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Lassa fever, deadly as Ebola
FOR Nigeria, it never rains but pours. Having overcome the dreaded Ebola disease that broke out in the country in 2014, Nigeria is now faced with another hydra headed monster, Lassa fever that has been described in some quarters as a dreaded viral assassin. The disease has claimed over 80 lives within a space of 12 weeks.
Fuka, a remote village in Muyan Lo¬cal Government Area of Niger State, was where recent cases of Lassa fever were first reported, late last year. By the time it was discovered, 16 people had already died from the virus. It then spread to Bauchi and Kano states, be¬fore hitting 15 other states including Abuja, the Federal Capital Territory.
Having sent over 80 people to their early graves with more than 239 others on watch list, the manner at which it has spread to over 80 local governments and 18 states, has made it a national emergency.
According to the Minister of Health, Prof Isaac Adewole, the affected states are Niger, Bauchi, Kano, Taraba, Riv¬ers, Ondo, Oyo, Edo, Lagos, Plateau, Gombe, Delta, Nasarawa, Ebonyi, Eki¬ti, Kogi and Zamfara, and the Federal Capital Territory.
The fever, according to the World Health Organisation (WHO), is an acute viral haemorrhagic illness caused by Lassa virus, which is transmitted to humans through contact with food or household items contaminated with the excreta or urine of infected multi-mammate rats.
This specie of rats is a common sight in both rural and urban areas in Nigeria. In some parts of the country, especially in Benue State, it is a delicacy.
In order tackle the problem that has become a national emergency, various measures have been taken by the fed¬eral and state governments as well as individuals and organisations.
Penultimate Friday, the Federal Gov¬ernment launched a Public call centre at Nigeria Centre for Disease Control (NCDC) that will serve the country on all public health emergencies.
Launching the centre, Professor Ad¬ewole reiterated the determination of the Buhari administration to provide access to health care information that will keep diseases away from Nigeria. He urged Nigerians to avail them¬selves of the opportunity provided by the centre to help government prevent diseases, especially Lassa fever out¬break.
The minister called on citizens who have symptoms of the fever to call any of the ten (10) numbers: 097000010 to 19 from anywhere in the country and that such calls will be directed to the appropriate state epidemiologists or refer them to the nearest health facil¬ity. The minister also said, where pos¬sible, patients could be picked-up from their locations and taken to the nearest health facility. He assured the public that anyone that uses the call facility would certainly receive help.
Adewole also called on all the states to strengthen their surveillance sys¬tems, report all cases and collaborate with the Federal Ministry of Health in the successful implementation of the Multi-Sectoral Response Strategy to fighting Lassa fever.
In the same vein, the Environmental Health Officers Association of Nigeria (EHOAN), Lagos State Chapter, on Monday said that it had destroyed no fewer than 4,400 rats at six major mar¬kets in the state under its de-rat market programme. Its president, Mr. Samuel Akingbehin, said that his association carried out the exercise at Onigongbo, Oshodi, Oke-Odo, Ikotun Idanwo, Ojuwoye and Mile 12 markets.
He said that de-rating the markets was part of the association’s efforts to curb the spread of Lassa fever in the state. “The exercise is strategic in our effort towards the prevention of com¬municable diseases, This,” he said, was part of efforts by the public and relevant agencies to de-rat markets which was reponsible for the Lassa fe¬ver that had broken out in many states.
Akingbehin appealed to traders from across the state to show under¬standing towards the efforts of the association to rid the markets of rats and rodents. He said that the plan was to de-rat markets in one local govern¬ment area per day starting from 5p.m. The association decided on the time to allow traders and buyers transact their legitimate businesses. ¬
“We also decided to put the exercise in the evening due to the nocturnal nature of rodents and our members had recorded successes in the markets visited till date. It took us about three hours to cover Oshodi market when our mem¬bers went there for the exercise. Today, Mon¬day, we will be visiting Suru-Alaba Market in Orile-Ifelodun LCDA by 5pm with about 400 EHOs to de-rat it.
“We are still calling on all other executive secretaries of the local government areas to as¬sist us toward the elimination of rodents in our markets and our environments,’’ he said.
Ogun State is also one of the states that has shown some proactive steps in this direc-tion. The state governor, Mr. Ibikunle Amosu, recently designated three hospitals to handle cases of Lassa fever just as the government an¬nounced emergency numbers, which residents could call should there emerge any case.
In the same vein, Benue State government has banned eating of rats. The governor, Samu¬el Ortom, gave the directive, and explained that it became necessary, as the state has recorded a case of the virus. Rat is a delicacy popular among the people of the state.
Niger, Bauchi, Taraba, Kano, Nasarawa and Plateau states, where the ailment are believed to be prevalent have not taken up the gauntlet.
Some households in Lagos, which could not afford the cost and services of fumigators bought rat poisons in large quantities and drop them at strategic locations where the rodents are found. Some compounds which could, have employed professional fumigators to eradicate rodents in their environments.
Saturday Sun findings revealed that many are not seeing the virus as a se¬rious threat even when it has claimed more lives than Ebola Virus Disease.
