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The resurgence of Lassa fever

Published by Guardian on Fri, 02 Mar 2012

THE outbreak of the dreaded haemorrhagic Lassa fever disease in some states in the country is worrisome. It reflects the failure of the relevant health authorities to adopt systematic research and monitoring strategy to track a disease that has been in Nigeria for more than four decades. Over this long period, almost on annual basis, incidents of the disease occur in parts of the country that were thought to be non-endemic.Within the past six weeks, no fewer than 40 persons have reportedly died from the scourge of Lassa fever across the states of the federation. The figure is out of the over 397 reported cases. The dead include six health workers made up of two doctors and four nurses. Eighty-seven others have been positively confirmed thereby raising the fear of more casualties except something is done urgently.Government has directed that all those suffering from the disease should be treated free of charge. That is a step in the right direction as otherwise majority of those affected would not be able to pay for treatment. And that would compound the problem.Initially, the disease was confined to the northern states from where it originated. But of late, it has spread down south even to the Niger Delta region, thereby threatening the economic base of the nation. The Federal Government should take proactive steps to stop further spread of the disease in the interest of public health.Minister of Health, Professor Onyebuchi Chukwu had at a press briefing in Abuja, the other day, disclosed that the disease had so far been reported in 12 states. The states are Edo, Nasarawa, Plateau, Ebonyi, Taraba, Yobe, Ondo, Rivers, Gombe, Anambra, Delta and Lagos. By this development, over 40 million people are at risk of infection.Already, 48 patients with the disease have reportedly been admitted into Irrua Specialist Hospital, Edo State. The hospital is one of the designated specialist centres for the diagnosis of the disease. The other is the Lagos University Teaching Hospital (LUTH). But that is not enough for a country with an estimated 150 million people. Why is there no designated specialist hospital in the north, which is the original source of the disease'Although Professor Onyebuchi explained that adequate quantities of Ribavirin injections and tablets, the antiviral drug for Lassa fever, have been released to the affected states, this has not addressed the question relating to the adequacy of the drugs; and whether or not there are enough medical personnel to handle the situation, particularly, in the northern states. What is being done to prevent the disease from spreading to other states'Amid the concern, the Federal Government said it would spend a whopping N500 million on the epidemic in the next three months. This again raises questions as to how government wishes to tackle such a serious epidemic. What is the basis for voting such a huge amount' On what is it going to be expended' Certainly, it is curious for government to plan N500 million-expenditure in just three weeks without a clear-cut framework for the expenditure.Where, for instance, did government raise the money' What has been done before now to stem the tide of Lassa fever' Isn't this measure an ad-hoc response to an endemic problem' Can the disease be eradicated' If yes, how' Or has government just awakened from slumber because of a threatening epidemic of the disease'There is need to address the problem on a sustained basis. A systematic strategy aimed at eradicating the disease entirely from the country is needed rather than the knee-jerk reaction that follows whenever the disease strikes. That approach has not been helpful. Experts are of the view that we need a Centre for Disease Control (CDC) given the preponderance of several communicable diseases in our undeveloped environment. The CDC would carry out research, track and plan ahead against such endemic diseases like Lassa fever, cholera and malaria.Lassa fever is an extremely deadly haemorrhagic disease spread by the rat species Mastomys, in particular, M. natalensis. The epidemic occurs mostly in the dry season than in the rainy season. It was first isolated in 1969 at a local hospital in Lassa, a small town in the River Yedesram valley in Borno State from where it got its name. The common symptoms include fever, abdominal pain, nausea and vomiting, diarrhoea or constipation. Some patients present neck swelling with sore throat. Some present with bleeding, which indicates a high risk of death.The disease is endemic not only in Nigeria but also in Sierra Leone and Liberia. It is also known to have occurred in Senegal, Mali and as far as Central Africa. There is need for sub-regional cooperation and collaboration in research and monitoring in order to curb further spread of the disease in the West African sub-region. Total eradication should be the overriding objective.In view of the failure of past ad-hoc and uncoordinated approach to check the disease over the years, government should re-strategise and adopt a more effective method. An aggressive public enlightenment is needed to educate members of the public on preventive measures. A clean environment is the first step towards its eradication. An effective fumigation programme could also be useful in eradicating the particular species of the vector rats that cause the disease.
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