By Sola Ogundipe
IN the last fortnight or thereabouts, the Southwest has been on edge over Lassa fever outbreak in Lagos and Ogun states. Between the two states, a total of six confirmed cases and two deaths were recorded, while 256 were placed on surveillance at the Lagos University Teaching Hospital, LUTH; Mainland Hospital, Yaba, Lagos, and Federal Medical Centre, Abeokuta.
Surveillance officers and health workers in the two states have since been on high alert, even as Ogun State confirmed case of Lassa fever and the LUTH, assured that confirmed cases in the institution are responding to treatment. In Lagos, two deaths were recorded with five confirmed infected cases and at least 150 suspected cases under surveillance, while Ogun had one confirmed case and around 106 placed under watch.
A deluge of media reports have trailed the development since the LUTH, confirmed deaths of patients and infections of healthcare workers by the deadly virus. Both patients were said to have presented themselves very late and died in spite of spirited efforts to save them. Management of the LUTH confirmed the deaths during a press conference Tuesday last week even as it revealed that a Resident doctor that was infected with the Lassa virus was admitted into the isolation centre.
Lassa fever infection
The newest outbreak began with an unnamed 32-year old pregnant woman that was presented at the LUTH with a bleeding disorder, died three days later after a stillbirth. She had been referred from a private hospital in Imota Town in Ikorodu and a post-mortem examination later confirmed Lassa fever infection, but the corpse had been released prior to this discovery.
The woman’s family had collected the corpse for burial, unaware of the cause of death and made arrangements to transport the body to Ilesha. However, the Disease and Epidemiology Unit of the Lagos State Ministry of Health stepped in and alerted state epidemiologists in Osun State. All HODs in lkorodu LGA and the five LCDAs were put on alert.
The Resident doctor that was infected who was from the Department of Anatomic and Molecular Pathology took part in the autopsy and later came down with the disease. No less than 150 contacts including hospital workers exposed to the index case were placed under watch. The second victim simply identified as Mr. O, a known sickle cell anaemia patient, died within 24 hours after admission. He was said to have travelled from a neighbouring state and came down with the disease on arrival in Lagos.
Unlike the index case, officials of the Lagos State Environmental Health Monitoring Unit, SEHMU, took over possession of the body for burial in accordance with regulations of the World Health Organisation. The Director, Disease Control, Lagos State Ministry of Health Dr. Eniola Erinosho, who confirmed the burial said consent was obtained from the family and that the outbreak was being confirmed. At the time of this report, LUTH had discharged one of the infected patients who fully recovered, and also cleared 60 of those under watch.
In Ogun, the Commissioner for Health, Dr. Babatunde Ipaye, who confirmed the outbreak, said a 20-year-old patient tested positive for the Lassa virus and had been moved to an isolation centre in the Federal Medical Centre, Abeokuta. The patient, a resident of Abeokuta, reportedly travelled to Lagos and came down with the symptoms on returning to Abeokuta. He is currently recovering.
Lassa fever or Lassa haemorrhagic fever (the bleeding fever), an acute viral haemorrhagic illness caused by Lassa virus, is transmitted to humans from contacts with food or household items contaminated with rodent faeces or urine. According to the experts, just one confirmed case of Lassa fever is an epidemic. However, the outbreaks tend to be small and self-limiting.
The disorder is often a predictor of a significantly higher risk of death preceded by shock and vascular collapse. Experts say even though 80 per cent of infections elicit no symptoms, if they do occur, they can be quite nasty.
It would not be the first time LUTH would be having Lassa fever outbreak. In fact, Lagos and Ogun have witnessed several Lassa fever outbreaks in the past. One incident was in January 2016, when Lagos confirmed two deaths from three confirmed cases with over 500 contacts placed under surveillance in the state.
One of the victims was a 27-year-old lady that died after admission at Ijede General Hospital where she presented with fever, vomiting, diarrhoea and body weakness. The unnamed lady had earlier travelled to Edo State in December, 2015 and returned to Lagos earlier in January, 2016.
Ogun State also recorded a series of Lassa fever outbreaks in 2016. The deaths included a 28-year-old man admitted into the isolation unit of the Olabisi Onabanjo University Teaching Hospital; a mortician and a nurse, both died after they contracted the deadly infection from a Lebanese that also later died at the Federal Medical Centre, Abeokuta.
Starting with a fever, Lassa infections can develop into chest pain, vomiting and diarrhoea. In at least a third of cases, victims develop various degrees of deafness, sometimes leading to permanent hearing loss. An infected person may die within two weeks of manifesting initial symptoms because of multi-organ failure.