Nigeria: Lassa Fever

[Shiloh]

Source: http://www.huliq.com/30/78694/nigeri...assa-fever-edo

Nigeria Carries Battle Against Lassa Fever To Edo

In continuation of the Federal Ministry of Health?s battle against the outbreak of Lassa Fever epidemic in some parts of the country, the Minister of Health, Professor Babatunde Osotimehin was in Irrua, Edo State, to commission the Lassa Fever Diagnostic and Research Laboratory, ministry sources have said.

The epidemic, which reportedly claimed six lives within two weeks of outbreak, has engaged the attention of the minister who had immediately directed the ministry?s department of Public Health to increase surveillance in all the affected states.

Professor Osotimehin had directed that Ribavirin, an anti-retroviral drug for Lassa fever, other drugs and protective clothing be given to the Federal Capital Territory (FCT) Health Department and other health facilities in FCT and environs for prompt and adequate treatment of cases and contacts.

The minister is expected to use the occasion of commissioning of the laboratory centre to continue his campaign for more commitment from the state and local governments to make better use of their closeness to the grassroots to curtail and control the spread of the disease.

Speaking earlier in the month, Osotimehin had called on the state governments to do more. ?State Government should wake up to their responsibilities of giving adequate attention to healthcare in their states. It is also very important that you establish task forces in your domains to ensure early detection of epidemics,? he
had said.

The laboratory at Irrua, a BSL-3 facility, with equipments donated by the Harvard University, USA and The Bernard-Notch Institute of Tropical Medicine, Hamburg, is the only diagnostic and confirmatory laboratory in Nigeria. There are however three diagnostic laboratories located at Owerri, Maiduguri and Ibadan.

Meanwhile, Nasarrawa State and the FCT have been the areas affected mostly. The minister had commended both the FCT Minister and the Governor of Nasarrawa State for working closely with the ministry for the control of the epidemic. Osotimehin, in a chat, disclosed to journalists that the ministry has received commitments from the World Health Organisation, WHO and the World Bank to offer assistance to help establish more laboratories in at least two more strategic locations before the end of the year.

[Shiloh]

Re: Nigeria: Lassa Fever

Source: http://www.ngrguardiannews.com/news/...Lasser%20Fever

Gari, Bush Rat May Cause Lasser Fever
From Terhemba Dake, Abuja

PEOPLE who eat gari, a staple food in the country and bush rats run a high risk of contracting the dreaded Lassa fever, National Lassa fever Stakeholders' Forum of Nigeria disclosed yesterday.

The association made the revelation in Abuja yesterday when it presented a memorandum to the Chairman House Committee on Health Alaba Lad-Ojomo.

Speaking at the presentation, Chairman of the Association, Prof. George Akpede, said people who hunt bush rat, which he noted is a delicacy in some parts of the country, without wearing gloves while removing the entrails of the animals are at high risk of contacting the Lassa virus.

He explained that the risk factor for them is very high because the fact that the rat carries the virus mainly lives in bushes around domestic settlements, he also noted that "in the production of garri, the grains are usually spread in places that are rat-infested and as such may have been contaminated by the faeces and urine of the dangerous rodents.".

He however said that "given the difficult position this situation may have put millions of people who are consume the commodity, the only way out is to ensure that the gari are re-warmed in a pot or micro-wave before it is soaked".

He said the incidence of Lassa fever has reached a state of national emergency with 51 million people being at risk across the country and 3 million cases being reported in the country annually.

"One single case is regarded by the World Health Organization (WHO) as an epidemic. A situation where many states and local governments are affected is a major disaster by all means," he said.

The scourge, according to him is responsible for 58, 330 deaths per year.

"Lassa fever accounts for at least 6 to15 per cent of fever in patients in endemic areas in the country. Outside outbreaks, over 15 to 20 percent hospitalized for Lassa fever died from the illness. It is also a common and important cause of deafness, maternal and foetal deaths in endemic areas.

"We believe that the problem of Lassa fever rivals that of HIV/AIDS, if it is not more serious," he said.

He noted that a more serious approach is needed to battle the Lassa fever problem.

The group also want an Act to establish a National Agency or Commission on Emerging and Re-emerging Infectious Diseases, noting that over N1.25 billion would be needed for a standard institute for the control and treatment of the fever.

The chairman of the House committee on Health, Ojomo said the committee would partner with the group to ensure that the Lassa fever epidemic is stopped.

