Protocol
I wish to begin this press briefing by wishing the citizens of Nigeria a Happy and Prosperous New Year, and to allay their fears on the current epidemic outbreaks of a Haemorrhagic Fever now confirmed by our laboratories to be Lassa Fever Viral Disease.
The public is hereby assured that the government and its partners, and other stakeholders are working tirelessly to address the outbreak and bring it to timely end.
It is important that I notify the nation through you, that in the last 6 weeks Nigeria has been experiencing Lassa fever (LF) outbreak which has so far affected 10 states. The States affected include Bauchi, Nassarawa, Niger, Taraba, Kano, Rivers, Edo, Plateau, Gombe and Oyo States. The total number so far reported is 81 and 35 deaths, with a mortality rate of 43.2%. Our laboratories have confirmed 17 cases, indicative of a new roundtrip of Lassa fever outbreak.
The first case of the current outbreak was reported from Bauchi in November, 2015. This was followed by cases reported by Kano State, and subsequently the other states mentioned above.
Lassa fever is an acute febrile illness, with bleeding and death in severe cases, caused by the Lassa fever virus with an incubation period of 6-21 days. Lassa fever was first detected in Nigeria 1969. The number of recorded cases peaked in 2012 when 1,723 cases with 112 fatalities were recorded. It has continued to decline since then. About 80% of human infections are asymptomatic; the remaining cases have severe multi-system disease, where the virus affects several organs in the body, such as the liver, spleen and kidneys. The onset of the disease is usually gradual, starting with fever, general weakness, and malaise followed by headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and bleeding from mouth, nose, vagina or gastrointestinal tract, and low blood pressure.
The reservoir or host of the Lassa virus is the “multimammate rat” called Mastomys natalensis which has many breasts and lives in the bush and peri-residential areas.
The virus is shed in the urine and droppings of the rats can be transmitted through direct contact, touching objects or eating food contaminated with these materials or through cuts or sores. Nosocomial transmission also occurs in health facilities where infection prevention and control practices are not observed. Person to person transmission also occurs most especially when a person comes in contact with the virus in the blood, tissue, secretions or excrements of an infected individual.
In response to these reported outbreaks, the Federal Ministry of Health under my leadership has taken the following measures to curtail further spread and reduce mortality among those affected:
i.Immediate release of adequate quantities of ribavirin, the specific antiviral drug for Lassa fever to all the affected states for prompt and adequate treatment of cases.
ii.Deployment of rapid response teams from the Ministry to all the affected states to assist in investigating and verifying the cases as well as tracing of contacts.
iii.Clinicians and relevant healthcare workers had been sensitized and mobilized in areas of patient management and care in the affected states.
iv.Affected States have been advised to intensify awareness creation on the signs and symptoms including preventive measure such as general hygiene.
Furthermore, it is important to note that Nigeria has the capability to diagnose Lassa fever. All the cases reported so far were confirmed by our laboratories. However, due to the non-specific nature of Lassa fever symptoms and varied presentations, clinical diagnosis is often difficult and delayed, especially in the early course of the disease outbreak.
In view of the major steps taken so far and the need to interrupt transmission in the communities and our health facilities urgently, it is important that I advise that the public is sensitized immediately using electronic and print media. In addition, health educational materials were distributed to all States, particularly the affected areas for effective health promotion to enhance good “community hygiene” including food hygiene and food protection practices. I urge all to ensure that they avoid contact with rodents/rats as well as food/objects contaminated with rats’ secretions/excretions. Avoid drying food in the open and along the roadside. It is also important to cover all food to prevent rodents’ contamination. Lastly, all suspected cases should be reported immediately to enable early treatment.
Family members and health care workers are advised to always be careful and avoid contact with blood and body fluids while caring for sick persons with symptoms similar to those listed for Lassa fever and any such patients should be taken to nearest health facility.
All health facilities in the country are hereby directed to emphasize routine infection prevention and control measures, and ensure that all patients are treated free.
Additionally, all health care workers should have a high index of suspicion of Lassa Fever in patients presenting with febrile illnesses particularly in endemic states, and all suspected cases should be reported to NCDC/FMOH and the State Epidemiologists.
On the basis of the effective control measures now instituted by the FMOH, no travel restrictions will be imposed from and to areas currently affected.
Healthcare workers seeing a patient suspected to have Lassa fever should immediately contact the State Epidemiologist in the state ministry of health or call the Nigeria Centre for Disease Control and Federal Ministry of Health using the following numbers: 08093810105, 08163215251, 08031571667 and 08135050005.
To support States and minimize impact and reduce mortality FMOH has procured and distributed additional Ribavirin for immediate treatment purposes and creation of strategic stock for future possible cases.
The World Health Organization (WHO) is being notified of the cases confirmed, and I wish to seize this opportunity to express my sincere gratitude to the WHO and other partners for the support so far.
The Nigeria Centre for Disease Control (NCDC) is already coordinating all our response activities and reporting to me on daily basis.
The Nigerian Government will continue to enhance its surveillance and social health education, information and communication activities to prevent the disease from spreading further in Nigeria. I wish to call for the support and understanding of all Nigerians.
I thank all our dedicated staffs on the field that are working tirelessly to curtail this outbreak. Finally, I thank all our partners who are supporting us in this trying time.
Thank you and God bless the Federal Republic of Nigeria.
Professor Isaac F. Adewole FAS, FSPSP, DSc(Hons)
Hon Minister of Health,
Federal Republic of Nigeria
8th January 2016
About Lassa fever
Lassa fever is an acute viral illness that occurs in west Africa. The illness was discovered in 1969 when two missionary nurses died in Nigeria. The virus is named after the town in Nigeria where the first cases occurred. The virus, a member of the virus family Arenaviridae, is a single-stranded RNA virus and is zoonotic, or animal-borne.
Lassa fever is endemic in parts of west Africa including Sierra Leone, Liberia, Guinea and Nigeria; however, other neighboring countries are also at risk, as the animal vector for Lassa virus, the "multimammate rat" (Mastomys natalensis) is distributed throughout the region. In 2009, the first case from Mali was reported in a traveler living in southern Mali; Ghana reported its first cases in late 2011. Isolated cases have also been reported in Côte d’Ivoire and Burkina Faso and there is serologic evidence of Lassa virus infection in Togo and Benin.
The number of Lassa virus infections per year in west Africa is estimated at 100,000 to 300,000, with approximately 5,000 deaths. Unfortunately, such estimates are crude, because surveillance for cases of the disease is not uniformly performed. In some areas of Sierra Leone and Liberia, it is known that 10%-16% of people admitted to hospitals every year have Lassa fever, which indicates the serious impact of the disease on the population of this region.
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