Four Children die due to Haemorrhagic Fever, not Lassa in Kebbi says Medical Director

[Catbird]

Tests are still pending but Lassa is suspected in a family cluster in Jega, Kebbi State. 7 cases, 4 deaths.

"Lassa fever not yet established in Kebbi (ETA: http://allafrica.com/stories/201302270381.html)

27 February 2013

... samples have been taken to the World Health Organization (WHO) office in the state to ascertain if Lassa fever was responsible for the death of four members of a family in Jega recently.

“It is the outcome of the result from WHO that will ascertain whether it is Lassa fever or not. On Tuesday, February 19, 2013, a yet to be identified disease broke out in a family in Jega Local Government Area of the state. A total of seven members of the same family were affected. Four died within 42 hours, while three are presently stable and receiving treatment at the hospital. Samples from the patients who died at home have been taken to the WHO office for analysis. The outcome of the test is being awaited, and the case has been officially reported to the Federal Ministry of Health,” he said.

Former chairman of Jega Local Government, Alhaji Lawal Buhari Jega, told newsmen that his child, Abdurrahman Buhari, died after suffering from vomiting and diarrhoea.

“The younger sister of the deceased, Rahama Buhari, died after complaining of headache and cold when she returned from school. Few hours later, my father in-law called to inform me that five others were ill and had been taken to the Federal Medical Centre in Birnin Kebbi”, he said."

 

[Ronan Kelly]

Four Children die due to Haemorrhagic Fever, not Lassa in Kebbi says Medical Director

Nigeria: Man Loses Four Children to Haemorragic Fever in Kebbi
BY SAAWUA TERZUNGWE, 4 MARCH 2013

Birnin Kebbi ? A disease, suspected to be Haemorrhagic fever, has killed four children of Alhaji Lawal Buhari, one time chairman of Jega Local Government Area of Kebbi State.

Buhari told Vanguard in Jega yesterday, the four children, between the ages of seven and 15, died within three days when the fever attacked them.

He said three of his children got infected from one of them who died earlier from the infection. He said he rushed the three to the Federal Medical Centre, Birnin Kebbi, where they died.

When contacted, the Chief Medical Director of Federal Medical Centre, Dr. Abdullahi Ibrahim, confirmed the deaths, saying it was suspected to be Haemorrhagic fever and not Lassa fever as some people thought.
http://allafrica.com/stories/201303040221.html

FluTrackers thread on current Lassa fever outbreaks in Nigeria - http://www.flutrackers.com/forum/showthread.php?t=198199

 

[alert]

Re: Four Children die due to Haemorrhagic Fever, not Lassa in Kebbi says Medical Director

Obviously, Lassa causes hemorrhagic fever.

If the wording above indicates that a viral hemorrhagic fever other than Lassa is suspect, Rift Valley Fever and yellow fever are possibilites. Meningitis can also be mistaken for hemorrhagic fever, and is common in Africa. Notably, the article above suspects the source of infection of several of the cases is a previous fatal case; neither RVF nor yellow fever is typically transmitted human-to-human.

 

[Shannon Bennett]

Re: Four Children die due to Haemorrhagic Fever, not Lassa in Kebbi says Medical Director

Since this is Africa, Marburg and ebola may also be the culprits. Both of these are contageous.

 

[alert]

Re: Four Children die due to Haemorrhagic Fever, not Lassa in Kebbi says Medical Director

Since this is Africa, Marburg and ebola may also be the culprits. Both of these are contageous.

Agreed, but neither virus has been reported in Nigeria before, so if they are behind this outbreak, it would represent a significant geographic expansion of the area in which they are found.

 

[Catbird]

Re: Four Children die due to Haemorrhagic Fever, not Lassa in Kebbi says Medical Director

I moved my earlier post on this from the Nigeria Lassa thread to here.

The article mentions a family cluster with a total of 7 patients, 3 of whom were being treated in the hospital. I'm wondering what their status is now.

It also seems to have developed rapidly, "... ?The younger sister of the deceased, Rahama Buhari, died after complaining of headache and cold when she returned from school. Few hours later, my father in-law called to inform me that five others were ill and had been taken to the Federal Medical Centre in Birnin Kebbi?."

 

[alert]

Re: Four Children die due to Haemorrhagic Fever, not Lassa in Kebbi says Medical Director

Is this the same outbreak? edit

Lassa is NOT airborne.