[Shiloh]

Re: Nigeria: Lassa Fever

Source: http://www.vanguardngr.com/content/view/31531/122/

W.A.R (War Against Rats) in Lagos over Lassa fever
Written by Sola Ogundipe
Saturday, 21 March 2009

Fall out of Lassa fever Search, find and destroy? is a slogan that is fast gaining ground in the city of Lagos as several inhabitants of the sprawling metropolis embark on what appears to be a vicious and unprecedented extermination of rats and mice.tbreak:

Granted, there have been no love lost between the average Lagosian and rodents in the environment; this latest level of intolerance is in a class of its own. Such has been the intensity, sincerity and enthusiasm of this ?anti-rat war? that the population of rats known in local parlance as eku asin in Yoruba, jaba in Hausa and nkapia or nkakwu in Igbo is under serious threat. Apparently, the development is coming in the wake of the Lassa fever epidemic that has gripped parts of the nation including Lagos State of late.

Saturday Vanguard gathered that while killing of rats has been a routine activity in densely populated areas such as Mushin, Ketu, Ikotun, Egbeda, Ajegunle, Agege and Ikeja amongst others, it had been more of a pastime and amusement exercise for the layabouts, jobless youths and dregs of the slums of the city.

However, the latest aggression against the rat and mice population smacks of a no-holds-barred battle for supremacy between man and rodent to determine who actually dominates Nigeria?s commercial nerve center.

In homes, schools, offices, shops and virtually every place of human activity, the new attitude of zero-tolerance for rats that has taken root, is not unconnected with recent reports of deaths linked to the Lassa fever outbreak. With this scare on their minds, people are going about the elimination of rats with a passion as if there has been an invasion of the vermin.

With sticks, brooms, traps and poisoned bait fresh, and a renewed resolve, they have engaged rats in a free-for-all battle in which there is ?no retreat, no surrender? to the extent that in quite a number of homes and yards these days, the sight of a rat running up and down or cris-crossing the room has been drastically reduced, thanks to the onslaught.

?We have an epidemic on our hands,? the Minister of Health, Prof Babatunde Osotimehin, remarked last week during a visit to Vanguard corporate headquarters in Lagos. ?Even a single confirmed case of Lassa fever is an epidemic.? He said the Federal Ministry of Health had already put the 36 state Health Ministries on alert, directing them to step up public awareness campaigns on prevention campaign strategies. ?People are being urged to observe and improve community hygiene through proper refuse disposal to discourage rats from taking refuge, and keeping food and drinking water in containers not accessible to rats.?

In the view of Ronke Shobayo, one of the proponents of the anti-rat campaign, ?It is not that we are being overrun with rats, but as you know, attack has always been the best form of defense, and we do not have to wait for these horrendous rodents to take over before we take them out.? Last year, when Ronke, a legal practitioner moved into her new house at Egbeda, there were just a few rats to contend with but now she says there seems to be hundreds of them.

?I?m almost going out of my mind. The pests are everywhere no matter how you try to keep them out. They breed very fast. Worse still, these rats are getting smart. They are no longer caught by poisoned bait or the common traps because they have learned to detect and avoid them, and with this latest Lassa fever epidemic in town, the best thing is to search and destroy rats. I often have to use a stick or broom.?

As for Musibau Omikunle who lives in Mushin, it is not just a war, but a fight to finish with rats. He tells Saturday Vanguard: ?It is bad enough that rats live in our homes, eat our food and destroy our property, should we now let them take our lives? No. We must fight and we are fighting. We are keeping our homes and surroundings as free as possible from rats. We have no choice other than to fight.?

In agreement that it is a fight to the finish is Chukwuma, a trader at Ladipo Motor Parts market, Papa Ajao, Mushin where the vendetta against rats is currently gaining prominence. ?Rats are destructive disease carriers and should not be tolerated for any reason. We are going to wipe them out because they spread all sorts of germs but this one - Lassa fever is the deadliest I have ever heard.

I hear people have died already and I know it can spread quickly within a short period of time. We are trying to keep our environment clean to discourage and prevent rats from breeding. My advice to everyone in Lagos is to set traps in and around their houses and to block all the entrances to rats. ?This is the best way to reduce risk of exposure to the infection by reducing all possible human contact with the rodents which promote the spread of the disease.?

