H5N1

Nigeria: ‘No cholera, lassa fever in Kaduna’

Via Daily Trust: ‘No cholera, lassa fever in Kaduna’. Excerpt:

Kaduna State Commissioner for Health, Pharmacist Turaki Kalik, has said that there is no cholera or Lassa fever outbreak in Kaduna State as against earlier suspicion of outbreak of the diseases. 

In an interview with Daily Trust, Kalik said, “Some months back, we suspected the outbreak of cholera and Lassa fever, but fortunately there wasn’t any outbreak. Though, we tried to put so many things in place, we procured commodities for our medical stores so that if it comes, we will combat it immediately. We have also positioned our surveillance officers in different locations across the 23 local government areas to be on the alert to report any emergency case.” 

While he harped on inculcating basic hygiene practices as a sure way of averting so many diseases, he stated that the state primary health care agency is developing a strategic plan to make sure that house to house visit by health officers is re-visited and that there will be punishment for anyone who does not keep his/her environment clean.     

Lassa fever: Why there are more public health questions than answers

Via The Guardian: Lassa fever: why there are more public health questions than answers. Excerpt:

I'm in a village in eastern Sierra Leone staring at a row of dead rats snared in branches, leaves and grass. The contraptions are called funnel traps, or tolei in the local Mende dialect. We're hoping these devices and other easily accessible or producible materials will lower the rodent populations in villages sufficiently to prevent Lassa fever. 

With a DfID-funded project called Wash (water, sanitation health), Facility Sierra Leone, Tulane University and Kenema Government Hospital are working in 20 villages introducing Lassa fever education and rodent control training. For the project to be successful, we have to control one of the most ubiquitous rodents in sub-Saharan Africa, Mastomys natalensis — the multimammate rat. 

Lassa fever is common in this part of the country where the disease can wipe out entire households and cause panic throughout villages. The disease has a gradual onset of fever, aches and pains that are indistinguishable from malaria or typhoid — diseases as familiar to villagers as the common cold. 

For some, Lassa fever will progress from these non-specific symptoms to sore throat, facial oedema, haemorrhaging and death. Although Lassa fever and its severe consequences are well-known by residents in this region, fewer know the rat that commonly infests their homes can spread the disease. 

I work with a team based out of KGH. This is the Sierra Leone ministry of health and sanitation's main hub for Lassa fever activities and the only place in the entire country a person can go for laboratory testing and treatment. For the past four years, I've had the privilege of working with five members of the community outreach and disease ecology units based there. We are trying to turn their combined 115-plus years of experience working on Lassa fever into strategies to control the disease. 

We think that connecting the dots from rat to Lassa fever in at-risk communities will mobilise residents. With some training and monitoring, maybe we can make a dent in the burden of this disease. 

We're using the WHO guidelines for control of Lassa fever which include the use of food storage containers and cats along with other interventions such as house repairs and rodent extermination. Eventually, we hope to integrate these methods into sanitation and hygiene programmes, such as community-led total sanitation campaigns, throughout Sierra Leone. 

The reality is we don't yet know what will work to reduce Mastomys to prevent Lassa fever at the community level. The virus was first identified in 1969 and the rodent as harbouring the virus (that is, being its 'reservoir') in 1973. Lassa virus is among the 'viral haemorrhagic fevers' — the terrifying group of viruses that people make movies and write books about. These diseases get attention, not because of the disease burden in endemic countries, but because of the fear they induce in wealthier nations — the fear that a deadly virus will emerge out of Africa (accidentally or intentionally) and cause mass hysteria, morbidity and mortality. 

Expenditures for Lassa fever research have reflected this perspective and have concentrated on detection, vaccine development and treatment rather than prevention and control in endemic areas. So here we are, 40 years after the reservoir was identified, without one empirical piece of evidence on how to prevent Lassa fever and very limited information on how the virus is maintained in rodent populations. 

Many are sceptical Lassa fever can be prevented with rodent control, maintaining that for sustained reduction we need a vaccine. Yet vaccine development of a neglected disease only endemic in west Africa seems unlikely in the near future. The US Centers for Disease Control and Prevention, an organisation that studied Lassa fever from the early 1970s to 2003, states "the complete control of this rodent is impractical." 

In the meantime, more and more cases are reported from Sierra Leone and Nigeria, where the disease is also endemic. The only strategy we now have in our toolbox is good old-fashioned sanitation and hygiene.

Nigeria: Ondo Lassa fever confined to single local government area

Via the Daily Trust: Ondo Lassa fever confined to single LG.

Outbreak of Lassa fever has been confined to a single local government area, Ose, according to local health workers. 

Since January at least nine cases, including a police officer, have been recorded and some of them treated at the lone private hospital which handles Lassa fever, said Dr Stanley Adelabu, medical director of Adelabu Hospital and Maternity, Ose. 

Ondo has received tablets and injections of Ribavirin, used to treat Lassa fever, and teams of medical experts in the wake of outbreak there, but Ose council has called for siting a diagnosis centre in the area. 

