa fever. All the cases reported so far were confirmed by our laboratories. However, due to the non-specific nature of Lassa fever symptoms and varied presentations, clinical diagnosis is often difficult and delayed, especially in the early course of the disease outbreak,” .

Control of the Mastomys rodent population is impractical, so measures are limited to keeping rodents out of homes and food supplies, as well as maintaining effective personal hygiene. Gloves, masks, laboratory coats, and goggles are advised while in contact with an infected person.

Also joining the fight against the Lassa Fever, is Benue State. The Benue State Government has directed its citizens to stop eating rats in the meantime in order to curtail the spread of Lassa Fever. The state governor, Samuel Ortom, disclosed this to State House correspondents shortly after meeting Vice President Yemi Osinbajo at the Presidential Villa, Abuja.

Gov. Ortom said the decision was taken because the state had recorded a case of the fever. Rat is a delicacy popular among the people of the state.
The governor said, “Benue is affected; we have one case (of Lassa Fever) right now that is under control. We have advised our people; rat which is a major carrier is a delicacy. I am finding it difficult, but I have told them to suspend eating rats until further notice.”

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