Tayo Ajayi, a housewife residing at Agege notes that many people are aware that rodents are attracted by food, so the kitchen or pantry is their usual point of call. ?They act like gangs and really do swarm. We have a serious problem with rats and it?s an indication of poor sanitation and bad hygiene. For me, I think it is very important to use plenty of traps, actually I use as my as 10 mouse traps in my home even though I believe there are no more than two or three mice there. Bigger buildings need more.? Tayo places her traps in darkened corners, along walls, behind appliances and any areas where droppings have been sighted.

One rat, one trap

But Saturday Vanguard got an interesting insight into the anti-rat war through Kola who claims to have helped to trap and kill more than 100 rats in his area in the last couple of weeks. In a narration that fell short of bragging, he told of his exploits. ?The tiny rats (mice are the dangerous ones) they are fast and very intelligent, but we humans must show them we are smarter. I have a perfect plan for trapping them.

My own plan is the one rat, one trap approach. I do not use poison or gum trap or spring trap. These rats know how to dodge all those. I use a special kind of trap which catches the rat alive. It is a rectangular box with a one-way opening inside, but no exit. It is made of transparent plastic with a fish or meat bait inside.

The rat sees the bait, is attracted, enters the box, and gets trapped. It has never failed, but is a bit expensive because it is one trap for one rat after which you throw the trap and rat into the fire to kill the rat. I don?t advise people to try re-use the trap because the rat may escape if you try to remove it alive.?

Kola says he used to buy the traps from Oshodi or Mushin before he learned to make them himself and even sell to people. He says: ?In trapping mice, traps should be placed about two to three meters apart since they don?t travel very far. Many people make the mistake of placing traps on the floor alone, but do you know rodents are good climbers?

Traps can be fastened with wire to the overhead rafters, beams, tree limbs, and on top of the gutters along the roof line. Care should be taken to set traps in areas where there is evidence of rodent activity such as fresh droppings, teeth marks, burrows, or urine stains.?

He notes that although professional traps do not need to be baited, persons who know better say baiting increases the catch rate in certain situations. When there is not a readily available food source, baits that will cause a strong aroma helps and the bait should be secured as the rodents can easily remove unsecured bait.

But some rats tend to be trapping shy. ?They are shy of new objects and placing unset traps in a new location for a few days will increase the catch. Camouflaging the trap in a shallow pan of grain or sawdust could hide it. Place the bait in a few small placements on the top surface without setting the trap. When the rats start taking the bait, set the trap, leaving one bait placement in the set trap. Rat traps should not be relocated once a good location is found as this will set up a new object reaction. Mice are naturally curious so frequent trap relocations will attract their interest.?

Generally, consensus is that glue boards work better with mice than rats. ?Place the glue boards on a flat surface paying attention to the rodent droppings for correct placement. You shouldn?t use glue boards in a dusty area that would reduce effectiveness. Many times a rat can get off the glue boards, but with mice it can quickly and safely reduce a population.

The glue boards are ideal to use in food plants, kitchens, restaurants, food processing plants, hospitals, residences, zoos and other sensitive areas where the use of poison is prohibited or discouraged. For traps, they are to be placed on a hard surface, perpendicular to a wall so that the trigger end is toward the wall. ?Traps should be set in areas where there is high activity such as fresh droppings, gnawings, rub marks, burrows, or urine stains.

When trapping, whether you use glue traps, snap traps or live traps, the key is to be persistent and aggressive with the trapping. You may need more traps than you think is warranted.

The rat species in question here is Mastomys natalensis which has been identified as the consistent host reservoir for the Lassa virus because of congenital neonatal infection, which results in rats with long-lasting and/or lifelong infection.

A community health worker at the Lagos University Teaching Hospital (LUTH) Idi-Araba, Lagos, told Saturday Vanguard that as a result of the mechanism of Lassa fever infection, there is no break in the natural chain from virus to host species. He notes that even though the rats might show no symptoms of the disease, they easily shed the killer virus freely in their urine, droppings and saliva.

?There are so many variants of the Mastomys rat that live in human homes, so the virus is easily transmitted to humans via direct contact with the rat urine, faeces, saliva, blood or contact with excretion- or secretion-infected materials or via ingestion of excretion-contaminated food. Humans can contract the disease from other humans via aerosol transmission (coughing), or from direct contact with infected human blood, urine, or semen.

