NIGERIA: Fighting lethal Lassa fever

Friday, March 6, 2009

Nigerian health officials are working to contain a resurgence of Lassa fever, a highly infectious disease that has killed at least eight people in the past month.

The World Health Organization (WHO) said over 93 cases of the virus had been confirmed in the capital Abuja and neighboring Nasarawa state since December.

At the Irrua Specialist Teaching Hospital in Edo state, confirmed cases rose by 60 percent between from December to January.

“That is a major increase and furthermore these are just the cases we hear about in hospital,” Marguerite Lamunu, WHO Lassa fever expert, told IRIN. ”In reality, there will probably be many more cases and deaths in the community, plus the disease is spreading from state to state”.

Lassa fever is an acute viral hemorrhagic condition transmitted through contact with the urine or faeces of rodents, especially rats and shrews. It was first discovered in 1969 in the town of Lassa in northern Nigeria's Borno state.

Lassa fever can also be transmitted through direct contact with the bodily fluids and faeces of an infected person or through airborne particles, according to Osi-Ogbu.

"We have an epidemic on our hands,” Ogugua Osi-Ogbu, head of Lassa fever prevention and care at the National Hospital (NHA) in Abuja, told IRIN. 

The disease, which has an incubation period of one to three weeks, has become endemic in parts of West Africa, where it kills at least 5,000 people each year among 300,000 to 500,000 cases, according to WHO.

The illness is especially severe late in pregnancy, killing the foetus and/or the mother in more than 80 percent of cases.


The Nigerian Federal Ministry of Health has alerted all 36 state health ministries, directing them to step up public awareness campaigns on preventing Lassa fever.

"We have embarked on a rigorous campaign on the radio to sensitise our people on the dangers of Lassa fever, how it is contracted and effective measures to avoid infection,” Kano State Health Commissioner Aisha Isyaku Kiru told IRIN.

"We are specifically calling on the people to observe and improve community hygiene through proper refuse disposal to discourage rats from taking refuge, and keeping food and drinking water in containers not accessible to rats", Kiru said.

According to residents many ethnic groups consume rodents, especially rats, hedgehogs and badgers.

Undergrowth is often burned to smoke out rodents for ''bush meat" as it is known locally, driving the animals to take shelter in homes, thereby increasing the risk of Lassa fever infection.

"Rodents are a source of meat to many of our people and the government needs to ban their consumption to effectively contain Lassa fever spread,” said Bernard Ayorchia, a private medical doctor in the central Nigerian city of Makurdi.

Another hurdle in tackling Lassa in Nigeria is the lack of laboratories. Only two facilities, in the southern states of Lagos and Edo, are equipped to diagnose the illness.

Initial symptoms, which include headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea and coughing, are similar to those of malaria, which can also make diagnosing Lassa fever difficult, according to the WHO.

Severe cases may progress to bleeding from the mouth, nose, vagina or gastrointestinal tract. In late stages seizures, shock, tremors and coma can occur.

"The government must urgently provide laboratories for diagnosing Lassa fever in all parts of the country,” said NHA's Osi-Ogbu. “Early detection of the virus and a prompt response are key in saving the life of an infected person."

WHO plans in the coming days to send an evaluation team to affected states in Nigeria to assess the scale of the outbreak.