Published Date: 2013-03-11 18:22:18
Subject: PRO/AH/EDR> Lassa fever - Nigeria (07): (KI) susp
Archive Number: 20130311.1581762

LASSA FEVER - NIGERIA (07): (KEBBI) SUSPECTED
*********************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Thu 28 Mar 2013
Source: Leadership, Nigeria [edited]
http://leadership.ng/nga/articles/48808/2013/02/28/lassa_fever_claims_8_jega.html


Lassa fever has claimed the lives of 8 people in Jega local government area of Kebbi State, while 3 others are still undergoing medical treatment at the Federal Medical Centre (FMC), Birnin Kebbi. A nurse at the FMC, Birnin Kebbi, who spoke on condition of anonymity, said they received the cases on Wed 27 Feb 2013 and that 3 people were confirmed dead on the spot, while 2 others died the following day.

The nurse further explained that on Friday [29 Feb 2013] 5 people were brought from the same local government, and one died in the night; another one passed away the following day, while the remaining 3 people are still undergoing medical treatment. "I was on duty on Wednesday [27 Feb 2013] when they brought them, and they were admitted in the A and E ward before they were taken to the main ward. You know, it is an airborne disease. The state government took care of their drugs free of charge," he said. One of the relatives of the deceased said that, initially, they assumed it was poison that had afflicted them, but on coming to the hospital, they discovered that it was Lassa fever. Efforts to contact the state commissioner of health, Alhaji Shehu Sambawa, were unsuccessful, as his line could not be reached.

--
communicated by:
ProMED-mail <promed@promedmail.org>

[Lassa fever is an acute viral illness that occurs in West Africa. The cause of the illness was found to be Lassa virus, named after the town in Nigeria where the 1st cases were found. The virus, a member of the virus family _Arenaviridae_, is a single-stranded RNA virus and is zoonotic, or animalborne. In areas of Africa where the disease is endemic, Lassa fever is a significant cause of morbidity and mortality. While Lassa fever is mild or has no observable symptoms in about 80 per cent of people infected with the virus, the remaining 20 per cent have a severe multisystem disease. Lassa fever is also associated with occasional epidemics, during which the case fatality rate may reach 50 per cent.

According to the CDC Special Pathogens website (http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/lassaf.htm): The number of Lassa virus infections per year in West Africa is estimated at 100 000 to 300 000, with about 5000 deaths. The reservoir of Lassa virus is a rodent known as the "multimammate rat", belonging to the genus _Mastomys_. _Mastomys_ spp. rodents breed very frequently, produce large numbers of offspring, and are numerous in the savannas and forests of West, Central, and East Africa. _Mastomys_ rodents readily colonize human homes.

About 15-20 per cent of patients hospitalized for Lassa fever die from the illness. However, overall, only about one per cent of infections with Lassa virus result in death. The death rates are particularly high for women in the 3rd trimester of pregnancy and for fetuses, about 95 per cent of which die in the uterus of infected pregnant mothers. Ribavirin, an antiviral drug, has been used with success in treatment of Lassa fever patients. It has been shown to be most effective when given early in the course of the illness. Otherwise, patients should receive supportive care consisting of maintenance of appropriate fluid and electrolyte balance, oxygenation, and blood pressure, as well as treatment of any other complicating infections.

Previously, ProMED-mail reported that 22 local government areas in 9 states of Nigeria had reported outbreaks of Lassa fever. Kebbi may be the 10th state.

 

[Catbird]

Re: Four Children die due to Haemorrhagic Fever, not Lassa in Kebbi says Medical Director

Here are some other reports from local media about the situation. The first 2 articles are dated Feb. 25 and illustrate some inconsistencies about the date. Feb. 25th was a Monday but a quote from the first article says:

"...Disclosing this to Peoples Daily yesterday at the FMC Center while visiting the victims, a medical nurse officer who didn?t want his name in print lamented that they received news of the outbreak on Wednesday."

So, according to this article, the reporter got the information from the nurse on Sunday, Feb. 24th and that the outbreak occurred on Wed., Feb 20th.

The 2nd article, also written on Feb. 25, says:

"People in the commercial town of Jega... over the week were thrown into mourning following an outbreak of a disease...according to the head of the family... Alhaji Lawal Buhari Jega, woke up on Tuesday to notice that one of his children, Abdurrahman Lawal Buhari , was vomiting and suffering from diarrhoea. The child was later to die at the General Hospital , Jega.

He told Blueprint that few hours later, the younger sister of the deceased, Rahama Lawal Buhari ,came back from school to complain of headache and cold. She later died at the shortly after she was taken for medical attention...".

So this article indicates that the first known case actually happened on Tuesday, Feb. 19th, with the 2nd and other cases occurring later that day or the next.