This, according to one of the man¬ufacturers of rat poisons, who have introduced varieties of rat poisons in the market to eradicate rodents in the homestead, Jossy Chukwu, the case of Lassa fever was an opportunity for business boom, but his organisa¬tion has not noticed any difference in sales. “Rat killer is a very impor¬tant product for people to buy. Even before the issue of Lassa fever came up, many people knew that rat is very dangerous to man and his property. In so many homes today, aside sickness, rats have caused a lot of agonies by eating up certificates and other im¬portant documents. Secondly, if rat enters your room, it will make you uncomfortable and sleepless”, he stated.
He said that another reason people kill rats is because they see them as instruments of witches and wizards. “We have observed that some people avoid rats, not because they spread diseases, but because they see rats as evil. So, they do everything possible to chase rats away from their homes always. That is why our business is steady.”
Chukwu was optimistic that with the outbreak of Lassa fever in Nigeria, rat poison business will boom while expressing his readiness to push more of the products to the market. “I am not sure that many people are aware that Lassa fever is caused by rats. But whenever they are aware of the dan¬gers of the disease, I am sure, they will not fail to buy rat killers. And, by so doing, we would make more sales”.
Another producer, David Ohake explained that the outbreak of the dis¬ease has not increased sales at the mo¬ment, but has made production of rat killer become tedious, as efforts are being made to ensure that the products are available in the markets for people to buy. “We have not started making extra sales yet since the case of Lassa fever came up. But we are putting ex¬tra efforts to see that the issue of Lassa fever is dealt with by making rat kill¬ers available, everywhere and at any time they are needed”, he added.
Ohake also explained that corpo¬rate organisations buy the rat killers due to the damages rats have done to their vital documents. “I have some customers from corporate oganisa¬tions who always come to buy rat kill¬ers in large quantities for use in their offices to keep their documents free from rats.”
He was also hopeful that as soon as more people become aware of the disease, rat killer business will boom.
A marketer at Iya Abiye Street, Il¬aje Otumara, Ebute-Metta Lagos, Mr Austin Obisere said sales have not in¬creased as a result of the disease, not¬ing that an active rat killer that is sold between N200 and N500 depending on the brand remains same.
He stated the reason business is moving in the area is because there are so many rats around due to the presence of the lagoon. “Our sales are not based on the fear of Lassa fever because there is low awareness on the disease. The truth is that a lot of people hate rats and do not want to see them.”
Obisere expressed optimism “that now the new disease is said to be kill¬ing many people, there is hope for more sales to be made.”
Another marketer at Ilaje area in Ebute –Metta, Mr. Solomon Okorie said: “We are not feeling the impact of the Lassa fever here in terms of sales. We make our normal sales. People are not even talking about it. Maybe, they have not been well sensitized on the disease.”
A user, Mrs. Daniat Koleosho, admitted that she has been hearing about Lassa fever on the radio and television, but does not understand what it is all about. “For sometimes now, they keep talking about Lassa fever and that it is caused by rat and is as dangerous as Ebola, but I do not believe that because I have not seen who it has killed, even with all these millions of rats around”.
She explained that she had always applied rat killers, anytime she noticed rat in her room because, she does not feel free staying with it. “Even before the Lassa fever they are talking about, I used rat killers because I hate seeing them around me.”
Another user, Elizabeth Uwarue expressed that she has not heard of the disease, yet she is an ardent user of rat killer. “I do not use rat killer be¬cause of Lassa fever, rather, I see rat as a dangerous instrument of the enemy. If it is as dangerous as Ebola, I do not know about that. So, the government needs to do something about it, so that some of us that lack means of infor¬mation could be safe”.
Garri, a staple food in Nigeria is said to be the channel through which the virus spreads, even as there have been campaigns to ban garri as a menu.
Saturday Sun visits to Lagos State University and Lagos State Poly¬technic revealed that some university students are afraid of drinking garri while some others have disposed their raw foodstuffs.
Also, one of Nigerian leading boarding schools, Woodland Hills High School, Jaiye-Oba, Shasha La¬gos State, has also taken it as a duty to remind its students on the Assem-bly ground about, the effect of Lassa fever. They have also taken extra pre¬cautions in keeping the student meals clean. According to the Head of the school, Ebenezer Olaitan Jegede, the school started educating the students immediately they heard that there was an outbreak of the virus in Lagos.
In a bid to curb the spread of the epidemic, medical experts warned Nigerians to apply caution in the consumption of garri. But despite this counsel, Saturday Sun findings revealed that the demand and sales of garri has continued to soar.
Our reporters’ visit to major garri sellers in Oyingbo, Daleko, Iyana- Iba and Ijesha markets revealed that most of the sellers are indifferent to¬wards the news of the outbreak of the disease. They were unruffled by the news linking their commodity to the deadly disease. Although many of the traders are aware of the ailment, some of them were quick to dismiss it by sheer wave of the hand.
Even with the warning, at the pop¬ular Daleko Market, Ijesha and Iyana Iba Markets, reporters observed many traders were intermittently shoveling a sizable pinch of raw garri with their hands straight into their mouths.
