The Town Of Lassa

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  • This paper is not intended to talk about the history of Lassa, a town in Borno State in Nigeria where the Lassa Fever virus was first described. It is to call to mind what the disease (Lassa Fever) is and how it can be prevented.  The disease shall be discussed under the following headings:

• Definition
• Brief History
• Mode of Transmission
• Symptoms
• Diagnostic Method
• Treatment


What is Lassa Fever?
Lassa Fever, also known as Lassa Hemorrhagic Fever (LHF), is an infectious viral disease caused by Lassa Virus (which belong to the family - Arenaviridae). The term hemorrhagic is used to describe bleeding while infectious is an adjective used to describe, in this case, a disease that is contagious i.e. can be passed from person to person.


Brief History
The disease occurs in West Africa and is known to be endemic in Benin, Ghana, Sierra Leone, Mali, Liberia, Guinea, and Nigeria. The disease was first diagnosed in Benin in 2014; Ghana in 2011; Mali, Guinea, and Liberia in 2009. In Nigeria, the virus was first described in 1969, following the death of two missionary nurses in the town of Lassa in Borno State. Estimated cases of Lassa Fever per year are between 100,000 – 300,000. Of this number, 5,000 deaths are recorded.

According to the Nigerian Center for Disease Control (NCDC); as at April 8, 2018:
• Total Confirmed Cases were 408
• Active States (States that have recorded at least 1 confirmed case) were 20
• Contacts identified from Active States were 4480
• Deaths in Confirmed Cases were 101.


How is The Virus Spread?
The virus is transmitted to humans through contact with food and household items contaminated with the urine or feces of an infected rodent (multimammate mouse). Spread can also occur between people via direct contact with body fluids. Once the virus is contacted, it takes 1 – 3 weeks before the victim starts showing symptoms of the disease.

There has not been any evidence to support the airborne spread of the virus between humans, neither has there been any reported case of it being sexually transmitted. However, this does not give people a free pass as there are other deadly diseases that are transmitted sexually.
Travelers from areas where Lassa fever is endemic (i.e. peculiar to a particular people, population or environment) export the disease to other countries.


Symptoms
Symptoms usually start with;
• A feeling of discomfort (or being tired),
• General weakness, and
• Fever.
After a few days;
• Headache,
• Sore throat,
• Muscle pain,
• Chest pain,
• Nausea,
• Vomiting,
• Diarrhea,
• Cough, and
• Abdominal pain may follow.
In severe cases;
• Facial swelling,
• Difficulty in breathing (as a result of fluid in the lungs),
• Bleeding from Mouth, Nose, Vagina, Anus, etc.
• Low blood pressure.
At a later stage;
• Shock,
• Tremor,
• Seizures,
• Coma.

In fatal cases, death usually occurs within 14 days of infection. Deafness occurs in 25% of patients who survive the disease. Victims that did not suffer permanent deafness may regain their hearing ability after 1 – 3 months. Organs that are affected by the virus are the Liver, Spleen, and Kidneys.


How do We Distinguish Lassa Fever from Other Diseases?
Other disease conditions that present with similar symptoms as Lassa Fever are Malaria, Typhoid Fever, Yellow Fever, and Ebola Fever. Lassa Fever can be distinguished from these other conditions by laboratory testing. One of such tests is ELISA – Enzyme-linked Immunosorbent Assay: a form of laboratory test that utilizes an enzyme-labelled immunoreactant (antigen or antibody) and an immunosorbent (antigen or antibody bound to a solid support).

Treatment
There are no vaccines for the Lassa Virus. Treatment is usually:
• Preventive,
• Supportive, or with an
• Antiviral medication.

Preventive Measures
• Isolate those who are infected.
• Promote good community hygiene to discourage rodents from entering homes.
• Store foodstuffs in rodent proof containers.
• Dispose garbage far from the homes.
• Buy Agnes (Cat) to hunt rodents.

Supportive Measures
• Early supportive care with rehydration and treatment of symptoms improve survival chances.

Antiviral Medication
• The antiviral medication Ribavirin may be useful when given early. Available dosage forms of the medication are
a. Tablets (100mg, 400mg, & 500mg)
b. 100mg/ml in 1ml ampoule.


Action Plan
Public enlightenment of people in high risk areas on the ways and practices that would discourage the breeding of rats in and around their homes. Why must we allow them to stay with us when they do not pay rents. Say “NO” to Rats. Say “NO” to Lassa Fever.

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