The 1st article, dated Feb. 25th, also has the identical quoted information supplied by "a medical nurse officer" as the article in the Leadership, dated Feb. 28th, except that the Leadership article inserts a date:

"A nurse at the FMC, Birnin Kebbi, who spoke on condition of anonymity, said they received the case on Wednesday Feb. 28, 2013, and that three people were confirmed dead on the spot while two others died the following day...".


Full text of the 1st article, from People's Daily:

"Published On: Mon, Feb 25th, 2013

Laser fever kills eight in Kebbi

Another tragedy has occurred in Jega Local Government Area of Kebbi state as laser fever out break sas affected a household and killed about eight people leaving three survivors still undergoing medical treatment at the Federal Medical Center Birnin Kebbi.
Disclosing this to Peoples Daily yesterday at the FMC Center while visiting the victims, a medical nurse officer who didn?t want his name in print lamented that they received news of the outbreak on Wednesday.

He further explained that on Friday, five people were brought from the same local government and one d;eath in the night was recorded while the next day, another person passed away.
?I was on duty on Wednesday when they brought them and they were admitted in A and E wards before taking them to the main ward while the state government has paid for their drugs, you know it is an air borne disease,? he said."



Full text of the 2nd article I mentioned above. It's interesting to note that this article also specifies that blood samples had been provided to the WHO by Feb. 25th. From the Blueprint:

"Lassa fever kills 4 in Kebbi
Feb 25, 2013

People in the commercial town of Jega, the headquarters of Jega local government area in Kebbi state, over the week were thrown into mourning following an outbreak of a disease suspected to be Lassa fever that claimed the lives of four people within 48 hours interval of the same household, while three were still receiving medical attention at the Federal Medical Centre (FMC) Birnin Kebbi.

The tragedy, according to the head of the family and former Council Chairman of Jega Local Government, Alhaji Lawal Buhari Jega, woke up on Tuesday to notice that one of his children, Abdurrahman Lawal Buhari , was vomiting and suffering from diarrhoea. The child was later to die at the General Hospital , Jega.

He told Blueprint that few hours later, the younger sister of the deceased, Rahama Lawal Buhari ,came back from school to complain of headache and cold. She later died at the shortly after she was taken for medical attention.

Buhari further explained that few hours later, his father in-law called over the phone to inform him that another set of five children were also affected and were taken to the Federal Medical Centre in Birnin Kebbi, about 50 kilometres from Jega.

Governor Sa?idu Usman Dakingari, condoled the families of the diseased and described the death as a tragedy and an act of God, he further directed the State Ministry of Health to investigate the root cause of the outbreak with a view to handling the situation before it escalated.

Speaking to our correspondent over the development, Director of Health Services in the state Ministry of Health, Dr. Aminu Haliru Bunza, disclosed that the ministry, in conjunction with World Health Organization (WHO), has taken blood sample of the victims for a laboratory test to ascertain the bacteria."



The other inconsistency is the total case count and number of fatalities. 1 of the articles from the 25th reports 8 dead with 3 still being treated for a total of 11 cases, and the other article reports 4 deaths with 3 other cases still being treated for a total of 7.

This last article, dated Mar. 4th from AllAfrica via Vanguard, mentions only 4 deaths and doesn't reference any additional cases. It also gives some detail on symptoms.

Nigeria: Man Loses Four Children to Haemorragic Fever in Kebbi
" 4 March 2013

A disease, suspected to be Haemorrhagic fever, has killed four children of Alhaji Lawal Buhari, one time chairman of Jega Local Government Area of Kebbi State.

Buhari told Vanguard in Jega yesterday, the four children, between the ages of seven and 15, died within three days when the fever attacked them.

He said three of his children got infected from one of them who died earlier from the infection. He said he rushed the three to the Federal Medical Centre, Birnin Kebbi, where they died.

When contacted, the Chief Medical Director of Federal Medical Centre, Dr. Abdullahi Ibrahim, confirmed the deaths, saying it was suspected to be Haemorrhagic fever and not Lassa fever as some people thought.

He said the symptoms of the disease include high fever, rashes on the body and weakness.

The head, clinical service at the Federal Medical Centre, Dr. Aisha Adamu, who had been attending to the affected children, said tests had been carried out and sent to the World Health Organisation, WHO, representatives.

She added that health workers had also been mobilised for further tests and preventive measures, especially in Jega town.

Dr. Aisha said samples of the tests had also been forwarded to a qualified medical facility in Irrua, Edo State, for more tests while the results were yet to be released...".