During the outgone year 2020, Ondo State did not only battle the deadly COVID-19, the state was also faced with Lassa fever. ADEWALE MOMOH writes on how the state recorded highest Lassa fever cases in Nigeria with over 80 deaths, as well as government’s intervention and survivors’ experiences
Despite the fatalities and scare caused by the dreaded COVID-19 pandemic, Lassa fever during the just concluded year 2020, killed more people in Ondo State.
According to records, 18% fatalities were recorded from the total reported cases of Lassa fever in the state when compared to the less than 1% of COVID-19 related deaths in the state. Edo State used to be the state with the highest burden of Lassa fever, but with the latest data, Ondo State is now sitting on at the top of the ladder.
The development is no doubt causing sleepless night for stakeholders and residents in the state. Lassa fever which is an acute viral haemorrhagic illness caused by Lassa virus, is reported to have a very high presence in three local government areas of the state, including, Ose, Owo and Akure North Local Governments.
According to proven facts, humans usually become infected with Lassa virus through exposure to food or household items contaminated with urine or faeces of infected Mastomys rats also known as multi-mammate rats. Withthedryseasonusuallyheralding the outbreakof thediseaseinthestate, effortsare in top gear towards ensuring that the situation is put under control in 2021.
During a visit to the Federal Medical Centre (FMC), Owo, whichistheonlymedicalfacilityinthe state certified to handle Lassa fever cases, it was gathered that the Lassa ward within the facility and the personnel at the ward are committed towards tackling the disease. However, with the concerted efforts by stakeholders towards getting rid of the fever from the state, the same cannot be said of some patients and residents alike who still believe that Lassa fever is not real.
According to Dr. Ayodeji Oluwafemi who is the Head, Infection Control and Research Centre (FMC), Owo, altitude of relatives of patients who were infected with Lassa fever could be frustrating.
With the diagnosis and treatment of Lassa fever patients totally free, Dr. Ayodeji stated that some patients still find its hard to believe in the process, as they often believe that they were being used for the purpose of medical research.
Dr. Ayodeji said, “the number one challenge is sometimes the altitude of the patients’ relatives. Many at times, some of them don’t want to corporate with us. They want to discharge their patients out of the hospital.
“Some of them will complain lack of money. When we tell them that they shouldn’t bother with lack of money, they begin to suspect that there is something we want to do with their patients. That is the number one challenge. If only we can get their full support. We’ve managed so many cases that have actually recovered. “Another challenge that we also have is late presentation of some of these patients.
They would have taken them round to so many hospitals. Sometimes to the herbalist home. It’s when the condition has actually deteriorated and the patients have developed complications, that is the time they will remember to bring them to the hospital. And at that point, the prognosis is usually poor.
But most of the deaths that we actually recorded were as a result of the latest presentation.” While emphasing that Ondo State has the highest burden of Lassa fever in Nigeria, with Owo, Ose and Akure North Local Governments taking the lead in the state, Dr. Ayodeji maintained that the facility is fully equipped to handle all cases of Lassa fever.
“At the Lassa ward in FMC, all our staff have been trained in Infection, Prevention and Control (IPC), as well as implementing its regulation. The IPC regulation include hand hygiene and usage of Personal Protective Equipment (PPE). Before anyone have contact with patients at the ward, and before they move into what we called high risk zone, they have to put their PPE.
“Apart from that, our waste management here is also IPC compliant. Even the design of the ward is also IPC compliant. We go from a low risk area to a kind of high risk zone. Even in the high risk zone, we go from the suspect ward to the confirmed wing of the ward.
Once you’ve entered you must continue until you get to the exit point. When you get to the exit point, there are hygienes that would be waiting to decontaminate you.” He added that in 2020, more than 300 patients were treated while up to about 280 patients had been managed and discharged with about 30 mortalities recorded. “Ahead of the peak period of Lassa in the state, we have been making some preparation. We have a ward that we are about to equip presently.
It’s actually a 40 bedded ward. Apart from that, we also have some tents, about two of them which we’ve also made available.
“For the PPE, it’s actually the government that has been taking care of that. For the treatment of patients, government has been assisting. Then is one NGO is assisting as well. The management of the hospital (FMC) also take care part of the cost of treatment. “Edo State used to be state with the highest burden of Lassa fever. When you look at the fact that we are close to Edo State.
We have a boader with Edo State. People move from time to time. So, when people move, you discover that some of them were actually infected with the virus, and by the time they crossover to Ondo State, it’s like importing the virus to Ondo State kind of. And some of them too, we they pack their load, and inside the load you may a just a single multi-mammate rat there.
And by the time they pack the load in a carton, and they bring it to Ondo State. “Another thing that is actually responsible, we have so manyherbal homes or’chemists’ that areactuallyinvolvedinthetreatmentof people. AndLassafeverisahighlyinfectiousdisease, especiallywhenthebodyfluidof apatienttouches thebody of another person.
So, insomeof those chemists, they give injections, they do so many things like wound-dressing and the likes. In the process they are infected with the disease. And we have lost some of them.
“At the peak of the out break, some of the members other team visit herbalists homes on sensitization and in the process, some of the herbalists made us to understand that there is something called “spiritual Lassa’ and it’s not for the hospital.