Director of local government administration, Olipede Dare, said a diagnosis centre in the area would "avoid taking samples to Irrua Specialist Hospital in Edo State," which alone providesw confirmation for Lassa fever outbreaks nationwide.   

Permanant secretary at Ondo health ministry, Dr Taiwo Oni, who received the drugs, insisted simple rules could help quell the outbreak. 

This, according to him, include "killing all rats at home and making sure that you don’t give room for rats to co-habit with human beings." 

Covering foods and drinks to avoid contamination is also advised.

Nigeria: Two dead from Lassa fever

Via Xinhua: Lassa fever claims 2 lives in Nigeria's middle-belt state: official. Excerpt:

Two people lost their lives on Wednesday in a recent outbreak of Lassa fever in Nigeria's middle-belt Plateau State, according to an official. 

Plateau State Commissioner for Health Fom Dawak told reporters in Jos, the state capital, that a woman and a man died while receiving treatments at the state-run Jos University Teaching Hospital (JUTH) and Vom Christian Hospital respectively. 

"Also, two other persons are currently on admission at the Vom Christian Hospital and are responding to treatment on Lassa fever, " the state official said, adding the Ministry of Health had despatched epidemiologists to popularize knowledge on how to contain the disease. 

There is a high possibility of treatment and survival for early diagnosis, he said. 

The Lassa virus is usually transmitted when the saliva, urine and excreta of the multi-mammalian rats come in contact with humans through their food or water. 

Dawak said another symptom of the deadly fever is bleeding, which is why it is usually referred to as haemorrhagic fever associated with bleeding through the nose, gums and urine.

Nigeria: Government moves to stop Lassa fever in Benue

Via allAfrica.com, a report from the Daily Trust: allAfrica.com: Nigeria: FG Moves to Stop Lassa Fever in Benue. Excerpt:

Makurdi — The Federal Ministry of Health has donated 4,500 doses of both Ribavirin and Virazole tablets including intravenous drugs to the Benue State government to control the spread of Lassa fever in the state. 

This followed the outbreak of Lassa fever which claimed three lives including that of a medical doctor last week at the Benue State University Teaching Hospital in Makurdi. 

State Director of Public Health, Dr. Joseph Kumba, said at the weekend that the Federal Ministry of Health has also dispatched a team of four experts to the state towards containing further spread of the highly contagious disease. 

He confirmed to journalists that the blood samples obtained from the victims and subjected to laboratory test at the Specialist Hospital, Irua in Edo State have revealed the outbreak of Lassa fever in Benue and as such, it is no longer a matter of suspicion. 

"Blood sample of one of the victims was taken to the Federal Government Lassa Fever laboratory at the Federal Medical Centre, Irua in Edo State and it has been confirmed that they had Lassa fever." 

"We are also pleased to inform you that the Federal Ministry of Health has dispatched a team of four to the state to help us contain the epidemic immediately because it is highly contagious and that is why even if we have just a victim we refer to it as an epidemic," Kumba stated.

A quick course in Lassa hemorrhagic fever

One of the treasures of Flublogia is the blog Infection Landscapes, which provides a great deal of information about infectious diseases. The latest post is on Lassa Hemorrhagic Fever. Excerpt:

This week at Infection Landscapes we begin to discuss the last group of viruses to be considered in this extended series on hemorrhagic fevers: the arenaviruses. In general, there is a greater prevalence of human infection in endemic areas than the other viruses causing hemorrhagic fevers that we have discussed in this series. We begin the section on arenaviruses with Lassa fever and follow next time with the American arenaviruses.

Ebola, Marburg and Lassa viruses must be designated as emerging diagnoses

Via News-Medical.net: Ebola, Marburg and Lassa viruses must be designated as emerging diagnoses. Excerpt:

The Ebola, Marburg and Lassa viruses are commonly referred to as emerging diseases, but leading scientists say these life-threatening viruses have been around for centuries. 

In a perspective in the Nov. 9 issue of the journal Science, researchers including a professor at The University of Texas Health Science Center at Houston (UTHealth) say it would be more appropriate to refer to these viruses as emerging diagnoses. 

"The infectious agents were identified around the middle of the 20th century but that does not mean that they were new," said Joseph McCormick, M.D., one of the authors of the perspective and regional dean of The University of Texas School of Public Health Brownsville Regional Campus, which is part of UTHealth. "Some of the viruses, including Lassa and Ebola, have been around for thousands of years." 

The viruses burst onto the scene in the 1960s when outbreaks decimated areas of west and central Africa. The viruses can lead to hemorrhagic fever, a condition characterized by bleeding, shock, vomiting and diarrhea. In severe cases, the death rate may reach 90 percent. 

These viruses thrive in animals - not humans. But people can get the viruses if they come in contact with infected animals or are exposed to virus-infected fluids or tissues. Infected people are moderately contagious with person-to-person transmission only through direct contact with infectious fluids such as blood or urine. Patients with Lassa virus can be successfully treated by antiviral medications. 

