The World Health Organization (WHO) reports that a little over a year ago, 91 suspected cases of Lassa Fever were reported in the small West Africa state of Liberia.
Terming the prevalence of the disease as “endemic” in the country, the WHO says the cases were reported in six sub-political sub-divisions of Liberia including Grand Kru, Lofa, Margibi, Nimba Grand Bassa and Bong Counties between January, 2017 and January, 2018.
Lassa Fever is also endemic in Guinea and Nigeria.
Citing a recent fatality due to the disease, WHO says, “On 9 January 2018, a patient from Guinea with fever, neck pain, body pain and vomiting was admitted to a hospital in Ganta in Nimba County, Liberia. The patient was treated with Ribavirin until her death on 11 January 2018. The patient first experienced symptoms on 29 December 2017. Prior to hospitalization in Liberia, she sought medical care at a health facility in Diécké in N’Zérékore Region, Guinea where she was treated for typhoid and malaria. On 10 January 2018, a specimen was collected and tested positive for Lassa fever by a reverse transcription polymerase chain reaction (RT-PCR) at the National Reference Laboratory in Liberia. On 11 January, a safe and dignified burial was conducted for the patient in Ganta.”
In its risk assessment, the Geneva based UN agency dedicated to international public health defined Lassa Fever as, “…an acute viral haemorrhagic fever illness that is transmitted to humans via contact with food or household items contaminated with rodent urine or faeces. Person-to-person infections and laboratory transmission can also occur. Overall, the case fatality rate is approximately 1%; however, it can be 15% or more among patients hospitalized with severe symptoms. Early treatment and rehydration improves the chance of survival. Lassa fever causes outbreaks almost every year in different parts of Liberia and West Africa…”
More cases of the haemorrhagic and potentially deadly disease were reported in January of this year, the WHO says.
28 contacts including 16 from the regional Ganta Hospital and 12 family members were identified. From the northern neighbor Guinea, 28 contacts, including 22 health care workers, were identified. And as of January 18, 2018, “two of the patient’s contacts in Liberia were symptomatic, but both tested negative for Lassa fever,” according to the WHO.
More follow ups are being made with the contacts identified. Meantime, Liberia and Guinea have triggered a public health responses:
In Liberia, the Nimba County Surveillance Officer was responsible for coordinating the response to this event.
A rapid response team was deployed to Ganta, Liberia and an investigation mission took place in Diécké, Guinea. A cross-border epidemiological investigation also took place.
In Guinea, an in-depth investigation has been conducted by an epidemiologist, infectious disease doctor and laboratory technicians.
Surveillance has been enhanced at the district and county levels. Contact tracing and active case finding has been conducted in both countries.
A total of 27 blood samples from 24 contacts and three febrile patients in Diecké Primary Healthcare Center, Guinea were collected.
Infection control measures were reinforced in Diécké’s public and private health care facilities.
Infographics on Lassa fever have been made available in Diécké public and private health care facilities and at points of entry.
Community engagement and sensitization activities have taken place in Nimba County, Liberia and Diécké, Guinea to increase awareness about the risks and prevention of Lassa fever.
According to the WHO, due to potential cross-border disease transmission, the WHO country offices of Liberia and Guinea have been collaborating to share information with each other about this event. The WHO has described the pathogen as an “urgent threat”.
Although the trend of the disease in Liberia has remained stable in the last year, the WHO says prevention methods are key and recommends the promotion of “hygienic conditions” such as preventing rodents like mice, rats, gerbils, Guinea Pigs, hamsters and squirrels from entering homes.
“In health care settings, staff should consistently implement standard infection prevention and control measures when caring for patients to prevent nosocomial infections. Travellers from areas where Lassa fever is endemic can export the disease to other countries, although this rarely occurs. The diagnosis of Lassa fever should be considered in febrile patients returning from West Africa, especially if they have been in rural areas or hospitals in countries where Lassa fever is endemic. Health care workers seeing a patient suspected to have Lassa fever should immediately contact local and national experts for guidance and to arrange for laboratory testing,” the WHO advises.
In another West African country, 73 persons have died from a Lassa Fever outbreak. Health authorities in Nigeria have disclosed that the disease has ticked up by 50% in a week.
The Lassa Fever virus was first identified by scientists in 1969.
Liberia, Sierra Leone and Guinea in West African were devastated n 2014 by another deadly pathogen Ebola. The already fragile and relatively non-existent health systems of these West African countries were laid bare at the height of the pandemic.
The Centers for Disease Control (CDC) in the United States reports that out of laboratory confirmed Ebola cases of 15,227 in the sub-region, the disease killed about 11,310 with the bulk of the fatality in Liberia – 4,810 persons.
By Emmanuel Abalo
West African Journal Magazine