Ameliorating Post Traumatic Stress Disorder

LASSA fever is an acute zoonotic viral haemorrhagic illness caused by a single stranded RNA virus called Lassa virus. The virus is found in a rodent (multimammate rat), which acts as its reservoir. The virus is socalled because it is named after Lassa town in Borno State, where it was first discovered.

Exposure to the virus is basically through two main ways: Firstly is rodent to human transmission, whereby there is ingestion of food or materials contaminated by infected rodent excreta or catching and preparing the rat as food. The second is human-tohuman transmission, whereby there is direct contact with blood, tissues, secretions or excretions, urine of infected humans and sexual contact.

Other modes of transmission can be needle stick or cut injury, transmission through breast milk. Inhalation of aerosolised virus is also reported.

Lassa fever can occur in all age groups and sexes. The symptoms of exposure are high-grade fever, headache, malaise, facial swelling, muscle weakness, conjunctivitis and mucosal bleeding. There can also be symptoms arising from affected organs. In the gastrointestinal system we can have nausea, haematemesis (vomiting of blood), dysphagia (inability to eat), diarrhoea, which can be bloody, abdominal pain and constipation.

In the cardiovascular system, it can lead to hypotension and tachycardia. In the respiratory tract, it can manifest as cough, chest pain, breathlessness and sore throat, while in the central nervous system, it can manifest as hearing loss, seizures and coma.

Lassa fever is also known to be severe in pregnancy, especially in the third trimester. The illness may manifest between of five to 21 days, which is the usual incubation period for the disease.

Lassa fever is diagnosed through the use of the case definitions mentioned above, as well as use of laboratory test to isolate /detect the virus. Lassa fever is treated mainly with an antiviral drug known as ribavirin, as well as other adjunct treatments given to treat the infected person, such as fluids and antipyretics, among others.

Prevention of Lassa fever can be ensured by adequate health education to the community. Good community hygiene should be implemented to prevent rodents from entering homes. There should be proper handling and storage of food in rodent-proof containers. Trapping and killing of rodents with proper and safe disposal of the carcasses should be ensured. Rodents should be avoided as source of food. Those who spread food outside for drying e.g. cassava grains or any other food should ensure they are covered and prevented from rodent’s infestation.

Where there are cases of Lassa fever, prevention methods to curtail its spread should also be done, such as promotion of good environmental and frequent/regular hand washing practices, as well as avoiding contact with infected people. Safe burial practices should also be done, where there are incidents of death. This may require professional handling of corpses.

In hospital settings where Lassa fever cases are treated, preventive measures should be instituted to avoid nosocomial spread (health worker to patient, and patient to patient spread of the infection). There should be isolation of cases, as well as universal safety precautions, such as strict barrier nursing and good hand washing practice, among others.

Protective clothing i.e. personal protective equipment (PPE) should also be worn by health workers. These include gloves, safety mask, gowns/overall, face shield and consistent sterilisation of contaminated equipment.

Lassa fever is a disease in which one case is said to be an epidemic, and it may result into death in 50 per cent of cases. Therefore, we need to create more awareness about the disease and ensure that the menace is curbed, particularly at community, state and national levels.

The prevention of Lassa fever virus is the key thing we need to ensure, because as Benjamin Franklin said: “An ounce of prevention is worth a pound of cure.”

Mpolitical ambition to become a senator of the Federal Republic of Nigeria suffered a huge loss during this year’s February 23rd Presidential and Senatorial elections. Meanwhile, he invested his entire business capital, as well as a huge loan he obtained from the bank into the political project. Spiff lost his left arm during one of the battles his troop engaged with Boko Haram in the

North East of Nigeria. Juliet was about to obtain her permanent resident documents in UK when she was arrested and deported.

These sad and sorrowful life events are typical tipping points, which orchestrate the incidence or exacerbation of post-traumatic stress disorders.

It is challenging and distressing that in some occasions the event that triggered off the PTSD is beyond the victim’s control. For instance, a soldier must go to war and cannot be in control of the weapons of mass destruction employed by the enemy.

Some accident victims, in spite of their skillful and careful driving, end up brutalized by other drivers and vehicles.

Post-traumatic Stress Disorder reminds us that life is a product of vicissitudes and vagaries.

During this earthly journey, human beings may not escape the trials and troubles, tests and tornadoes of life.

The victorious pathway is to prepare one’s mind to overcome and conquer every challenge life offers. This is a major reason I once declared that attitude, more than aptitude, determines people’s altitude. In other words, attitude more than any investment determines people’s level of success in life. Such an understanding significantly introduces us to the issue of developing effective strategy for dealing with PTSD.

The two major approaches used to handle PTSD are Medical (Chemotherapy) and Psychotherapy. With reference to the former, the use of selective serotonin reuptake inhibitors has been recommended for treatment of clinical depression and sometimes the treatment of serious cases of anxiety disorders.

The target of Psychotherapy in PTSD is to help the victim to learn coping skills as well as to adjust to new challenges that arise as a result of the disorder. Some of the recommended psychotherapeutic strategies for handling PTSD include, Group, Family and Eye Movement Desensitization and Reprocessing (EMDR) therapies. Very remarkable excellent results of psychological treatment of PTSD have been recorded with the use of Cognitive Behaviour and Psychodynamic therapies. Of course, one cannot describe the technicalities of these psychotherapeutic models here. I proceed by focusing on some basic psychological principles of handling PTSD.

A rule of the thumb principle in all health issues is that of early detection and reports of symptoms. The incubation period of PTSD is variously given to last between a month and a few years and the consequences will be less threatening and devastating if detected, reported and handled immediately. Consequently, family members and friends can play significant roles in helping the victim to seek early professional help.

Victims of PTSD can benefit from engagement in quality rest. By this arrangement, the pressure of work is removed from the victim. However,

PTSD patients shouldn’t be left alone. They should be guided and guarded by adults. This is to forestall any form of the former engaging in personal harmful activities. Depending on the degree of damage to one’s health and personality, the patient may benefit from some form of productive activity. Also, such activity should fit into the patient’s regimen.

Fundamentally, involvement in physical exercise will help to distract the patient from concentrating on the negative memories, which normally characterize PTSD. As the patient engages in physical exercise, he/she experiences release of tensions, anxieties and fears. This cathartic role of physical