Expert seeks adequate hygiene to prevent Lassa fever

A medical expert, Dr Francis Sanwo, has stressed the need for improved household and community hygiene to prevent Lassa fever.

Sanwo, the Medical Director of Our Lady of Apostles Catholic Hospital, Oluyoro, Ibadan, said this in an interview in Ibadan.

He said this would discourage rodents identified as major carriers of the Lassa fever virus from entering homes.

The family physician, who also emphasised effective measures, including storing grains and other foodstuffs in rodent-proof containers, also stressed the need to dispose of garbage far from homes and maintain clean households.

He added, “Family members should always be careful to avoid contact with blood and body fluids while caring for sick persons in healthcare settings.

“Hospital staff should always apply standard infection prevention and control precautions when caring for patients, regardless of their presumed diagnosis.

“Healthcare workers caring for patients with suspected or confirmed Lassa fever should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials.

“When in close contact (within 1 metre) of patients with Lassa fever, health-care workers should wear face protection (a face shield or a medical mask and goggles),
a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).”

The medical expert also emphasised that samples taken from humans and animals for investigation of Lassa virus infection should be handled by trained staff and processed in suitably equipped laboratories under maximum biological containment conditions.

He explained that Lassa fever is an acute viral hemorrhagic illness with an incubation period of ‘2-21 days duration that occurs in West Africa.

According to him, the Lassa virus is transmitted to humans via contact with food or household items contaminated with rodent urine or faeces.

Sanwo noted that person-to-person infections and laboratory transmission can also occur, particularly in hospitals lacking adequate infection prevention and control measures.

“The onset of the disease, when it is symptomatic, is usually gradual, starting with fever, general weakness, and malaise.

“After a few days, headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and abdominal pain may follow.

“In severe cases, facial swelling, fluid in the lung cavity, bleeding from the mouth, nose, vagina, or gastrointestinal tract and low blood pressure may develop.

“Protein may be noted in the urine. Shock, seizures, tremors, disorientation, and coma may be seen in the later stages.

“Death usually occurs within 14 days of onset in fatal cases. The disease is especially severe late in pregnancy, with maternal death and/or foetal loss occurring in more than 80 percent of cases during the third trimester,” he said.

He further explained that Lassa fever occurs in all age groups and both sexes, stating that persons at greater risk are those living in rural areas where Mastomys are usually found.

“Definitive diagnosis requires testing that is available only in reference laboratories.

“Laboratory specimens may be hazardous and must be handled with extreme care; Lassa virus infections can only be diagnosed definitively in the laboratory.

“The antiviral drug ribavirin seems to be an effective treatment for Lassa fever if given early in the course of clinical illness.

“There is no evidence to support the role of ribavirin as post-exposure prophylactic treatment for Lassa fever.

“There is currently no vaccine that protects against Lassa fever, and the overall case-fatality rate is 1 percent.

“Among patients who are hospitalised with severe clinical presentation of Lassa fever, case-fatality is estimated at around 15 percent,” he said.

Sanwo, however, remarked that early supportive care with rehydration and symptomatic treatment could improve survival.