The ignorantly claimed that it’s there own responsibility to take care of “spiritual Lassa’ and by the way they get themselves exposed.” Meanwhile, some of the survivors of the disease who recounted their experiences lamented that despite their recovery from Lassa fever, they were stigmatized for many weeks.
According to one of the survivors, Mr Michael Olonite who is from Ogbese in Akure North Local Government while narrating his experience said that he was infected with the disease in 2019.
Olonite who also a trader said that “In 2019, I visited one of our family friends at Ogbese here. I discovered that one of their daughters was sick. She was having symptoms of fever. So, I had to assist them in taking her to health centre for treatment.
“Later, she was transferred to Federal Medical Centre (FMC) in Owo, where it was discovered that it’s Lassa fever. With me having contact with the lady, I suspected that I must have been indirectly infected.
“When my temperature was increasing, I became extremely weak with loss of appetite. I experienced dizziness as well as reddish eyes.
My temperature was as if I was placed very close to a blazing fire. I had sleepless nights with pains all over my body. I was one of the luckiest patients at the hospital. When I was admitted, the ward was already filled with Lassa fever patients. There was a special room with only one bed, so they put there and it was very close to the door. That gave me the opportunity to witness all that happened in the ward through my stay.
My window is just directly to the entrance. So, if they are bringing any patient in, they pass through one door, and if anybody dies, the body will be taken through the same door. But survivors don’t pass the door out. With that I noticed everybody coming in. But I survived it as well as the daughter of the family friend and other members of the family had it.
The stigmatization attached to Lassa fever patients is a serious issue. But I made up my mind to be one of the advocates that will save people from being killed by Lassa fever.
“When I came back from hospital after two weeks of treatment, I discovered that some of my friends that got to know that I had Lassa fever were avoiding me. But I sympathized with them due to their ignorance. I’m telling everybody, boldly and boastfully that I’m a survival.
I feel more secured because anybody that survives Lassa has been immuned against Lassa for life” Another survivor, Jimoh Tajudeen sated that the first time I heard of Lassa fever was when I was infected. I noticed that I was becoming extremely weak. I went to the health centre here at Ogbese. I was given drugs and drip but there was no improvement.
“The health workers at the health centre advised that I should go the the State Specialist Hospital in Akure but I refused. Instead, I went to FMC. On getting to FMC, I explained everything to them, particularly that I was vomiting reddish substance that looks like blood.
It was then that I was told I had Lassa fever. I was immediately admitted to the Lassa ward where I spent one month and 20 days. “Honestly, the medical practitioners at the Lassa ward are professionals to the core.
They provided absolute care for us and ensured that they engaged us in order for us not to be depressed. “It was when I was on admission that my wife and my elder sister were brought in after it was confirmed that they had also contracted the disease. But my sister did not survived it.
“With all that happened, people distanced themselves from us. No one came visiting. But later people began to associate with us again. Concerned with the development, the Ondo State Government embarked on massive sensitization on the eradication of Lassa fever from the state.
Speaking during one of the road walk sensitization, the Acting Commissioner for Health and Special Adviser to the Governor on Health, Dr Jibayo Adeyeye stated that of all the confirmed cases of the disease in Nigeria, 75% are from three states with Ondo State topping the chart with 36%.
While appealing to residents on the need to always maintained proper hygiene by ensuring that rodents which are the carriers of the disease are exterminated from their surroundings, Dr. Adeyeye who disclosed that the dry season usually heralds the outbreak of the disease in the country.
The Acting Commissioner stated that the only way that Lassa fever can be eradicated is only when rodents are wiped off from communities, hence the distribution of 10,000 rodenticides free of charge to residents in order to exterminate rodents by the state government. He said, “We are in an unfortunate situation of COVID-19 all over the world. It has killed over 40 people in Ondo State from January till now.
But Lassa has killed more than 80 people. 18% of Lassa fever victims have died compared to 1% of COVID-19 “It has been with us for long. It is when the dry season starts that we usually experience the issue of Lassa Fever. Ondo State is one of the states in Nigeria that disease is rampant. This is a serious situation which must not be taken lightly.
We are determined about this disease, so want to eradicate it. “Unlike COVID-19, Lassa can be prevented if we eradicate rodents from our homes and surroundings. The rodenticide is distributed free of charge which must not be sold. It only meant to be applied in homes to eradicate rats.
If we don’t kill rats, they will kill us. “Owo and Ose is the epicentre of the disease in the state, hence the commencement of the campaign against the disease in the state.
The two Local Governments have the highest cases of Lassa fever in the state. It is a very serious health challenge. Speaking further on the dangers Lassa fever could portend for the state if not urgently addressed, the State Epidemiologist, Dr Stephen Fagbemi, maintained that the age group affected the most by the disease are those between 21-30 years.
The Epidemiologist added that from January to December, 2020, a total of 806 confirmed cases of Lassa fever were recorded with 204 deaths in the country. Earlier, the Olowo of Owo, Oba Ajibade Ogunoye had lauded the state government for its proactiveness to tackle the deadly disease.
“The state government under Akeredolu has taken the right step towards eradicating rats from the state. It will help in stamping out the yearly occurrence of Lassa fever. With the level of our development, I think we have the capacity to manage it from reoccurring.”