LASSA FEVER: A SILENT KILLER

The virus which causes Lassa fever was discovered in 1969 in Lassa, Nigeria, but interest in it died. After the 1970s, only sporadic attention was paid to it from time to time. However, this disease has been very much with us. It is endemic in Nigeria and has claimed so many lives. There are occasional outbreaks of the disease in Federal Capital Territory, Edo, Nassarawa, Plateau, Borno, Imo, Enugu, Ebonyi, Benue, Taraba, Adamawa, Ogun, Ondo, Kogi and Anambra States.

Many cases of Lassa fever have been mistaken for other common diseases in the country like malaria, typhoid fever and pneumonia. Prof. Akpede observes that “A patient who is experiencing fever and acute abdominal pain could be suspected of having appendicitis or perforation resulting from acute typhoid fever. But we have since found out that Lassa fever could also manifest with this same type of symptom. On one or two occasions, we have had patients whom we had to perform surgery upon because they manifested these symptoms only for us to later realize that these were cases of Lassa fever. And in a situation like this, both the surgeon and entire medical personnel are exposed to risk” (Vanguard, Wednesday March 18, 2009, p.41). He reports that this kind of situation led to the death of a surgeon and his assistant at Umuahia in Abia State. They both had thought the patient they were treating had appendicitis, but unknown to them it was a case of Lassa fever. He remarks that once a pregnant woman suffers from Lassa, she would die in eight or nine cases out of ten.

It was stated at the inauguration of the Lassa Fever Diagnostic and Research Laboratory of the Institute of Lassa Fever Research and Control of the Irrua Specialist Hospital, Edo State that 51,000,000 Nigerians are at risk of contracting the disease with the annual number of illness estimated at 3,000,000, and annual number of deaths put at 58,330 (cf: Saturday Vanguard, March 21, 2009). Lassa fever can completely wipe out a whole family, which sometimes people can attribute to the work of the enemy. Shoddier still is the fact that many physicians do not know the pros and cons of this disease.

Causes
This disease is usually spread by rats which live in the bush, but come into people’s houses in search of food. In this process, they could contaminate food stuff that may not have been covered. This could be garri, bread or other food items. Although rats might show no symptoms of the disease, they easily shed the killer virus freely in their urine, droppings and saliva. The virus is easily transmitted to human beings through direct contact with the rat urine, feaces, saliva and blood. Traditionally, it is transmitted by rat urine/feaces contamination of food, drink and household items. It could also be transmitted via body fluid and could be airborne. Somebody can contact this disease from another person through contact with aerosol transmission (coughing), or from direct contact with infected human blood, urine, or semen. Victims are also infected via skin breaks, and through mucous membranes from aerosol transmission from dust-borne particles.

Symptoms
Among the common symptoms of Lassa fever which might occur between 1 and 24 days after infection are fever, pain in the chest, back pain, general fatigue, sore throat, cough, abdominal pain, vomiting, diarrhea, conjunctivitis, facial swelling, red spots on the skin, protein in the urine and mucosal bleeding. The fever can be confused with malaria, typhoid fever, septicaemia and dysentery. Lassa fever is a haemorrhagic disease in the class of Ebola and Marburg haemorrhagic fevers because in the severe cases, it causes a swollen face and massive bleeding from every bodily orifice (eyes, mouth, nose, ears and genitals.

Prevention and Treatment
In the first place, war is to be waged against rats in the home. Poor sanitation and bad hygiene attract rats. There is the need for improved hygiene through proper refuse disposal to discourage rats from taking refuge, and keeping food and drinking water containers where they are not accessible to rats. Antibiotics may be administered to patients to ward off or treat secondary and opportunistic bacterial infections. Currently, there is no effective prophylactic treatment, except for a drug called Ribavirin used for people at high risk. It is sad that no human protective vaccine is presently available.
-Chidiebere Ugwu