Declare national emergency now; set up interdisciplinary One-Health Committee — NAS
By Sola Ogundipe & Gabriel Olawale
A total of 1,047 Nigerians have died of Lassa fever since the first reported case in 1969, the Nigerian Academy of Science, NAS, has stated.
The NAS is the apex and official science academy of Nigeria, established in 1977 as an association of Nigeria’s foremost scientists.
The President of NAS, Professor Kalu Onuoha, who made the declaration, said that over the past 50 years, Lassa fever has become a disease occurring in perennial outbreaks in nearly all the 36 States of Nigeria, with increasing numbers of suspected cases, dry season peaks, and unacceptably high case fatality rates.
In a statement entitled: Lassa Fever Outbreaks in Nigeria: Time for Positive and Sustained Action, the NAS president said Nigeria should declare Lassa Fever disease a public health event of national emergency.
Onuoha, who stressed that Nigeria must take positive and sustained action necessary to prevent and control Lassa Fever now, said the country should not wait until more fatalities are recorded as a result of the yearly occurrence.
Onuoha said: “The NAS calls on the Federal government to declare Lassa fever disease a public health event of national emergency and to set up interdisciplinary One-Health Committee (comprising of medical and veterinary specialists, epidemiologists, social scientists, media practitioners, community representatives etc.) to advise and assist the Nigeria Centre for Diseases Control, NCDC, in investigating and managing outbreaks.”
He recalled that since Lassa fever was first reported in Nigeria in January 1969, “a total of 16,783 suspected cases have been reported with 1,047 deaths. Of the fatal cases, 73 healthcare workers (doctors, nurses and other categories of hospital staff) have died.
“Between 1969 and 2007, Lassa Fever was reported in only two states (Borno and Plateau). However, from 2008 to 2012, the disease spread to an additional 8 other states; from 2013 until 2019, at least 23 states report Lassa fever cases annually.
“Over the 50-year period of Nigeria reporting 16,783 suspected Lassa Fever cases, 11,195 (67 percent) were reported between 2016 and January 29, 2020, while 632 (60 percent) of 1,047 Lassa fever deaths were reported during the same period.
“In 2016, 921 suspected cases were reported. The respective figures for 2017 and 2018 were 1,030 and 3498 suspected cases. An alarm was raised over the tripling of the number of suspected cases between 2017 and 2018, only for the reported number of suspected cases to rise in 2019 to 5057 which was 145 per cent of the reported 2018 figures.
“During the period 1969 to 1975, the range of Lassa Fever mortality in hospitalised patients was 33 per cent – 100 per cent. In recent years, the mortality rate has dropped to 20 per cent. Laboratory confirmation of suspected cases has been of great concern. Of the 3,498 suspected cases in 2018, only 633 (18 percent) were confirmed Lassa fever positive, while in 2019, only 833 (16.5 per cent) of the 5,057 suspected were confirmed.
The NAS observed that: “Over the past 50 years, Lassa Fever has become a disease occurring in perennial outbreaks, in nearly all the States of Nigeria, with increasing numbers of suspected cases, dry season peaks, and unacceptably high case fatality rates.
“While a drug exists for the treatment of the disease, the inefficient laboratory diagnosis and late hospital admission of patients, add up to make the drug less effective in treating patients. The spread of the disease throughout the country may have resulted from increasing human -rodent contact in an explosive population of rodents generated by pervasive poor environmental sanitation.”
Acknowledging and commending the effort of the federal government, the Federal Ministry of Health, the NCDC, and other relevant agencies, the Academy hereby calls for more action and recommends that: “Government should provide adequate funds for a sensitive disease surveillance system backed by a reliable network of diagnostic laboratories. Given that only about 20 per cent of suspected Lassa fever cases are usually confirmed, there is the need to improve the capability and enhance the capacity of the national laboratory network for reliable and efficient definitive diagnosis of suspected cases.”
Further, NAS said: “The Federal and State Governments need to mount an extensive and sustained public Lassa fever prevention and control awareness programme. Each State should establish a functional isolation ward for the treatment of Lassa fever patients.
“It is important to set up a mechanism for improving environmental sanitation in a sustained manner throughout the country to reduce the rodent population and rodent human contact. Funds should be provided for research into finding new drugs for Lassa fever treatment and the development of vaccine.”