While NCDC and health ministry assure citizens, epidemiological figures point to an outbreak getting out of control
Last week, the World Health Organization (WHO) announced that Nigeria’s Lassa fever outbreak has reached record highs with 317 laboratory confirmed cases, according to figures released by the Nigeria Centre for Disease Control (NCDC).
It is worthy to note that while Nigeria is endemic to Lassa fever, figures had never reached this case count in Nigeria before. The number of confirmed cases during the past two months exceeds the total number of confirmed cases reported in 2017.
The outbreak has affected 18 states since the first case was detected on 1 January 2018, resulting in 72 deaths caused by the acute viral haemorrhagic fever. A total of 2,845 people who have come into contact with patients have been identified and are being monitored.
“The ability to rapidly detect cases of infection in the community and refer them early for treatment improves patients’ chances of survival and is critical to this response,” said Dr Wondimagegnehu Alemu, WHO Representative to Nigeria.
The fight against Lassa fever in Nigeria has attracted vast international support involving the WHO and several other donor agencies that are supporting the NCDC-led response with a focus on strengthening coordination (including through the Global Outbreak Alert and Response Network), surveillance, contact tracing, laboratory testing, clinical management of patients, and community engagement. State health authorities are mobilizing doctors and nurses to work in Lassa fever treatment centres.
What is NCDC doing?
Coinciding with the WHO report, NCDC issued a statement informing Nigerians about the outbreak and offered an official account of what it has done so far.
It said it raised the activation of its Emergency Operations Centre to its highest possible level.
“With this escalation, all the resources available to the agency will be focused primarily on controlling this outbreak. The World Health Organisation and other partners are also mobilising resources to support activities of the Centre and the States most affected,” NCDC stated.
Also, Nigeria’s Minister of Health, Professor Isaac Adewole in the recently held Emergency Council of Health meeting in Abuja where he called on all States in Nigeria to escalate their response activities. He requested that each State urgently invest resources in protecting the health of residents of their States by carrying out risk communication activities to inform residents on simple measures to prevent infection, and what to do when they become ill. Healthcare workers across the country have also been re-educated on Lassa fever, especially in recognising early symptoms to ensure rapid referral for appropriate care and on the use of universal precautions to protect themselves and their patients.
“With the activation of the National Reference Laboratory in Abuja, the testing capacity in Nigeria has increased from two to three laboratories. This is in addition to the Irrua Specialist Teaching Hospital and the Lagos State University Teaching Hospital, which were the only two laboratories with the capacity to diagnose Lassa fever. Efforts are currently being made to ensure that there is a functional molecular laboratory with the capacity to test for Lassa fever in each of the six geopolitical zones in the country,” NCDC stated.
It announced that workers in the major treatment centres at the Irrua Specialist Teaching Hospital, Federal Medical Centre Owo and the Federal Teaching Hospital, Abakaliki have received adequate supplies of personal protective equipment to manage their patients from Government and partners.
Big problem
The WHO in its review of the crisis in Nigeria noted that health facilities are particularly overstretched in the southern states of Edo, Ondo and Ebonyi.
“WHO is working with health authorities, national reference hospitals and the Alliance for International Medical Action (ALIMA) to rapidly expand treatment centres and better equip them to provide patient care while reducing the risks to staff. Among those infected are 14 health workers, four of whom have died,” the organization said.
Confirming the development, Dr Alemu added that given the large number of states affected, many people will seek treatment in health facilities that are not appropriately prepared to care for Lassa fever patients and the risk of infection to healthcare workers is likely to increase.
While NCDC’s transparency with the data is widely commended, the regular report of new cases had made several stakeholders to question the efficiency of Nigeria’s current Lassa fever measures.
In its Feb 7 editorial, ThisDay said the Nigerian government could could do more than it is currently doing to tame the Lassa virus.
“What is particularly disturbing is that the relevant authorities are not consistent on adopting simple measures to control the disease after containing the initial outbreak,” ThisDay observed.
This was supported with the unexpectedly high number of health professionals that had contracted the Lassa fever. In Ebonyi state alone, over 40 health care workers had been infected making experts to believe that if hospital health workers are not safe, then who is?
In its position on the continuous spread of Lassa fever in Nigeria, the University Graduates of Nursing Science Association (UGONSA) noted that if the country is serious about stopping the spread of Lassa fever in it hospitals, it would make provision for hand sanitisers, electricity and running water.
“They have become essential commodities in our hospitals, leaving our nurses and physicians with the pathetic option of treating patients largely unprotected,” the association.
The president of the Nigerian Medical Association (NMA), Dr Mike Ogirima, supported UGONSA’s position by decrying the poor condition under which medical practitioners, especially those in public hospitals, work.
“When patients are taken to emergency room, there are no examination gloves and hand sterilisers among other protective gadgets” said Ogrima.
Low level of awareness
Lassa fever has killed way more Nigerians than Ebola virus disease but the later is more popular among Nigerians than Lassa fever and HealthNews.NG is not the only media platform that had made this observation.
On March 2, NCDC Chairman, Dr. Chikwe Ihekweazu, told Channels TV that in spite of the unexpectedly large number of cases so far recorded, things could still get worse.
“We may see more cases of Lassa fever in the next few weeks as we’re looking harder, expanding our diagnostic capacity and increasing awareness. We are however ramping up our response activities also,” he said.
Crunching NCDC’s Lassa fever data showed that 85% of all cases of Lassa fever in Nigeria are from Edo, Ondo and Ebonyi.
“Our response activities here are intensified and NCDC Rapid Response Teams are supporting the State,” NCDC said recently.
Ihekweazu during his Channels interview added the NCDC is strengthening its messages to the general public and health workers.
“This has gone down to the front line where we have primary health care centres,” he said.
But many Nigerians attending clinics at private and public health centers in various parts of the country are not informatively aware of how the disease could be prevented. This is further made complex by the condition’s less unique symptoms that could be confused with other conditions – fever, sore throat, vomiting, back pain, cough, abdominal pain, restlessness, and general body weakness.
This is more reason why steps should be taken by the federal government to direct all health facilities in the country to emphasise routine infection prevention and control measures.
“Healthcare workers should also be advised to always be careful to avoid contact with blood and body fluids in the process of caring for sick persons,” ThisDay recommended.
