The recurring outbreaks of Lassa fever across the country leading to multiple deaths have assumed a worrisome dimension. With many deaths associated with each outbreak of the Lassa fever virus, many Nigerians are anxious to know what the virus really is and how to treat it. In this interview with Anya Victor, the Senior Doctor at the Blue Cross Hospital, Ogba-Lagos, Dr. Gideon Edekunu speaks on how to contain the spread of the virus and its treatment.
Many deaths have been traced to Lassa fever over the years, what is Lassa fever?
Lassa fever belongs to the group of diseases known as viral haemorrhagic fever, the various diseases that are classified under this group include: the popular Ebola, Marburg, Yellow fever, Lassa fever etc. The obvious symptoms of viral haemorrhagic fever include: high grade fever, joints and general body pains, malaise and bleeding through the orifices. Bleeding is known medically as haemorrhage. So, Lassa fever is a disease that is caused by a virus known as Lassa virus which belongs to the group of viruses known as arena viridi. Lassa fever is common in the country.
What are the common symptoms of Lassa fever? How can we easily identify the symptoms of Lassa fever?
It is certain that eighty percent of people infected by the Lassa fever virus will not develop any symptoms. But of the remaining twenty percent of it; one out of every five which is twenty percent of the remaining twenty percent will develop very serious disease which will affect their kidneys, livers and other organs of the body. Now, for the other infected persons that will develop mild symptoms, the symptoms are very vague and this is why it is very difficult to differentiate between someone who has Lassa fever from someone that has malaria because the symptoms range from fever; that is hotness of the body, malaise; that is general weakness, muscle pains, chest pains, sore throat, cough, catarrh; all of these vague symptoms are also similar to the symptoms of malaria, fever, yellow fever etc. This is why it is very difficult to differentiate between Lassa fever and malaria. But infected persons who have undergone the vague symptoms will develop very severe symptoms such as bleeding from the mouth, nose, virginal and anus. This stage can lead to more serious disease like renal failure. These are symptoms of Lassa fever.
As you were explaining the symptoms of Lassa fever, you did say that eighty percent of persons with the virus will not develop the symptoms, why is it so?
About eighty percent of those who contract the Lassa fever virus may not develop any symptoms because viral diseases are self-limiting and human beings also have innate immunity. This is because God has created immunity in our bodies; our white blood cells help us to fight diseases. To this end, healthy people who have intact immunity, once the virus comes in contact with their bodies such bodies with intact immunity will destroy the virus. So, this is why about eighty percent with the virus will not develop the symptoms.
It is widely reported that rats are the major carriers of the virus that causes Lassa fever, what species of rats carries the deadly virus?
Every rat should be considered a threat because it is not easy to identify the rat that carries the Lassa fever virus and which does not carry it except it is diagnosed. However, the species of rats that carries the Lassa fever virus iscalled Mastomys natalensis also known as Natal multimammate is the natural reservoir of the Lassa fever virus. This species of rats has multiple and prominent mammary glands.
Lassa fever is a communicable disease, apart from rats, what other agents spread the virus that causes Lassa fever?
The Mastomys natalensis is the natural reservoir of the virus that causes Lassa fever. When human beings are infected by the virus they can spread it to other human beings. So, human beings are important carriers of the virus.
How do people contract the virus that causes Lassa fever?
People contract the Lassa fever virus when they eat foods like garri, rice, beans, powder milk that have been contaminated by the urine and excreta of the Mastomys natalensis rats. People can also contract the virus by touching, kissing and having contacts with the fluids of people that have the virus.
It is said that coming into contact with the urine of the species of rats that carries the virus that causes Lassa fever makes one to contract the disease. How can Nigerians avoid contracting the virus since they like to drink garri and it is also said that rats usually urinate on most garri that is sold in the market?
This is a very funny question. You have to be very sure of your source of garri, I am saying this because I am from the region of Nigeria where garri is well processed and I am familiar with the processes that cassava goes through to become garri. First and foremost, I would advise that you should have a good source of garri. Personally, I don’t buy garri just from anybody is either I get from my home state or I know people in Lagos who get from my home state; I am sure of where I am getting my garri. Second, having gotten the garri, you need to get protective containers like in my house I have plastic containers that have covers so that your garri, rice or other foodstuffs can be protected from being invaded and infested by rats. During the outbreaks of the virus, I will not advise Nigerians to drink garri even though we like to drink garri because you can never be hundred percent sure of the garri that is contaminated by the virus or not. But when there are no outbreaks of the virus, you are free drink garri at will.