Victims can also become infected via skin breaks, and via mucous membranes from aerosol transmission from dust-borne particles.? Initially, the disease manifests with malaria-like symptoms and is easily mistaken for malaria, hence it is under-treated or mis-treated.

The highly contagious disease is transmitted traditionally by rat urine/faeces contamination of food, drink and household items/goods. It is also transmitted via body fluids and could be airborne. Symptoms include fever, general fatigue and weakness, headache, sore throat, chest pain, nausea, vomiting, diarrhea, cough, abdominal pain, and red spots.

Lassa fever is a haemorrhagic disease in the class of Ebola and Marburg haemorrhagic fevers because in the advanced/severe cases, it causes a swollen face and massive bleeding from every bodily orifice (eyes, mouth, nose, ears and genitals).

The bleeding is often a predictor of a significantly higher risk of death preceded by shock and vascular collapse. Certain death occurs rapidly if proper and urgent medical attention is not administered.

The clinical picture of Lassa fever is nightmarish. After an incubation period of between 1-24 days, most patients only seek hospital treatment when the identified symptoms begin to show. Some patients experience bleeding from the gums, but there could be differences in its general manifestation.

With mortality rates typically estimated at 15-20 per cent, research of infection vs. mortality rates indicates that less than 1per cent of all Lassa-virus infections in West Africa will eventually result in fatal disease, but could be much higher in people of non-African race.

Antibiotics may also be administered to patients to ward off or treat secondary and/or opportunistic bacterial infections. Currently, there is no effective prophylactic treatment, except for a drug called Ribavirin used for people at high risk. Sadly, no human protective vaccine is currently available.

Lassa fever was first recognized in 1969 in Lassa, Nigeria and subsequent outbreaks occurred in the country as well as in Liberia, and Sierra Leone where 10-16 per cent of all patients admitted to hospitals have the disease.

There is an estimated 100,000-300,000 infections per year in West Africa. About two-thirds of all reported cases are aid to be women, but this might be a result of exposure, rather than a tendency toward greater susceptibility in women to the disease.

At the inauguration of the Lassa Fever Diagnostic and Research Laboratory of the Institute of Lassa Fever Research and Control of the Irrua Specialist Hospital in Edo State, it was stated that 51 million Nigerians are at risk of contracting the disease with the annual number of illness estimated at three million and annual number of deaths put at 58,330. ?Lassa Fever kills in a trail.

It is not uncommon for it to completely wipe out whole families. It is a ?hidden cause? of much talked-about non-decline in maternal and under-five mortality in Nigeria.

Earlier, the Guild of Medical Directors regretted that enough was not been done in the area of research about the disease in Nigeria. But with the coming on board of the new diagnostic and confirmatory research laboratory at Irrua, the three other diagnostic laboratories located at Owerri, Maiduguri and Ibadan will be complemented.

There has been marked rise in Lassa fever cases in recent times. According to the Chief Medical Director of Irrua Specialist Hospital, Prof George Akpede, out of 229 suspected cases reported between January and December 2008, 30 died. Lagos, Ondo, the FCT, Nasarawa and a number of other States have also reported fatalities. The Irrua figure represented about 60 per cent and 80 per cent increases respectively.

The Irrua Specialist Teaching Hospital had entered into partnerships with Behard-Notch Institute of Tropical Medicine, Hamburg, Germany, and Harvard University, USA for collaboration in Lassa fever research and control efforts. Part of the collaboration resulted in donation of diagnostic.
Click below to read: How entire family was wiped out by Lassa Fever

http://www.vanguardngr.com/content/view/31547/152/

[Shiloh]

Re: Nigeria: Lassa Fever

Source: http://www.thisdayonline.com/nview.php?id=139011

Lassa Fever Outbreak Blamed on Poor Sanitation
From Mustapha Shehu in Abuja, 03.24.2009

