Prevention by Education on Lassa Fever

We were able to curb Ebola with awareness and healthy living, although we lost people, the Lassa fever has killed more people than Ebola did in Nigeria, and even though it has not reached outbreak status, we pray we can curb it at the epidemic level, help by sharing information to friends and family… CkNaija2016

“The Federal Ministry of Health has confirmed that out of the 76 victims of Lassa fever outbreak, 35 had lost their lives.This disclosure came as panic spread across the country with 10 states said to be battling to curtail the spread of the disease.

The affected states are: Bauchi, Nassarawa, Niger, Taraba, Kano, Rivers, Edo, Plateau, Gombe and Oyo.
The Minister of Health , Prof Isaac Adewole, in a statement issued in Abuja in response to the outbreak of disease in the country, said “the total number of suspected cases so far reported is 76 with 35 deaths, and a Case Fatality Rate of 46 per cent.”

But the federal government yesterday said the impact had not reached the magnitude which the disease could be declared a national emergency.” ~ ThisDayLive

“The first case of the current outbreak was reported from Bauchi in November, 2015. This was followed by cases reported by Kano State, and subsequently the other states mentioned above. “Lassa fever is an acute febrile illness, with bleeding and death in severe cases, caused by the Lassa fever virus with an incubation period of 6-21 days. Lassa fever was first detected in Nigeria in 1969.The number of recorded cases peaked in 2012 when 1,723 cases with 112 fatalities were recorded. It has continued to decline since then. 
“About 80% of human infections are asymptomatic; the remaining cases have severe multi-system disease, where the virus affects several organs in the body, such as the liver, spleen and kidneys. The onset of the disease is usually gradual, starting with fever, general weakness, and malaise followed by headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and bleeding from mouth, nose, vagina or gastrointestinal tract, and low blood pressure.” ~ ThisDayLive 
For more about this article visit 

http://www.thisdaylive.com/articles/lassa-fever-spreads-to-10-states-fg-confirms-35-deaths/229961/
healthcare workers seeing a patient suspected to have Lassa fever should immediately contact the State Epidemiologist in the state ministry of health or call the Nigeria Centre for Disease Control and Federal Ministry of Health using the following numbers: 08093810105, 08163215251, 08031571667and 08135050005.
Symptoms of Lassa fever

The incubation period of Lassa fever ranges from 6-21 days. The onset of the disease, when it is symptomatic, is usually gradual, starting with fever, general weakness, and malaise. After a few days, headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and abdominal pain may follow. In severe cases facial swelling, fluid in the lung cavity, bleeding from the mouth, nose, vagina or gastrointestinal tract and low blood pressure may develop. Protein may be noted in the urine. Shock, seizures, tremor, disorientation, and coma may be seen in the later stages. Deafness occurs in 25% of patients who survive the disease. In half of these cases, hearing returns partially after 1-3 months. Transient hair loss and gait disturbance may occur during recovery.
Death usually occurs within 14 days of onset in fatal cases. The disease is especially severe late in pregnancy, with maternal death and/or fetal loss occurring in greater than 80% of cases during the third trimester.
Transmission

Humans usually become infected with Lassa virus from exposure to urine or faeces of infected Mastomys rats. Lassa virus may also be spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of a person infected with Lassa fever. There is no epidemiological evidence supporting airborne spread between humans. Person-to-person transmission occurs in both community and health-care settings, where the virus may be spread by contaminated medical equipment, such as re-used needles. Sexual transmission of Lassa virus has been reported. 
Lassa fever occurs in all age groups and both sexes. Persons at greatest risk are those living in rural areas where Mastomys are usually found, especially in communities with poor sanitation or crowded living conditions. Health workers are at risk if caring for Lassa fever patients in the absence of proper barrier nursing and infection control practices.
Diagnosis

Because the symptoms of Lassa fever are so varied and non-specific, clinical diagnosis is often difficult, especially early in the course of the disease. Lassa fever is difficult to distinguish from other viral haemorrhagic fevers such as Ebola virus disease; and many other diseases that cause fever, including malaria, shigellosis, typhoid fever and yellow fever. 
Definitive diagnosis requires testing that is available only in specialized laboratories. Laboratory specimens may be hazardous and must be handled with extreme care. Lassa virus infections can only be diagnosed definitively in the laboratory using the following tests:
antibody enzyme-linked immunosorbent assay (ELISA)

antigen detection tests

reverse transcriptase polymerase chain reaction (RT-PCR) assay

virus isolation by cell culture.

Treatment and vaccines

The antiviral drug ribavirin seems to be an effective treatment for Lassa fever if given early on in the course of clinical illness. There is no evidence to support the role of ribavirin as post-exposure prophylactic treatment for Lassa fever.
There is currently no vaccine that protects against Lassa fever.
Prevention and control

Prevention of Lassa fever relies on promoting good “community hygiene” to discourage rodents from entering homes. Effective measures include storing grain and other foodstuffs in rodent-proof containers, disposing of garbage far from the home, maintaining clean households and keeping cats. Because Mastomys are so abundant in endemic areas, it is not possible to completely eliminate them from the environment. Family members should always be careful to avoid contact with blood and body fluids while caring for sick persons. 
In health-care settings, staff should always apply standard infection prevention and control precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe burial practices.
Health workers caring for patients with suspected or confirmed Lassa fever should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials such as clothing and bedding. When in close contact (within 1 metre) of patients with Lassa fever, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).
Laboratory workers are also at risk. Samples taken from humans and animals for investigation of Lassa virus infection should be handled by trained staff and processed in suitably equipped laboratories. 
On rare occasions, travellers from areas where Lassa fever is endemic export the disease to other countries. Although malaria, typhoid fever, and many other tropical infections are much more common, the diagnosis of Lassa fever should be considered in febrile patients returning from West Africa, especially if they have had exposures in rural areas or hospitals in countries where Lassa fever is known to be endemic. Health-care workers seeing a patient suspected to have Lassa fever should immediately contact local and national experts for advice and to arrange for laboratory testing.
Source : World Health Organisation site 

http://www.who.int/mediacentre/factsheets/fs179/en/

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