With the aid of epidemiologic, ecologic and genetic studies, researchers have learned that these viral hemorrhagic fevers are endemic in several areas of Africa. And, the Ebola viruses are endemic in other parts of the globe. 

"The Arenavirus family of viruses that occur on many continents, of which the African Lassa virus is a member, is an ancient family of viruses that have likely evolved along with their rodent hosts over millions of years," said McCormick, former chief of the Special Pathogens Branch of the Centers for Disease Control and Prevention. 

So what would designating the viruses as emerging diagnoses mean? "It means that these viruses have lurked as enzootic viruses in the environment and that their 'discovery' was related to the scientific capacity to make the diagnosis rather than their 'emergence,''' McCormick said. 

"However, it also means that we also now know more about the risks of encountering them and therefore, how to identify those who may be at risk for infection."

Sierra Leone: Not only cholera but also yellow fever and Lassa fever

The cholera outbreak I reported yesterday seems to be more than that. Via allAfrica.com, a report in the Concord Times: Sierra Leone: Yellow Fever, Cholera, Lassa Fever Outburst-66 Reported Dead. Excerpt:

Director of Disease Prevention and Control at the Ministry of Health and Sanitation, Dr. Amara Jambai, has yesterday disclosed that the outbreak of yellow fever in the Pujehun District, Lassa fever in Kenema district, cholera in Port Loko, Kambia, Pujehun and Kailahun districts and the Western Area has claimed 62 lives so far. 

Speaking to journalists at the weekly press briefing at the Ministry of Information and Communications, Dr. Jambai said the outbreak, which started in three districts but has extended to other parts of the country, should be a serious concern to the government and people of Sierra Leone. 

"Only recently, 367 cases were reported on a daily basis out of the thirteen districts. In the first instance, Lassa fever is a viral disease which is carried by rats. It is spread from infected rodents to humans through direct contact with urine and droppings of an infected rat. Yellow fever on the other hand is potentially a fatal viral infection that is transmitted by mosquitoes. Our investigation team is trekking to Bevehun in the Pujehun District to look into the outburst," Dr. Jambai explained adding that 26 cholera deaths have been reported in Kambia, 22 in Port Loko, nine in Pujehun and another nine in the Western Area which sum up to 62 cholera cases reported since January to date.

Nigeria: Lassa fever kills 5,000 yearly

Via The Nigerian Voice, a report from NBF News: LASSA FEVER: 5,000 NIGERIANS KILLED, 300,000 INFECTED ANNUALLY -EXPERT. Excerpt:

Between 100,000 to 300,000 Nigerians are being infected with Lassa fever virus on a yearly basis, while record has shown that about 5,000 have died. 

A medical expert from the University College Hospital (UCH), Mrs Catherine Ayegboyin disclosed this at the weekend in Ibadan. 

Mrs Ayegboyin, a trained Nurse, while delivering a lecture at Aperin Baptist Church, Ibadan, on the awareness and dangers inherent in contacting the deadly viral disease, said the disease was discovered in 1969 in a village called Lassa in the northern part of the country, where two nurse-missioners were killed. 

She added that the disease had been rampant in countries like Sierra-Leone, Guinea Republic, Liberia and Nigeria, while its causative agent was mainly rodents. 

Aside from being spread through urine and faeces of rodents dropped on foods, Ayegboyin added that the disease was contagious as it could spread through inhaling of the viral disease. According to her, some doctors and nurses in Port- Harcourt lost their lives early in the year to the fever through contact with the infected patients. 

Ayegboyin, who had served at the Sacred Heart Hospital, Abeokuta,Ogun State, disclosed that four personnel were killed in 2009 at the hospital due to unconscious contact with the disease.

Nigeria: 3 doctors, 4 nurses die in Lassa fever outbreak

WHO has published a Global Alert and Response: Lassa fever in Nigeria. Excerpt:

At the beginning of 2012, WHO was notified by the Federal Ministry of Health in Nigeria of an outbreak of Lassa fever. As of March 22, 2012, 623 suspected cases, including 70 deaths have been recorded from 19 of the 36 States since the beginning of the year. 

Laboratory analysis undertaken at the Irrua Specialist Teaching Hospital, Irrua Edo State has confirmed the presence of Lassa virus infection in 108 patients. Three doctors and four nurses were reported to be among the fatalities. This information is provisional and subject to change when laboratory results for Lassa fever in suspected cases become available. 

The Federal and State governments are responding to the outbreak by enhancing the disease surveillance for early detection, reinforcing treatment of patients, and conducting awareness campaigns among the affected population. 

Major challenges are the ongoing security risks in the country limiting access to some areas as well as the limited availability of resources to respond to the escalating outbreak. 

WHO does not advise or recommend any restrictions on travel or trade with Nigeria. Travellers returning from affected areas who develop symptoms of fever, malaise, headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, and abdominal pain should seek medical advice.