Context

The Nigerian Academy of Science has called for the current outbreak of Lassa fever in Africa’s most populous nation to be declared a national health emergency because of its severity.

About

About Lassa fever:

• Lassa fever is a viral haemorrhagic diseasecaused by the Lassa virus (a member of the arenavirus family of viruses) which naturally infects the widely distributed house rat.

Lassa Fever virus is a single-stranded, enveloped RNA virus that belongs to the genus Mammarenavirus, of the Arenaviridae family of viruses. The natural reservoir for Lassa fever virus is the Mastomys natalensis rat.

• Transmission: It is transmitted through the urine and droppings of infected rats found in most tropical and subtropical countries in Africa.
• Communicable: They are able to contaminate anything they come in contact with. The Lassa virus spreads through human to human contact with tissue, blood, body fluids, secretions or excretions.
• Symptoms:  A fever is usually the first symptom followed by headaches and coughing, nausea and vomiting, diarrhoea, mouth ulcers and swollen lymph glands.
• Treatment: Lassa fever can be fatal, but it can be treated if diagnosed early.

How serious is the current Lassa fever outbreak in Nigeria?

 The current outbreak is serious enough given the worsening trend. It has spread from just two states when it was first diagnosed in 1969 to 23 states in 2019.

• In 2018, the Nigerian Centre for Disease Control reportedthe largest ever a number of cases in Nigeria, with over 600 confirmed cases and over 170 deaths.
• And the numbers have continued to rise. An alarm was raised over the tripling of the number of suspected cases between 2017 and 2018 only for the reported number of suspected cases to rise in 2019.
• Outbreaks have historically occurred during the dry season – November to April. But in recent years there have also been cases during the rainy season.

What difference would a public health emergency make?

 A recent, and good example, of the difference this can make, was the announcementof a public health emergency in 2014 to tackle the Ebola virus outbreak.

• The announcement led to an emergency mode being activated with the attendant political will and funding which ultimately stoppedthe spread of the disease within 93 days.
• This is why the Nigerian Academy of Science is calling for more action.
• In particular, it is recommending that an interdisciplinary committee be set up comprising medical and veterinary specialists, epidemiologists, social scientists, media practitioners, community representatives.
• This would be along the lines of an approach known as One Health.
• This is rooted in the understanding that human health is affected by interactions between people, the environment and animals.
• Equally important is the need for the government to enhance the capacity of the national laboratory network for reliable and efficient diagnosis of suspected cases.
• This is because only about 20% of suspected Lassa fever cases are usually diagnosed.

The government should also provide adequate funds for a sensitive disease surveillance and response system. This is a system that ensures disease outbreaks (not just Lassa fever) are quickly noticed, diagnosed, and appropriate responses or containment measures are started in the shortest possible time.