Lassa fever in nigeria

Lassa fever in nigeria

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  A N AD 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.
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  Welcome & Introductions 2 Logistics  Emergency exits  Restrooms
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  Agenda 3  Lassa feverDisease  Importance of Topic.  Clinical Signs and Symptoms.  Diagnosis and Treatment  Preventing Lassa fever
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  What is LassaFever? 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.
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  What is LassaFever? 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.
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  What is LassaFever? 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
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  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
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  Map of StatesWith Lassa fever Cases in Nigeria 8
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  Graphical Display ofPrevalence 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 Anambra Ebonyi Edo Gombe Lagos Nasarawa Ondo Plateau Rivers Taraba Yobe Anambra 1 Ebonyi 15 Edo 326 Gombe 1 Lagos 1 Nasarawa 5 Ondo 6 Plateau 5 Rivers 4 Taraba 29 Yobe 4
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  Clinical Signs andSymptoms 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
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  Clinical Signs andSymptoms 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
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  Clinical Signs andSymptoms 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.
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  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
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  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.
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  Questions 15