Nigeria Centre for Disease Control (NCDC) Activates Emergency Operations Centre for Lassa Fever Response Following Outbreaks

The Nigeria Centre for Disease Control (NCDC) has activated the national multi-sectoral and multi-disciplinary Lassa fever Emergency Operations Centre (EOC) in response to the Lassa fever outbreak in some parts of the country. This became necessary given the increase in the number of confirmed Lassa fever cases across the country and a joint risk assessment with partners and sister agencies.

As of 23rd January 2022, a total of 115 confirmed cases with 26 deaths (a case fatality ratio of 22.6%) have been reported. These cases were reported from thirty (30) Local Government Areas (LGAs) across eleven (11) States. Furthermore, the reports in weeks 1 and 2 show the highest number of confirmed cases recorded in the last four years for the same period. See the latest situation report here (https://www.ncdc.gov.ng/diseases/sitreps).

Lassa fever is an acute viral hemorrhagic illness transmitted to humans through contact with food or household items contaminated by rodents infected with the Lassa fever virus. Person-to-person transmission can also occur, particularly in a hospital environment with inadequate infection control measures. Like several other countries in West Africa, the disease is endemic in Nigeria and is often recorded during the dry season, often between November and May.

Since 2016, NCDC has worked hard to improve diagnostic capacity for the disease. Currently, seven laboratories can conduct confirmatory tests for Lassa fever in Nigeria and are coordinated by the NCDC National Reference Laboratory (NRL). This has improved active case detection for the disease. Similarly, care for affected individuals has improved with NCDC providing support to states including the provision of emergency medical and laboratory supplies as well as oral and intravenous Ribavirin for preventive and curative treatment to treatment centres across the country. In addition, Nigeria through NCDC is participating in the largest-ever Lassa fever study that aims to provide an accurate assessment of the incidence of the disease in West Africa. This will also accelerate the development of vaccines and therapeutics for Lassa fever. These are supported by the Coalition for Epidemic Preparedness Innovations (CEPI) and the Wellcome Trust.

To support and strengthen the response efforts of states, NCDC has continued to deploy Rapid Response Teams (RRT) as required to states. The RRTs through the State Public Health Emergency Operation Centres (PHEOCs) work with states across all response pillars to strengthen preparedness and response activities. This includes outbreak investigation, contact tracing, response coordination, case management, psycho-social care for infected people, risk communication, and infection prevention and control activities.

Furthermore, using a One Health approach, the NCDC is working with relevant ministries, departments, health agencies, and partners to strengthen the capacity of states to effectively manage this outbreak alongside COVID-19 and other diseases of public health relevance. Risk communications activities are ongoing through radio, posters, flyers, and social media. The Federal Ministry of Environment is also implementing a Lassa fever Environmental response campaign in high burden states.

Lassa fever presents initially like any other febrile illness such as malaria. Its symptoms include fever, headache, sore throat, general body weakness, cough, nausea, vomiting, diarrhoea, muscle pains, chest pain, and in severe cases, unexplainable bleeding from ears, eyes, nose, mouth, and other body openings. The time between infection and the appearance of symptoms of the disease is 3 to 21 days. Early treatment and diagnosis increase the chances of survival.

To reduce the risk of the spread of Lassa fever, the NCDC offers the following advice:

Ensure proper environmental sanitation – i.e. keep your environment clean at all times, block all holes in your house to prevent rats from entry.

Cover your dustbins and dispose of refuse properly. Communities should set up dumpsites very far from their homes to reduce the chances of having rodents within homes.

Store foodstuff like rice, garri, beans, corn/maize, etc in containers that are well covered with tight-fitting lids.

Avoid drying foodstuffs outside on the floor, roadside where they will be exposed to contamination

Avoid bush burning which can lead to the displacement of rats from bushes to human dwellings.

Eliminate rats in homes and communities by setting rat traps and other means.

Practice good personal hygiene by frequent washing hands with soap under running water /or use of hand sanitisers when appropriate.

Visit the nearest health facility if you notice any of the signs and symptoms of Lassa fever as mentioned earlier, and avoid self-medication.

Health care workers are also advised to practice standard precautions and to maintain a high index of suspicion at all times. Ensure appropriate use of personal protective equipment any time there is a risk of body fluid exposure. This is critical for breaking the chain of transmission of the disease. Rapid Diagnostic Test (RDT) must be performed for all suspected cases of malaria. When the RDT is negative, other causes of febrile illness including Lassa fever should be considered. Accurate diagnosis and prompt treatment increase the chances of survival.

The Nigeria Centre for Disease Control remains committed to supporting States’ Public Health Teams to achieve the goal of reducing the Lassa fever case fatality rate to a single digit; preventing and responding to public health threats.