A garri seller at Ijesa market, Mr. Anthony Michael, who was also seen chewing the food, disclosed that the demand and price of the staple food have remained stable, and gave rea¬sons why he still chews garri even with the medical warning about the inherent risk. “I don’t believe in all that they are saying about Lassa fe¬ver. People still buy, and I still chew and drink garri. Is it today that rats have lived around man’s surround¬ing? Is this not the same story they peddled during the ‘killer beans’ era? Everybody stopped buying and eat¬ing beans even when we didn’t see any person killed by beans. Last year people were asked to stop eating bush meat because of Ebola. Now they have come again telling us to avoid garri. For me I don’t rely on them to live, I believe my life is in God’s hands.”
At Oyingbo and Iyana Iba Mar¬kets, garri sellers were seen making brisk sales of the commodity. None complained of drop in demand of the commodity. One of the buyers, Mrs. Florence Adaba, who spoke to Sat¬urday Sun, disclosed that though she has heard of the outbreak of Lassa fe¬ver, the news does not deter her from either chewing or ‘drinking’ garri. “The price of garri has not changed so, I still buy and drink it. We keep hearing about death tolls but nobody seems to know the victims. So I chose not to believe it,” she said.
However, some other sellers and buyers that have heard about Lassa fever claimed to have adopted precau¬tionary measures, including de-rating their stores and stalls and tying their garri in sacks. Some of the buyers that spoke to Saturday Sun disclosed that the fear of being infected by Lassa fe¬ver has made them to quit taking garri as a staple food and have switched to eating wheat and pounded yam. “I have heard about it, and I’m con¬scious not to drink or chew my Ijebu garri again. On many occasions, I’ve seen rat faeces inside garri. I buy at the local markets, so my family won’t be consuming garri again, at least for now,” housewife, Mrs. Mary Tolake told our reporter.
Giving more insight into Lassa fever, Dr. Wole Omotehinse of Ola¬bisi Onabanjo University Teaching Hospital, said Lassa fever belongs to Arenavirus category of fever. This, he said, is the type referred to as haem¬orragic fever. Fevers in this group in¬clude Ebola virus and Marbug virus.
On the symptom of the disease, Ometehinse said, Lassa fever symp¬toms vary. According to him, the common symptoms include head¬ache, high fever, tiredness and mus¬cle pains. “These symptoms later progress into some throat, cough, abdominal pain, and diarrhea, and if left untreated, the victim will later start having seizures, and can also start bleeding from nose, and mouth. The victim can also start passing blood, stool and also start breathing from the skin”. He pointed out that the incubation period for Lassa fever is between less than a week to three weeks, and warned that there is noth¬ing like first aid treatment. According to him, “if you notice the symptoms, then there must be prompt diagnosis to be followed immediately by early treatment.”
On the facilities available for its treatment, Omotehinse said govern¬ment has made available some drugs for treatment. Some of these include Ribverin and antibiotics, and the treat¬ment takes about two weeks.
He noted that “at this stage, the vic¬tim will still have to be placed under surveillance because he can still trans¬mit Lassa fever to another person be¬cause the virus can still be in the vic¬tim’s semen for up to three months.”
Lassa fever was described as a ‘disease of the poor’ by the Director of the World Bank funded African Centre of Excellence for Genomics of Infec¬tious Diseases, Redeemer’s Universi¬ty, Ogun State, Prof. Christian Happi. This was corroborated by Dr. Omote-hinse, who opined that those living in rural areas are most vulnerable, say¬ing, “One of the major reasons for this, is that information dissemination is limited, and not only that; treatment and health care facilities are limited.” Lassa fever, according to him, “has been around in Nigeria for about 50 years, but the public awareness has not been strong or has been limited. This is as a result of the fact that Lassa fever affects people in the rural areas. If you see any report of it in the urban area, that means that somebody from the rural area brought it.
“But in Ebola’s case it was brought into Nigeria by a diplomat and the first case was reported in a highbrow hospital in Ikoyi and from there the news spread. Subsequently, informa¬tion dissemination about Ebola be¬came faster. We are lucky that Ebola didn’t come through rural area, oth¬erwise, its effects would have been more devastating”.
Pregnant women, he warned are also vulnerable. “Where pregnant women contact Lassa fever, then the pregnancy has to be terminated in or¬der to save the life of the woman.” He warned that “though rats are the sole carriers, they now transmit the virus to human beings. It is then you now have human being to human being transfer of the virus. Lassa fever can also come through contact with body fluid of victims, which is why you see some health workers including doc¬tors losing their lives to the virus”.
Commenting of what people should eat under the present circum¬stances, he said, “what is important is to keep your food away from rats or rat’s urine and excreta. For now, peo¬ple are also advised not to eat rats, and even if rat is one of your best delica¬cies, if you love yourself, for now, ab¬stain from it. There is nothing wrong in taking garri, but the most important thing is to ensure that the garri is not contaminated. One of the best ways to do this is by ensuring that you put your garri in safe containers”.
Culled from the Saturday Sun Newspapers of January 30th, 2016 edition.