Poor sanitary habit of residents of the Federal Capital Territory (FCT) is the cause of the outbreak of Lassa fever in the Territory, Minister of State for FCT, Chief Chuka Odom, has said.
Odom spoke at the launching of ?Keep Abuja Clean? campaign in Gwagwalada Area council. ?The people must cultivate good sanitation habits that could prevent the outbreak of Lassa fever and other diseases that are largely preventable,? he warned. Odom explained that the administration?s commitment to the health needs of the people was the motivating factor in its determination to rid the territory of filth and dirt. He pointed out that the huge money spent on preventable diseases could be used for other purposes and called on the people to take the issue of sanitation seriously.
Odom stressed that the bulk of the administration?s health budget was spent on diseases caused by the people?s reluctance to observe simple sanitation principles. ?But it is time the people took seriously the issue of hygiene and sanitation because lack of them is beginning to drain the resources of government? he said.
He added that ?henceforth, the administration will demand that the environment is kept clean. Indiscriminate disposal of refuse will no longer be tolerated.? While noting that sanitation was not entirely government business as citizens should play their role in the sanitation exercise, Odom charged the people to hold their councils? authorities responsible in the event of unsightly refuse heaps in any unauthorised areas.
In his remarks at the occasion, Chairman of Gwagwalada Area Council, Hon. Zakari Angulu-Dobi said the council was in the process of presenting a bill to effect a bye-law on sanitation and related issues.
This, he said, was in addition to the services of private organisations the council has engaged to keep the environment clean. He gave the assurance that with the effort so far put in, ?very soon our satellite towns will be comparable to the city centre of Abuja .?

[Shiloh]

Re: Nigeria: Lassa Fever

Source: http://www.financialstandardnews.com...98978351851852

Addressing the meningitis, lassa fever pandemic

By Editorial
Cartoon


The recent health alert warning Nigerians of the out break of two deadly diseases, cerebrospinal meningitis and lassa fever must be taken seriously by the Federal Government. The warning on the outbreak of cerebrospinal meningitis was issued by Professor Babatunde Osotimehin, minister of Health who said the disease has killed over 333 people since the first reported case of the disease in December 2008.
According to him; ?As of today, we have recorded 5,323 cases with 333 deaths in 22 states. The first case of meningitis was reported to the Federal Ministry of Health in December 2008.? Cerebrospinal meningitis which is the inflammation of the tissue surrounding the brain and spinal cord is caused by viral or bacterial infections. The second warning from the National Lassa Fever Stakeholders? Forum (NLFSF) warns that Nigeria was rife with lassa fever. According to NLFSF, the country has a risk population of 51 million people, annual number of illness of about three million and annual death of about 58,330. The warning was issued by Professor George Akpede, national chairman of NLFSF during an interactive session with the House of Representatives Committee on Health in Abuja. Lassa fever is a zoonotic disease, transferred to human beings on contact with an infected animal usually rats.
Unlike the cerebrospinal meningitis which is triggered by extreme atmospheric conditions, the virus that causes lassa fever is carried in the urine and excreta of the rat. The lassa virus passed in the urine and droppings of the rat could also become air borne when the urine dries. Although the rats that carry the lassa virus do not fall ill or die as a result of the virus, they easily spread the disease to human beings on contact, consumption of the vector or consumption of food items contaminated by the virus. More than 55 persons have so far died from lassa fever epidemic since the outbreak earlier this month. So far, reports available show that both diseases are more prevalent in the northern parts of the country though not restricted to that region. They are both more common during the dry season because of the intense heat and bush burning which drives rats out of bushes into people?s homes.
According to Professor Akpede ?the best way to prevent contracting lassa fever is for individuals to avoid contact with the mouse that is commonly referred to as African soft furred rat (Mastomys natalensis) in every way possible. This is the brownish, long tail rat called Emo in Yorubaland. The virus is in the urine and faeces of the rat. The fever is more endemic mostly around the dry season because the rat comes out when people burn bush. They then go to human habitation. When they urinate, they pass out the lassa virus and the virus in the urine is later spread by air when the urine dries off and inhaled.? According to him, if the threats posed by lassa fever is to be effectively tackled, the Federal Government must as a matter of urgency make budgetary provision for national prevalence and morbidity/mortality for Nigerians to know areas that are prone to the dreaded disease because ?lassa fever is a silent killer that continues to send thousands to their grave although other causes may have been attributed due to low awareness on the part of the citizenry.?
The Federal Government must therefore deploy adequate resources to fight both diseases which have left a large segment of the population on the verge of annihilation. According to Professor Akpede, one way for the Federal Government to succeed in its efforts at combating the diseases is to establish zonal Lassa fever control centres and a central coordinating agency to help tackle advocacy crusade as well as preventive and curative assignments. Professor Akpede who argued that the battle against lassa fever has been largely hampered by lack of political will, lack of information and poor funding also called for attitudinal change among Nigerians, saying that negative behaviour bad hygienic environment, beliefs and other poverty related factors worsen the disease situation.
Certainly, the Federal Government must realise that if efforts at controlling the spread of cerebrospinal meningitis and lassa fever is to have the desired affect, then it must take urgent measures to educate the public on the cause and consequences of the disease. This is because rats which transmit the disease are found all over the country and as such, they could easily have access to many people?s homes and contaminate food items. Moreover, with excruciating poverty afflicting over 40 per cent of Nigerians, hundreds of thousands of the citizenry have taken to eating rats and other wild rodents popularly referred to as bush meat as a delicacy. Many others who cannot afford to buy refrigerators or who cannot use their refrigerators because of the epileptic power supply have resorted storing their food in cupboards where rats easily contaminate them. There are also those who processing food stuff such as cassava flakes, maize, beans among others by spreading them outside in the sun to dry before selling to consumers. It is noteworthy that anybody who consumes these foodstuffs processed by drying under the sun where rats easily have access risks contacting lassa fever.
The Federal Government must put in place measures to inculcate Behaviour Change Communication (BBC), an advocacy campaign programme that provides a step-by-step approach and emphasises prevention through education, awareness and practical support for behaviour change to successfully contain the spread of both epidemics. Its major aim is to encourage and facilitate a voluntary adaptation of attitudinal changes to achieve desired results. This would involve the citizenry taking responsibility for cleaning of their immediate environment as well as ensuring adequate ventilation of the houses. If the citizenry imbibe the habits of handling and preserving food items hygienically and keeping themselves hydrated by drinking adequate water, they would have done something significant to protect themselves. The task of combating the cerebrospinal meningitis and lassa fever pandemic may appear tough one but it is achievable. The Federal Government must encourage Nigerians to adopt healthy habits and clean their environment more often because health is wealth just as a healthy nation is a wealthy nation.

