From the beginning of January 2020, Nigerians have been greeted with stories of the endemic Lassa fever. Between January 1 and January 26, this acute viral haemorrhagic fever caused by the Lassa virus has resulted in the death of dozens of persons among nearly 300 cases reported from 19 states in the country. Edo, Ebonyi and Ondo states, according to reports, have the highest number of cases.
While the authorities are stepping up measures to tackle the rise, some doctors in Lagos have called for precaution and good hygienic practice among residents of the state. Owing to the state’s population of over 20 million people, doctors fear that an outbreak would be disastrous compared to what has been recorded in some other states.
Lassa fever is an animal-borne illness. According to the World Health Organisation (WHO), rodent population is the reason for the presence of Lassa fever in some West African countries like Nigeria, Benin, Ghana, Guinea, Liberia, Mali, Sierra Leone, and Togo. Persons are infected with the virus through exposure to food or household items contaminated by the urine or faeces of infected rats. The virus affects several organs of the human body such as the liver, spleen and kidneys. As reported by the Nigeria Centre for Disease Control (NCDC), in 2018, the country saw the largest number of cases of Lassa fever, with over 600 confirmed cases and over 170 deaths.
WHO has noted that signs of the disease are usually gradual, starting with fever, general weakness and malaise. After a few days, other signs like headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough and abdominal pain may follow. According to the NCDC, Lassa fever was first reported in Lassa, a community in Borno State, after which it was named, in 1969, when two missionary nurses died from an unusual febrile illness. More cases and deaths have been recorded since then.
Asked whether the outbreaks in other states should cause panic among Lagos residents, Dr. Onifade Michael, a general practitioner with Randle General Hospital, Surulere, said no. He maintained that the situation does not call for panic but carefulness among residents. Nonetheless, he warned that Lagos residents should not be carefree because no case has been reported yet in the state.
“As it stands, the outbreaks shouldn’t actually bring fear. Rather, Lagosians should be very careful. That a case has not been recorded in Lagos does not mean that people have to be carefree about it. The same universal precaution that is being taken around the country to address the situation should be taken here in Lagos. One thing we need to understand is that Lagos is very highly populated. We pray we don’t record any case here. If we have a case here, the spread would be very easy.
“One of the ways Lassa fever spreads is through rat droppings. This is a time to eradicate rats in the environment and people should take it seriously. Citizens can even patronise those selling rat poisons just to make sure rats are eliminated from the environment,” Onifade said.
Dr. Chinonso Ofoegbu, house officer, Lagos University Teaching Hospital (LUTH), was concerned about the rate of movement of people across states in the country. He said it contributes greatly to the spread of the virus. While calling for a national emergency following the outbreak, he urged Lagos residents to be particular about their environment. He also compelled them to imbibe the habit of regular hand-washing.
His words: “Eighty per cent of Lassa cases are asymptomatic. Some infected individuals do not know they have the virus until they come down with the signs.
“Lagosians should try to get rid of rodents, rats basically, and when they come in contact with someone, they should always wash their hands.”
But in spite of the dense population of Lagos State, Dr. Ofoegbu said he was optimistic about the level of awareness of Lagos residents on Lassa fever. He added that health practitioners in the state were taking advantage of platforms to enlighten the people about the fever. But he also encouraged them to report suspected cases immediately.
Dr. Abayomi Ogunbekun, medical superintendent, Hoare’s Memorial Methodist Hospital, Sabo,Yaba, is a firm believer in prevention being better than cure. The general practitioner, who prays that Lagos does not experience an outbreak, said the state was a prime community for Lassa fever, based on the lifestyle and environmental factors in the state.
He also maintained that residents should not panic because it would not solve anything. Rather, they should be prepared for eventualities, all sectors and communities must cooperate in ensuring that preventive and curative measures are effectively in place.
His words: “Lagos is densely populated, with many poor communities generating lots of solid waste thus encouraging massive breeding of rats. This is an indication that Lagos is a natural environment for Lassa fever.
“But we must also note that Lagos is also a metropolitan city with a mixed population. It has highly educated and social people. Even those without formal education are enlightened. Also, we have responsive, proactive government operating robust health care delivery, especially in the area of preventive public health medicine.
“We pray that the outbreak will not get to Lagos because it is a prime community for the outbreak of Lassa fever due to lifestyles and environmental factors. It will be disastrous, especially if preventing measures and infectious disease treatment facilities are not adequate.
“Government should carry out more enlightenment programmes, develop more rapid diagnostic tests, increase availability of the only known drug treatment, carry out research to develop vaccine against Lassa fever and collaborate with the private sector, non-governmental organisations and faith-based medical institutions that are accountable for the treatment even in remote rural areas where there is no government presence.
“Residents should be proactive in safeguarding their lives by keeping the home clean and discouraging rats from entering the house, not eating rats, avoid contact with the blood and secretions of infected patient, and avoid getting too close to people who are sneezing persistently for long periods,” he said.