The loss, last month, of 20 children in the Otodo-Gbame Community in Lagos to the vaccine-preventable measles infection is both shocking and embarrassing. More embarrassing, however, is the failure of the state’s health authorities to immediately identify the disease. Initial reports on the death of the children attributed it to “a strange disease”, which had been reported to the World Health Organisation (WHO). This understandably set off a panic button, considering Nigeria’s recent experiences with the Ebola Virus Disease and Lassa Fever, which claimed several lives across the country.
The Lagos State Health Commissioner, Dr. Jide Idris, had initially told Nigerians that 34 other cases of the “strange disease” were being monitored after the outbreak was first identified by the Medical Officer of Health of the Eti Osa Local Government Area on February 9. He confirmed that the outbreak had been reported to the Federal Ministry of Health and the WHO.
However, the commissioner last week announced that laboratory investigations had shown that the disease that killed the children was measles. He explained that all the five blood samples taken to the Public Health Laboratory, Yaba, tested positive for recent infection with measles virus. In addition, throat swabs and one blood sample investigated at the Virology Reference Laboratory of the Lagos University Teaching Hospital (LUTH) indicated the presence of the measles virus.
The failure of the state’s health authorities to initially diagnose and treat the victims of this measles epidemic is unbecoming. The reported symptoms of the infection — fever, rash and swollen testicles — are the classic measles symptoms and it is odd, indeed, that the disease was considered “strange” and reported to the WHO. A quicker diagnosis of the infection would probably have saved the lives of some of the victims.
Twenty children are dead and it turns out that they all died of measles, an illness for which there is a cure, and a vaccine for its prevention. The explanation by Dr. Idris that the children in the Otodo-Gbame community missed out on the state’s routine and mop-up immunisation programmes because it is a reclaimed, sand-filled area that the Ministry of Health was not aware of is not good enough. It is, indeed, questionable that a community with thousands of residents, as disclosed by the commissioner, would be in existence without the state government having an inkling of it, and including it in its health programmes.
The excuse that Otodo-Gbame is a sandy, riverine, camp-like settlement of mostly Egun people that developed from migration to Lagos from neighbouring states is also not tenable. It is disturbing that the water samples taken from four of the wells in the area were found unfit for human consumption. Otodo-Gbame residents had clearly been living on the fringes of civilisation with no government presence or record of their existence.
What the commissioner’s statement confirms is that there are serious gaps in the state’s immunisation activities. It means the children were only not immunised against measles, but also against other killer childhood diseases like polio, diphtheria, tuberculosis, tetanus and whooping cough. The states’ health authorities should quickly immunise them against all the vaccine-preventable diseases. Let the Federal Ministry of Health use the lesson of this unfortunate incident to return to the basics and resume national propagation of its immunisation programmes.
It is, however, commendable that the Lagos State health authorities have since resolved to conduct a mapping of slums and blighted communities towards reducing the health hazards associated with them. We encourage Lagosians to help the government in the identification of these slums. Residents of the slums should ensure environmental sanitation at all times since measles and most of the other infections are products of dirty environments. The public and other health workers have also been given certain telephone lines to call to report whatever they regard as “strange illnesses” in future. The health authorities have also conducted a house-to-house search for cases. The 34 identified cases were to have recovered from the disease while 587 children were immunised and administered with Vitamin A. No new cases have been reported since the intervention of the Ministry of Health. Intensive surveillance and sensitisation are said to be continuing. These, indeed, are reassuring steps.
Again, the quickness to ascribe ailments to ‘strange’ forces without even the benefit of preliminary laboratory tests is proof of the destructive influence of poor education, ignorance and superstition in our polity. The Lagos Ministry of Health owes the public an explanation and should conduct a public inquiry on why there was no serious laboratory investigation to properly diagnose the “strange disease” until 20 children died.