[Shiloh]

Re: Nigeria: Lassa Fever

Source: http://allafrica.com/stories/200903260187.html

Nigeria: Lassa Fever Could Be Contacted From Garri-Prof. Akpede
Okey Ndiribe
26 March 2009
*
interview
Lagos ? Prof. George Akpede, the Chief Medical Director ( CMD) of Irrua Specialist Teaching Hospital ( ISTH) has set a goal for himself and his colleagues: That of drawing national and perhaps international attention to the serious threat that Lassa Fever constitutes to the nation's public health.
Three million Nigerians suffer from the disease annually out of which 58,330 lose their lives and 51 million are at risk of being infected. Between 30 and 60 percent of patients hospitalised for the disease die during epidemics. The death rates for unborn babies is 95 percent closely followed by that of pregnant women. He spoke to OKEY NDIRIBE at Irrua, Edo State


WHAT have the various tiers of government done to combat Lassa Fever in Edo State ?

We have interacted on a number of occasions with the leadership of Edo State Chapter of the Association of Local Government of Nigeria ( ALGON). At one stage we made a power-point presentation to them in order to thoroughly explain to them the nature and extent of spread of Lassa Fever epidemic and its implications.

On that occasion they promised to assist the Institute of Lassa Fever Research and Control ( ILFRC) of the Irrua Specialist and Teaching (ISTH) with N18 million which translates to one million naira per local government. But they are yet to redeem that promise. It must be noted that Hon. Patrick Ikhariale who represents Esan West, Central and Igueben Federal Constituency at the House of Representatives has made substantial financial contributions towards the eradication of the disease.

At the state level, we have had discussions with a number of commissioners for health who have served several administrations in the state. We informed the last administration in the state on the need for them to assist this hospital with its Lassa fever control efforts but so far we do not have any concrete response. I cannot remember much of what was done by the State Government during the eight year administration of former Governor Lucky Igbinedion beyond having sensitisation programmes.

The administration of Comrade Governor Adams Oshiomhole has only recently assumed office. Therefore we have not yet had the opportunity to brief him directly. It is only the Hon. Commissioner for Health that we have briefed and he was present at the sensitisation workshop which also entailed capacity building for health-care workers in the state that took place here in Irrua last month.

From 2001 when the Federal Government's attention was drawn to this epidemic, it designated three federal tertiary health institutions in the country as Lassa Fever Control Centres. These hospitals are ISTH, the University of Maiduguri Teaching Hospital (UMTH) and the Federal Medical Centre, Owerri.

