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'Why people are less concerned about Lassa fever' - News - Nurses Arena Forum

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'Why people are less concerned about Lassa fever' by Idowu Olabode : January 17, 2016, 09:12:42 PM
Lassa fever has broken into an epidemic proportion in Nigeria nearly every year since 1969 when it was first identified and named Lassa—after the town in Borno where researchers traced it.

The latest outbreak since November and the rising death toll in its wake has prompted concern about its continued recurrence—a marked departure from how Nigeria contained with Ebola for the first time in its history--with one call to give Lassa the Ebola treatment.


The fatality rate from Ebola is higher—an infection is nearly always fatal. Lassa hasn’t seen the same level of concern. The virus has been hitting and petering out for 47 years.

That may be one reason many haven’t taken it as serious as it should be, suggests Dr Muhammad Askira, president of the Nigerian Association of Resident Doctors.
But death toll from Lassa fever has surpassed death toll from Ebola fivefold.

Nigeria had some 21 infections, including Patrick Sawyer—a Liberian American visiting Lagos after being infected with Ebola.
By contrast, more than 80 infections of Lassa fever have been recorded since November and more than 40 have resulted in death.
But the difference is not in the science of the viruses. It is how Nigeria deals with them.
Lassa fever has this year generated a massive campaign in mass and social media—with the federal health ministry pushing out photo charts and Infograph detailing everything to be known about Lassa and the multimammate rat that harbours it.
But the anti-Lassa campaigns are done only during epidemics, says Askira.

“Once it is gone, people think it is over. You hardly hear about Ebola because we think we are over.”
Information structure across the country does not take into account the need to maintain awareness about the virus all year round.

“Whether outbreak or not, what we should do is to prevent the outbreak,’ says Askira. “The rodents are always endemic.”
Rodents follow you home

Endemic means the rodents are here. “They are all around us. They follow you home,” says Askira, “unlike Ebola where you go out into the bush to get the animals.”

The choice is between controlling the rodent population and preventing them coming into homes or contaminating food supplies.

Multimammate rats which harbour Lassa fever virus don’t fall sick from it. Instead they excrete the virus in urine, faeces and other bodily secretions, which contaminate food sources.
Last week, Senator Shehu Sani caused a stir on social media as lawmakers debated Lassa fever when he added an extra prayer “that the federal ministry of health should be encouraged to breed more cats,” the Senate said on its Twitter handle @NGRSenate.

The Twitter post sparked a backlash of sarcasm; with Ronald Zimora (@ronaldnzimora) suggesting the health ministry “should also breed snakes, hawks and owls while at it. We need all the help we can get.”
Adhoc strategy

Strategies for dealing with Lassa, and most outbreaks, are makeshift.

Sure, doctors can suspect a thing or two when seeing patients, but it takes some deaths to whip the health system into alarm mode before a suspected case is confirmed and an epidemic declared.
In all that time, many would have been exposed, and then begins the laborious task of tracing contacts to be placed under observation or quarantine.

Askira says Nigeria needs already clear strategy and strong referral system from wards and primary health care centres up to tertiary health facilities.

“We don’t want to wait until there are outbreaks to start rushing,” he adds.

Global concern

Outbreak of Ebola was already causing global concern for being the first-ever outbreak in West Africa on record. Thousands had already died and thousands more infected.

Nigeria was also caught up in the wave of hysteria—and awareness was a flood before Ebola came flying in.

“It was imported, not endemic,” says Askira, “and there was already clear-cut understanding of the disease.”

Striking doctors

Ebola chose the right time to hit—while public hospital doctors were on massive nationwide strike and facilities were not operational. So Sawyer wound up in a private hospital.

Doctors reason that if public hospitals were working at the time and small primary health facilities got involved in treating Ebola virus cases without knowing, it would have spread more.

Something similar is on-going with Lassa where small hospitals unable to manage it are getting involved.
And present outbreak across 11 states with populated cities—Lagos, Port Harcourt, Kano—can explain how far it will go, says Askira.

Source : Daily Trust

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