Before Lassa fever, meningitis get out of hand

No doubt, the nation’s health sector is battling with many challenges. These range from inadequate equipment, brain-drain, incessant strikes and incidence of fake and adulterated drugs, among others. It is because of these identified problems that concerted efforts should be made to ensure that potential outbreaks of Lassa fever and meningitis diseases are vehemently curtailed, because of the low capacity and capability of the nation to control such emergencies, if they ever occur.

We recall that in 2016, Lassa fever ravaged many states of the country. Since then, the nation has witnessed rising cases of the disease, leading to the death of several people in the northern and southern parts of the country. Lassa fever has been a recurring decimal for health authorities since it was first diagnosed in 1969 in Lassa village of Borno State. It is a viral disease transmitted when a person gets into contact with an infected rats waste rine or bodily fluids of an infected human. These rats are often found in several homes, even the most neatly kept! Transmission through contaminated food is common, as the rats often leave their excretions in food stores. For emphasis, symptoms of Lassa fever include persistent high fever, stooling, vomiting and bleeding from the mouth, nose and anus. Lassa fever has been described as the acute viral haemorrhagic illness of one to four weeks period that occurs mainly in West Africa. The infections usually have no noticeable impact in some patients but it could be fatal in others and it is treated with the antiviral drug; Ribavirin.

More worrisome is the revelation that Lassa fever outbreak portends high risk of another viral epidemic, Ebola. This should not be allowed, again. The resurgence of the deadly viral disease is nothing but a failure of the relevant authorities to put effective measures in place, to prevent its spread. The Nigeria Centre for Disease Control (NCDC) has confirmed some deaths and other cases arising from fresh outbreaks of Lassa fever. Between 2012 and 2013, Nigeria recorded close to 3,000 Lassa fever cases across the states. In response to the outbreak, the Federal Government inaugurated the Lassa Fever Eradication Committee, to design an effective response plan to curb the spread, tame future outbreaks and reduce deaths from the disease. Unfortunately, not much is known to have been achieved by the committee in carrying out its assignment. To be more proactive, state governors should come in and do more to ensure that the scourge is tamed in their respective states.

Concrete steps that should now be taken would involve directing all health facilities in the country to emphasise routine infection prevention and control strategies. Because of the highly contagious nature of the virus, family members and healthcare workers should remember to avoid contact with blood and body fluids while caring for sick persons. Furthermore, this is ideal the time to internalise all the lessons learnt from the way and manner in which the Ebola scourge was successfully handled in the country, to the admiration of the world. While members of the public are advised to always keep their environment clean, healthcare workers are enjoined to immediately contact epidemiologists and other designated officers in the States Ministry of Health or the Federal Ministry of Health on seeing any patient suspected to have the fever without unnecessary bureaucracy. Dedicated and active toll-free telephone numbers should be available for the people to use at any time of the day.

On a personal level, Nigerians should completely improve their hygiene. Combating the menace of Lassa fever is a joint effort by individuals, the people and the government at all levels. Stipulations given by reputable health bodies such as the World Health Organisation (WHO), should be religiously adhered to. For now, more emphasis should be given to identifying the symptoms to look out for in terms of the causes, prevention and immediate actions for people to take on either suspected or confirmed cases. They should not show apathy or be unnecessarily docile as a result of religious sentiment; similar to the claim alluded to the Zamfara State Governor, Alhaji Abdulaziz Yari, who has attributed the renewed outbreak of the disease to flagrant disobedience to God, saying the outbreak was a punishment for people’s alleged sins and nefarious activities.

For meningitis, the cogent reason why emphasis should now be placed on the disease is for the fact that with the current high atmospheric temperature and heat-wave, there is the likelihood of severe spread of meningitis across the country. Meningitis, medically known as cerebrospinal meningitis, was reported to have so far claimed over 400 lives in the country. Meningitis is an infection of the thin lining that surrounds the human brain and spinal cord, known as the meninges, as viral infections are said to be its most common cause while bacterial meningitis tends to be more severe. The causative microbe; Neisseria meningitides, can be carried in the throat and can sometimes overwhelm the body’s defenses by allowing infection to spread through the bloodstream. Bacterial meningitis can seriously cause epilepsy, mental retardation, deafness, necrosis by leading to limb amputation of patients.

Further frightening disclosures by medical experts show that the microorganisms causing the disease are said to be mutating; rapidly changing in form such that eliminating the microorganism from the human body becomes very difficult, after infection. The disease is usually transmitted through sneezing, coughs and oral secretions. The symptoms range from restlessness, high fever, stiff neck, headaches and vomiting. For prevention, the use of vaccination, which could last from between two and three years, is considered very effective. Preventive measures involve sleeping in well-ventilated rooms, avoiding overcrowding and observing excellent personal hygiene.

During the hot months and weather conditions, such as the one being experienced now, it is expedient that we are well prepared for the scourge, going by the sincere admittance by Federal Government that it was caught off guard by the renewed outbreak of meningitis. The way forward is for both the federal and state governments should be more committed to rigorously fighting meningitis. Apart from the current outbreak, which has overwhelmed the existing stock of vaccination, state governments in the meningitis belt should wake up from their slumber and champion putting an end to the scourge because we cannot afford this avoidable and recurring annual loss of lives. Sustained efforts through consistent enlightenment campaigns are needed at this critical period at the grassroots level because many people still live in ignorance on how to mitigate the disease. Ultimately, government should draw out a plan realisable action plans to obtain and stock the needed vaccines from multilateral organisations and other reputable sources. Hoarding by unscrupulous persons for financial gains, at the detriment of public health, should be prevented.

We should always learn from our past experiences. Nigeria has suffered from poor management of diseases that are taken for granted in other countries of the world. Many people are daily being inflicted with other serious ailments and do not have the means to take care of themselves. Despite past attempts by successive governments, what we need to do now is to put in place, a solid healthcare system that is built on sincerity of purpose, commitment, continuity in governance by revamping the various public health institutions throughout the country through adequate and sustainable funding. In addition, the National Health Insurance Scheme (NHIS) should be restructured in such a way that many people could benefit from the scheme while the coverage and scope of operations should be broadened, to achieve its objectives. The private sector should also invest more in the lucrative health sector, to discourage medical tourism from Nigeria and to generate employment opportunities for the people.

Kupoluyi wrote this piece from Federal University of Agriculture, Abeokuta, Ogun State.