The Federal Government has also provided rivabirin injections and tablets freely for the treatment of Lassa fever patients and has since continued to do so. In addition to this, the Federal Government has also provided additional funds to combat the disease. The additional fund that was allocated to this hospital was used to procure a vehicle to continued with the campaign efforts and for the construction of a small isolation unit for treatment of lassa fever patients which was subsequently commissioned by the Honourable Minister of Health in 2003.

Subsequently realising the limitation of that facility, the Board of Management of this hospital then under the chairmanship of Mike Ajotomre established ILFRC. The Institute has components. It decided to expand the isolation facilities so that it can accommodate many more patients.

Last year, 229 cases of the disease were managed in this hospital alone. The small facility we had was no longer enough for handling our patients. So the Federal Government is expanding the isolation facilities and developing the critical care units.

In some cases when patients are critically ill with lassa fever they also suffer renal, respiratory and heart failure. Other advanced symptoms include convulsion and bleeding and they also go into coma. Such patients require very intensive care. Aside from that the disease is highly contagious. So, a dedicated corps of personnel including doctors and nurses are needed to manage them. It is very unsafe to manage such patients in the open ward. So all these facilities are being put in place now.

Based on our experience, we have come to realise that there is much dearth of capacity for the treatment and management of the disease across the country. So among the facilities being developed at the Institute is a training centre. This is necessary so that both doctors, nurses, epidemiologists and other medical personnel involved in the treatment and management of the disease could undergo training to have their capacities developed. Research is also another important part of what the Institute handles.

This is because as we speak we do not yet know the extent of spread of lassa fever. There are estimates but estimates are different from having exact information. We need to know how many states in Nigeria where lassa fever occur and states where it does not occur. In those states where there is lassa fever, we need to know the burden.

For instance, a study done in this hospital in 2003 or 2004 showed that six percent of patients who had fever were confirmed to be suffering from lassa fever. At the University of Maiduguri Teaching Hospital, a study that was done by one Dr. Baba and his team at the beginning of this millennium also revealed that 17 percent of patients who complained of fever were diagnosed to have evidence of past infection of lassa fever.

Another study that was done in the 1970s by Prof. Tomori and his co-workers showed that about 21 percent of Nigerians from diverse places had evidence of past infection of lassa fever. So more studies need to be conducted to determine the extent of spread of this disease in this country. In this part of the country, the disease is experienced all year round.

Part of what the Federal Government has done to combat this disease is the establishment of diagnostic laboratories. One of them was commissioned here last Monday. This laboratory was established through partnership between the Federal Government as represented by this hospital and some foreign partners including the Institute of Tropical Medicine in Hamburg, Germany and Harvard University in the United States. I am aware that the Minister of Health Prof. Babatunde Osotinmehin is working towards establishment of four additional laboratories in other parts of the country. The institute and the laboratory were established last year.

Don't you think that a vaccine should be developed to tackle the spread of this deadly disease?

We are aware that there are on-going efforts to develop a vaccine. As far as I know that effort is being made outside the country. Part of the brief of the Institute is to also join in the effort to develop a vaccine through this collaborative approach. All of us are working to develop rapid diagnostic tests. However, indications so far show that when such a vaccine is ultimately developed, it might be quite expensive. In addition to these efforts, there is need to examine the situation within the country and our sub-region because there are other viruses which are similar to that which causes lassa fever. For instance, the HIV and hepatitis B virus.

One of the briefs of the Institute is that even though it would concentrate its efforts on lassa fever, with time it would also begin to examine these other infections that have a relationship with lassa fever. Among the similarities of these diseases is their routes of transmission. For instance, just like HIV, the lassa fever virus could be transmitted through sexual intercourse. For instance, men who have just recovered from the disease could transfer it to their spouses.

Hence, after suffering a lassa fever attack, men need to wait for about three months before having intercourse with their wives to prevent infection. The disease could be contacted through contaminated food, broken skin and through direct contact with the blood, urine and droppings of infected rats. It could also be transmitted through health institutions if the personnel there are not careful. The virus could also be inhaled. This means that it is also an airborne disease especially where there is a concentration of rat droplets. It could rise up like dust from the ground. It could also be inhaled when there is a concentration of patients suffering from the disease in an enclosed place.