Lassa fever is described as a West African disease, why is it described as a West African disease? Is it only in West Africa the disease is found?
Lassa fever is described as a West African disease because the outbreak of the virus occurred first in a village called Lassa in the present Borno State in 1969. Since then several outbreaks of the virus have been reported in other West African countries such as Sierra Leon, Mali, Ghana, Liberia, Republic of Benin etc. It started in Nigeria and it has spread to some other West African countries. Though, there have been outbreaks of the virus in a few other parts of Africa, it is prevalent in West Africa.
It is believed that Lassa fever is the second most deadly disease after Ebola, how true is this?
It is so because of all the viral haemorrhagic diseases that have been reported in the world, Lassa fever is the second most deadly disease after Ebola because it can cause the deaths of many people within a short period of its outbreak just like Ebola but it can be cured if it is diagnosed and treated early with the appropriate drug. But Ebola has no known cure yet.
Why is Lassa fever so deadly?
Lassa fever is deadly because it affects every organ of the victim. Again, it is very difficult to diagnose as its symptoms are vague and similar to those of other common diseases like typhoid fever, yellow fever, cough, cold, malaria, so it is very difficult to differentiate these symptoms from that of Lassa fever as the patient may be treated for the above mentioned diseases. Also, Lassa fever is not easily diagnosed because there are few diagnostic centres in Nigeria and before the samples from the infected patient are taken to the diagnostic center the patient might have developed complications and died.
Where are the diagnostic centres located in Nigeria?
The diagnostic centres are located in Edo State University Teaching Hospital, Irrua, University of Calabar Teaching Hospital, Calabar, University of Nigeria Teaching Hospital, Nnsuka, Lagos University Teaching Hospital, Iddi Araba, and Aminu Kano University Teaching Hospital, Kano. These are the five diagnostic centres in the country for Lassa fever.
How can the spread of Lassa fever be prevented?
There must be massive campaigns about Lassa fever. I must commend the Nigerian Government for the way they handle the Ebola outbreak. I was working in Delta State then and on every radio station in Delta State was talking about it, at least in every 30 minutes, there was massive sensitization programme going on then. There were jingles on radio and television stations. People have to know the cause of the disease, people have to know the symptoms of the disease, people have to know when to seek help. So, the government I think, will have to play a very key role here in order to sensitize the people about the disease.
There should be public private partnership in containing the spread of the disease by providing soaps and water with which people can wash their hands in various primary and secondary schools, organizations and companies just as we have in our hospitals. Government should build a diagnostic centre in every local government so that people do not travel over long distances before they can access a diagnostic centre.
Also, healthcare professionals should always wear gloves and other protective materials before they examine their patients so that they don’t spread the virus. People should stop self-medication; they should always visit the hospitals whenever they fall sick. Individuals who have cough, cold or fever should seek help in hospitals instead of engaging in self-medication or patronizing local patient medicine vendors. Medical doctors should be proactive in handling their patients, if a patient has been treated for malaria, fever, typhoid fever three times or more in a week without improvement, such a patient should be diagnosed for Lassa fever virus as the disease has a window of between 6-21 days of incubation period before the symptoms of Lassa fever virus emerge. If such a person is not responding to ant-malaria and antibiotic, the person should be recommended for Lassa fever diagnosis.
Is there a cure for Lassa fever yet?
The only known medicine for the treatment of Lassa fever presently is ribavirin which is an antiviral agent. But for it to be effective, it must be administered to the patient at the early stage of contracting the disease because once the virus has developed into an advanced stage it will be difficult for the drug to be effective. Also, it should be combined with supportive treatment by giving the patient IV fluid and treatment for pains should be added.
What is the percentage rate of survival for a patient that has Lassa fever?
For those who sought treatment early over 80 % of them will survive. However, for those who didn’t seek treatment early and the virus has developed in them, over 80% of them will die.