14 December 2021 | Abuja � NCDC intensifies activities for Lassa fever surveillance and response following outbreaks of cases in Nigeria
On the 8th of December 2021, the Nigeria Centre for Disease Control (NCDC) was notified of the death of two persons from Lassa fever. The first case was a pregnant woman who presented in a health facility in Nasarawa State and the next one, a medical doctor involved in the management of the patient that later sought medical care in the Federal Capital Territory (FCT). In addition, another medical doctor linked to the index case has also been confirmed to have Lassa fever and he is currently receiving medical care in FCT. The Nasarawa State Ministry of Health with support of NCDC has commenced an in-depth epidemiological investigation of the cases to understand the possible source of infection and the extent of spread of the disease. Contact tracing of all the close contacts of the patients has commenced.
Following these confirmations of Lassa fever cases in Nasarawa state and FCT, the NCDC has intensified the activities of the national multi-sectoral and multi-disciplinary Lassa fever Technical Working Group (TWG) for Lassa fever surveillance and response in the country. Lassa fever Emergency Operation Centres have also been activated by the affected state and FCT. The NCDC sympathises with the families of the patients and the healthcare workers who have lost their lives to the disease.
Lassa fever is an acute viral hemorrhagic illness that is transmitted to humans through contact with food or household items contaminated by infected rodents. Person-to-person transmission can also occur, particularly in healthcare settings when there is the absence of or inadequate infection control measures. Lassa fever presents initially like any other febrile illness such as malaria, so a high index of suspicion is required especially for attending healthcare workers. Its symptoms include fever, headache, sore throat, general body weakness, cough, nausea, vomiting, diarrhoea, muscle pains, chest pain, and in severe cases, unexplainable bleeding from ears, eyes, nose, mouth, and other body openings. The time between infection and the appearance of symptoms of the disease is 3 to 21 days. Early treatment and diagnosis increase the chances of survival.
The disease is endemic in Nigeria like in several other countries in West Africa, and most cases are seen during the dry season, often between November and May. Since January 2021, a total of 434 confirmed cases with 80 deaths (i.e., a case fatality rate of 18%) have been reported from seventeen (17) States and sixty-three (63) Local Government Areas (LGAs) in Nigeria. See latest situation report here (https://ncdc.gov.ng/diseases/sitreps)
Since 2016, NCDC has worked hard to significantly improve diagnostic capacity for the disease. Currently, seven laboratories have the capacity to test for Lassa fever in Nigeria and this is coordinated by the NCDC National Reference Laboratory (NRL). This has improved active case detection and care for affected individuals which may have gone unnoticed five years ago. In addition, Nigeria through NCDC is participating in the largest ever Lassa fever study supported by Coalition for Epidemic Preparedness and Innovations (CEPI) to provide accurate assessment of the incidence of the disease in West Africa. This is also geared towards the development of vaccine and therapeutics for Lassa fever.
The NCDC continues to provide support to states through the provision of emergency medical and laboratory supplies and by the deployment of Rapid Response Teams (RRT). The RRTs through the State Public Health Emergency Operation Centres (PHEOCs) work with states across all response pillars to strengthen preparedness and response activities. This includes outbreak investigation, contact listing and tracing, response coordination, case management, risk communication, and strengthening infection prevention and control practices.
Following the recommended One Health approach, the NCDC is working with relevant ministries, departments and agencies and partners to strengthen the capacity of states to effectively manage this outbreak alongside COVID-19 and other diseases of public health relevance. Additionally, risk communications activities are ongoing through radio, posters, flyers, and social media. The Federal Ministry of Environment is also implementing a Lassa fever environmental response campaign in high burden states.
To reduce the risk of the spread of Lassa fever, the NCDC offers the following advice:
a) Ensure proper environmental sanitation � i.e. keep your environment clean at all times, block all holes in your house to prevent rats from entry.
b) Cover your dustbins and dispose of refuse properly. Communities should set up dump sites very far from their homes to reduce the chances of having rodents within homes
c) Store foodstuff like rice, garri, beans, corn/maize, etc. in containers that are well covered with tight-fitting lids
d) Avoid drying foodstuffs outside on the floor, roadside where they will be exposed to contamination
e) Avoid bush burning which can lead to the displacement of rats from bushes to human dwellings
f) Eliminate rats in homes and communities by setting rat traps and other means
g) Practice good personal hygiene by frequent washing of hands with soap under running water /or use of hand sanitizers when appropriate
h) Visit the nearest health facility if you notice any of the signs and symptoms of Lassa fever as mentioned earlier, avoid self-medication
Healthcare workers are also advised to practice standard precautions and to maintain a high index of suspicion at all times. Rapid Diagnostic Test (RDT) must be applied to all suspected cases of malaria. When the RDT is negative, other causes of febrile illness including Lassa fever should be considered. Accurate diagnosis and prompt treatment increase the chances of survival.
The Nigeria Centre for Disease Control remains committed to supporting States� public health teams to prevent and respond to public health threats.
About the NCDC
The Nigeria Centre for Disease Control is the country�s national public health institute, with the mandate to lead the preparedness, detection and response to infectious disease outbreaks and public health emergencies. The Bill for an Act to establish NCDC was signed into law in November 2018, by President Muhammadu Buhari. The mission for the NCDC (2017-2021) is �To protect the health of Nigerians through evidence-based prevention, integrated disease surveillance and response activities, using a One Health approach, guided by research and led by a skilled workforce�.
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Dr. Ifedayo Adetifa
DG, Nigeria Centre for Disease Control