Pregnant woman, medical doctor die of Lassa fever as NCDC releases health advisory

An outbreak of Lassa Fever has led to the death of a pregnant woman and a medical doctor as confirmed by the Nigeria Centre for Disease Control (NCDC).

In a press release on Tuesday, December 14, the NCDC said the pregnant woman had presented herself at a health facility in Nassarawa where it was discovered that she had Lassa fever. She died from the disease.

A medical doctor involved in the management of the woman also contracted the disease. He died in Abuja where he had gone to seek medical care. Another doctor who also had contact with the deceased woman is receiving treatment.

The NCDC said it has started contact tracing of all those who had close contact with the patients. It added that it has also commenced an in-depth

epidemiological investigation of the cases to understand the possible source of infection and the extent of spread of the disease.

The centre said: “Following these confirmations of Lassa fever cases in Nasarawa state and FCT, the NCDC has intensified the activities of the national multi-sectoral and multi-disciplinary Lassa fever Technical Working Group (TWG) for Lassa fever surveillance and response in the country. Lassa fever Emergency Operation Centres have also been activated by the affected state and FCT. The NCDC sympathises with the families of the patients and the healthcare workers who have lost their lives to the disease.”

It also provided some guidelines on how the disease is spread and how to prevent it. The  virus is spread through:

1. Direct contact with urine, faeces, saliva or blood of infected rats.
2. Contact with objects, household items and surfaces contaminated with urine, faeces,  saliva or blood of infected rats.
3. Ingesting foods contaminated with urine, faeces, saliva or blood of infected rats. 
4. Person-to-person transmission can also occur through contact with blood, urine, faeces,  vomitus and other body fluids of an infected person

Lassa fever initially presents like any other febrile illness such as malaria. Its symptoms include fever, headache, sore throat, general body weakness, cough, nausea, vomiting, diarrhoea,  muscle pains, chest pain, and in severe cases, unexplainable bleeding from ears, eyes, nose,  mouth and other body openings. The time between infection and the appearance of symptoms of the disease is 6 to 21 days. Early diagnosis and treatment increase the chances of survival. 

People most at risk are:

1. People of all age groups who come in contact with the urine, faeces, saliva or blood of infected rats
2. People living in rat-infested environments  
3. People who consume potentially contaminated foodstuff especially those left open overnight or dried outside in the open
4. People who handle or process rodents for consumption 
5. People who do not perform hand hygiene when appropriate 
6. Caretakers of infected persons with poor infection prevention and control measures 
7. Health care workers including: 
8. Doctors, nurses and other health workers providing direct patient care in the absence of standard precautions.
9. Hospital staff who clean and disinfect contaminated surfaces, materials and supplies without adequate protective gear
10. Laboratory staff who handle blood samples of suspected Lassa fever patients without appropriate precautions
11. Medical or support staff who prepare and or handle dead bodies without appropriate precautions

To reduce the risk of Lassa fever, the Nigeria Centre for Disease Control (NCDC) offers the  following advice:

1. Keep your environment clean at all times 
2. Block all holes in your house to prevent the entry of rats. 
3. Cover your dustbins and dispose of refuse properly. Communities should setup dump sites very far from their homes to reduce the chances of having rodents within homes

4. Store foodstuff like rice, garri, beans, corn/maize etc. containers that are well covered with tight-fitting lids

5. Avoid drying foodstuff outside on the floor, roadside where it will be exposed to contamination

6. Avoid bush burning which can lead to the displacement of rats from bushes to human dwellings

7. Eliminate rats in homes and communities by setting rat traps and other means available 
8. Practice good hand hygiene by frequent washing hands with soap under running water or use of hand sanitisers when appropriate

9. Visit the nearest health facility if you notice any of the signs and symptoms of Lassa fever as mentioned earlier, avoid self-medication

10. Healthcare workers are advised to always practice standard precautions: i.e., wear gloves and other appropriate personal protective equipment while handling patients or providing care to an ill patient/relative.

11. Healthcare workers should maintain a high index of suspicion for Lassa fever i.e., be vigilant and consider a diagnosis of Lassa fever when seeing patients presenting with febrile illness.

Any febrile illness that has not responded to 48 hours use of anti-malaria or antibiotics should raise an index of suspicion for Lassa fever! Please if your healthcare worker suspects Lassa fever,  advise him or her to contact your local government Disease Surveillance and Notification Officer for immediate access to healthcare. This is essential because early treatment for cases and preventive treatment for high-risk contacts appear to be more effective when started very early.