The World Health Organisation has issued a warning to anyone travelling through Lagos, Nigeria after an outbreak of Lassa fever has spread across the capital.
So far 72 people have been confirmed dead from the virus and 317 have been infected making this the worst Lassa Fever outbreak that the region has experienced to date. A further 764 are thought to be infected and 2845 others are suspected to have been in contact with those that are carrying the fever.
Lassa fever is not a new disease, but the current outbreak is unprecedented, spreading faster and further than ever before.
Health workers are overstretched, and a number have themselves become infected and died.
The potentially fatal disease is a so-called “viral haemorrhagic fever”, which can affect many organs, and damage the body’s blood vessels. Most people who catch Lassa will have only mild symptoms such as fever, headache and general weakness.
They may have none at all. In severe cases, it can mimic another deadly haemorrhagic fever, Ebola, causing bleeding through the nose, mouth and other parts of the body.
Lassa fever normally has a fatality rate of about one per cent but in the Nigerian outbreak it is thought to be more than 20%, according to the country’s Centre for Disease Control. It is notoriously difficult to treat.
The fever has now spread to 18 states since it began in January. It is known to spread through contact with infected rats. Person-to-person transmission is low but has been seen in Nigerian hospital settings this year. Fourteen health workers were infected, of whom four died within eight weeks.
“The ability to rapidly detect cases of infection in the community and refer them early for treatment improves patients’ chances of survival and is critical to this response,”
There are now concerns that anyone transiting the area is at risk of catching the disease. This includes seafarers who are stopping at ports in the region.
ARX Maritime Security Consultant, Tom Cockburn, has issued the following advice for people planning or currently carrying out transits through Lagos and the rest of Nigeria:
“Firstly, Lassa fever relies on poor hygiene, so an initial simple step is to follow your company hygiene regulations while on board the vessel and at any ports. Good hygiene on board will discourage rodents from entering the vessels. To limit the risk of person to person transition, the crew should ensure they avoid contact with the blood or bodily fluids of anyone living in the area. Regular hand washing and sanitisation through disinfectants are a must when anchored at Nigerian ports. Following health advice from your company and the IMO is essential, and early reporting of fever-like symptoms.
“As for your vessel- effective measures include storing grain and other foodstuffs in rodent-proof containers and to store and dispose of garbage far from the vessel. Where possible it is also advised to have a sterile vessel whilst in Nigerian ports. Then ensure rat guards are in place on anchor chains and mooring lines and should you bunker a careful and thorough check of all incoming goods is mandatory.”
- Lassa fever is an acute viral haemorrhagic illness of 2-21 days duration that occurs in West Africa.
- The Lassa virus is transmitted to humans via contact with food or household items contaminated with rodent urine or faeces.
- Person-to-person infections and laboratory transmission can also occur, but are less common.
- Lassa fever is known to be endemic in Benin, Ghana, Guinea, Liberia, Mali, Sierra Leone, and Nigeria.
- The overall case-fatality rate is 1%. This rises to 20% in Nigeria.
- Early supportive care with rehydration and symptomatic treatment improves survival rates.
- There is currently no vaccine that protects against Lassa fever.
Because the symptoms of Lassa fever are so varied and non-specific, clinical diagnosis is often difficult, especially early in the course of the disease. Lassa fever is difficult to distinguish from other viral haemorrhagic fevers such as Ebola virus disease as well as other diseases that cause fever, including malaria, shigellosis, typhoid fever and yellow fever.