Lassa fever in nigeria
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Transcript of Lassa fever in nigeria
A N A D A P T A T I O N F R O M C D C P R E S E N T A T I O N , W H O F A C T S H E E T S A N D N E M A E P I D E M I C S U P D A T E .
A N U G O M A . E M E K A
Lassa Fever Presentation.
Welcome & Introductions 2
Logistics Emergency exits
Restrooms
Agenda 3
Lassa fever Disease Importance of Topic. Clinical Signs and Symptoms. Diagnosis and Treatment Preventing Lassa fever
What is Lassa Fever? 4
A viral haemorrhagic fever caused by the Arenavirus Lassa. A single stranded RNA virus that is animal-borne. This was discovered following the death of two Nurses in Nigeria in 1969 and named after the town in Borno state, Nigeria, where it was first discovered.
Transmitted from rodents to humans.
The species of rats transmitting this disease is prevalent in West Africa. (‘The multimammate rat’, mastomys species-complex), and is spread via their urine and droppings.
What is Lassa Fever? 5
There is secondary human to human
transmission, via body fluids exchange or in hospitals, via reused needles or contaminated medical equipment
The virus can be transmitted through direct contact with these materials or via cuts and sores or via poorly stored food (as Mastomys rodents are home scavengers)
It can also be airborne via inhalation of tiny particles in air contaminated with rodents excreta.
Also since mastomys are consumed as food source, it may also occur via direct contact when they’re caught and prepared for food.
What is Lassa Fever?
6
It’s seasonal, with clusters in late
rainy and early dry season, affecting all age groups and both sexes.
Its is endemic in areas of West
Africa including Nigeria, Liberia, Sierra Leone and Guinea.
Annual incidence of 100,000 to 300,000 with approximately 5,000 deaths in West Africa.
Incubation period is 5-21 days
Importance of Topic. 7
There is a recent outbreak in
Nigeria over the past 7weeks, which has claimed 40 lives, with Edo state accounting for 22 of this.
11 of the 36 states in Nigeria have been affected by this and a total of 397 cases have been reported, out of which 87 have been confirmed.
397 cases 40 deaths 12 States
Map of States With Lassa fever Cases in Nigeria 8
Graphical Display of Prevalence in Nigeria 9
1
15
326
1 1 5
6 5 4
29
4
Prevalence of lassa Fever in Nigeria as at 12th Feb 2012
AnambraEbonyiEdoGombeLagosNasarawaOndoPlateauRiversTarabaYobe
Anambra 1 Ebonyi 15 Edo 326 Gombe 1 Lagos 1 Nasarawa 5 Ondo 6 Plateau 5 Rivers 4 Taraba 29 Yobe 4
Clinical Signs and Symptoms 10
Gradual fever onset Headache Malaise Other Non-specific symptoms Pharyngitis Myalgia, retro-sternal pain Cough Gastrointestinal symptoms Few have the Classic symptoms of : - Bleeding - Neck/facial swelling - Shock
Clinical Signs and Symptoms
0 10 20 30 40 50 60 70 80 90 100
Swollen Neck or Face
Bleeding
Deafness
Conjunctivitis/Subconjunctival Hemorrhage
Abdominal Pain/Tenderness
Cough
Dizziness
Retro-sternal Pain
Headache Fever
Arthralgias/Myalgias
Sore throat/Pharyngitis
Weakness
Vomiting
Diarrhea
Chills
Lymphadenopgathy
Confusion
Percent
Clinical Signs and Symptoms 12
Case fatality of Hospitalized cases:15-
20%
Its severe in pregnant women and their offspring.
-Increase 3rd Trimester mortality (>30%) -Increased fetal/neonatal mortality (>85%)
Deafness is a common sequela, not
related to severity of acute illness, maybe bilateral/unilateral and may persist for life in one-third of those affected.
Diagnosis and Treatment 13
Clinical diagnosis is often difficult ELISA (Enzyme-linked immunosorbent
assays) for antigen, IgM, and IgG Postmortem tissue
Immunohistochemistry Reverse trancription-PCR for reasearch. Supportive Measures Drug of Choice is: Ribavirin -Most effective when started within first
6days of illness. -It is presently contraindicated in
pregnancy but maybe warranted if mother is at risk)
-Doesn’t reduce incidence of severity of deafness.
-Side effects are: reversible mild hemolysis and suppression of erythropioesis
Preventing Lassa Fever 14
Avoid contact with Mastomy rodents
and bush burning Store food properly in rodent-proof
containers Keep homes clean and discourage
rodent entry. Using rodent as food source is
discouraged. Clean traps and dispose carcass neatly. Prevent person-person transmission
via use of PPEs (Masks,Gloves,Gowns and Goggles) especially for health workers
Sterilize equipment after use Isolate infected patients from contacts.
Questions 15