24 out of the 36 states in the country have been hit by the outbreak considered to be the worst in the history of the disease.
The fever has afflicted over 284 Nigerians from different parts of the country between August 2015 and September 2016.
Fresh cases are recorded every day in some states like Ondo and Bauchi, where the outbreak had earlier stopped, signalling that the disease could spread further.
What implications does this development portend for Nigeria a year after the latest outbreak began? What lessons do we learn? Could this outbreak become an epidemic? No one can provide definite answers to these questions presently.
The new Director-General of the Nigeria Centres for Disease Control, NCDC, Abuja, Dr. Chikwe Ikpeazu, had, recently, in an interview, maintained that Lassa fever outbreak is yet to become an epidemic but there are fears that the continued deaths of Nigerians as a result of the fever may be pointing in a different direction.
Health watchers believe that unlike the response to Ebola outbreak, government may have failed to do same to Lassa. Rather, the outbreak has been greeted with the attitude of complacency.
For instance, the Minister of Health, Prof Isaac Adewole, while speaking to State House Correspondents in Abuja said Nigeria cannot win the battle against Lassa the same way it won the battle against Ebola because Lassa is endemic in Nigeria.
The Minister also, at an Emergency National Council on Health meeting, said the country should not be talking about control, but rather should sign off the obituary of Lassa.
He said: “I call it an embarrassment because as a nation we cannot witness Lassa fever every year; it is rather abnormal for a nation that has resources like we should have to be witnessing such epidemic.”
He promised that with the strengthening of the nation’s epidemiology surveillance and response, Lassa would be put under locked and key.
Before now, millions of Nigerians did not imagine the seriousness of the threat of Lassa outbreak.
Unfortunately, months after the inauguration of the committee on the fever, the current outbreak has taken a new dimension, as the country may have failed to interrupt the transmission.
Currently, the likely risk for medical personnel is the newest security threat confronting Nigeria.
With the deaths of many doctors in the country, the threat of possible epidemic of the disease cannot be ruled out coupled with the resurgence of wild polio virus at a time Nigeria is facing serious economic challenges.
Contrary to the assumption that Lassa is a seasonal disease, the Chairman, Lassa Fever Control Committee, Prof Oyewale Tomori, at a symposium in Lagos, disagreed that the outbreak was an emergency, adding that poor disease surveillance system has caused the escalation and persistent re-occurrence.
According to him, no fewer than three people are diagnosed of the disease daily in the latest out-break.
“We have little value for life, until more than 100 people die, it is not an emergency. For many years, Lassa has been with us but we don’t take it serious. In other parts of the world, when a single person dies of a disease, it is a national emergency. For how long are we going to continue to call tragedy an embarrassment?
He explained that the breakdown in disease surveillance did not make the country notice that Lassa has consistently brought sorrow, pains and agony to several homes.
“If you are not hearing of new cases, it is not that the disease is not occurring, but because our disease surveillance is not up to par. We deceive ourselves that it’s a seasonal disease, but the fact remains that it occurs throughout the year. At least, three people are diagnosed of Lassa daily somewhere in the country,” Tomori said.
“We abandon disease surveillance and control activities; there was a time people worked together, the laboratories at Ibadan, the Ministry of Health, NIMR, joined forces to protect the country. In the 60s to 80s at Ibadan, we produced every reagent we needed in the country. We did not depend on importation. But now we are lazy and everybody wants to make money from importation.”
Sadly, with the new trend of the infectious disease, only few Nigeria laboratories can give accurate results.
To Tomori, Six to seven laboratories in the country cannot give proper results due to lack of support. The only few that function in the country have the support of partner agencies and backing from abroad. The professor of virology also, in a report, described Lassa as an annual recurrent budget of death for poor people of Nigeria, adding: “Because we have lived in a state of denial of the disease, we handle it with characteristic laxity, laissez-faire, negligence, sloppiness, slackness, disregard, triviality and freewheeling abandon.
“Lassa lacks the zeal and trepidation that Ebola outbreak inspired and Nigeria still wakes up every year an outbreak is reported, “running like a decapitated chicken in any which direction, and forgetting about the disease till another year another outbreak.”
To another stakeholder, a renown professor of pharmacognosy and President, Bioresources Development Group, Prof. Maurice Iwu, Lassa was more than an embarrassment because the country has the personnel required, knowledge of the fever and how to prevent it, but the disease still claims lives.
Iwu argued that unless the country adopts the approach used during the Ebola outbreak, many more people would fall victim.
“As long as Lassa fever is anywhere in the country, as long as we have restaurants that don’t keep good hygiene, as long as we have houses that are co-infested with rat and horse, as long as we have dirty environment, we are all vulnerable,” he said.
“The only thing we can do is keep track of the virus, and from time to time do research. Our universities should make sure that 80 percent of their research is localized to treat our own diseases, issues and viruses we live with.”
Findings show that as far as the average Nigerian is concerned, a confirmation of pockets of the disease across the states is alarming, while an epidemic would be catastrophic. Such fears are well founded. The latest Lassa fever outbreak affected 24 states in Nigeria. Unlike outbreaks of the past, it is spreading in rural and urban areas. In the country today, millions of people are walking around with high fevers and other kinds of symptoms that could confuse diagnosis of Lassa fever. Worse still, Nigeria has been listed among countries that may be threatened by global spread of Zika virus, another terrible, viral disorder caused by mosquitoes. This time, even health workers are not spared.
Update on the World Health Organisation, WHO, website showed that between August 2015 and 17 May 2016, WHO has been notified of 273 cases of Lassa fever, including 149 deaths in Nigeria. Of these, 165 cases and 89 deaths have been confirmed through laboratory testing (CFR: 53.9 percent). The cases were reported from 23 states.
Since August 2015, 10 health care workers (HCW) have been infected with Lassa virus, of which two have died. Of these ten cases, four were nosocomial infections. Just two weeks ago, two medical doctors died from the disease in Anambra and Delta States.
As of 17 May 2016, eight states reported Lassa fever cases (suspected, probable, and confirmed), deaths and/or following of contacts for the maximum 21-day incubation period. Currently, 248 contacts are being followed up in the country. The other 15 previously affected states have completed the 42-day period following last known possible transmission.
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