Chijioke Agwu, Abakaliki
Mr. and Mrs. David Nwamini, a young couple from Ndubia village, Ezza Inyimegu, in Izzi Local Government Area of Ebonyi State, died recently from an ailment suspected to be Lassa fever.
It was gathered that David, a petty trader, returned from his base in Lagos State to see his wife and their only son, and he took ill. After some symptoms associated with Lassa fever were noticed, the young man was rushed to a mission hospital in Onuenyim Agbaja village within the same local government. He died at the hospital.
A resident of the area, Mr. Sunday Nwoffia, told the reporter that, shortly after Nwamini’s death at the hospital, his wife began to show similar symptoms. She was vomiting blood and bleeding through her nostrils. Villagers took her to the same health facility where she also gave up the ghost.
Nwoffia said: “Before the man died, he vomited blood and bled from his nostrils. Same thing happened to his wife. Our fear now is how to save the lives of other residents with common signs who had resorted to herbal medicines following their inability to afford hospital bills.”
However, the couple was immediately buried by the villagers and sympathisers for fear of spread of the disease.
In December last year, Daily Sun reported that at least five persons died in Igbeagu Izzi following an outbreak of Lassa fever epidemic in the area. Consequently, the Ebonyi State government ordered immediate closure of St. Vincent’s Hospital, Ndubia, in Igbeagu, due to reported deaths and increasing spread of the disease at the facility.
The correspondent had gathered that, out of over 10 Lassa fever patients reportedly admitted at the hospital, no fewer than five of them were said to have died there as at Thursday, December 26.
The hospital was battling to manage the development until the death of one Ephraim Ogaranya prompted the hospital to contact the Ebonyi State Ministry of Health.
The victim’s sister, Uchechi Ogaranya, who was attending to her brother before his death, and many other patients were subsequently moved to the Virology Centre at the Alex Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA2 ) for treatment.
Governor David Umahi’s Special Assistant on Media, Mr. Francis Nwaze, in a statement, said the governor ordered the closure of the mission hospital to curtail further spread of the disease.
Several other cases are not reported to the health authorities, especially in the northern part of the state where the disease has been most prevalent. Right now, even as the nation joins the rest of the world in grappling with the challenge of containing the spread of the deadly novel coronavirus pandemic, Lassa fever is silently killing people daily in Ebonyi State.
Regrettably, most of victims of the deadly virus are poor villagers who do not have access to quality health care. And not many of those who make it to the hospital come back alive.
Lassa fever was first discovered in Nigeria in 1969 in a town called Lassa in today’s Borno State. The symptoms of the diseases are often fever, headache and bleeding. It is an animal-borne disease transmitted through contact with infected rodents. The virus has an incubation period of six to 20 days.
The virus has been endemic in Ebonyi for many years and has killed more persons in the state than any other disease in recent times.
The Nigeria Centre for Disease Control (NCDC) recently disclosed that Lassa fever death toll had risen to 193 in 12 weeks alone, with a case fatality rate (CFR) of 18.9 per cent.
Director-general of NCDC, Dr. Chikwe Ihekweazu, who gave an update on the outbreak of the virus, noted that most of the casualties and reported cases were from Ebonyi and 10 other states: Edo, Ondo, Bauchi, Taraba, Plateau, Kogi, Abia, Enugu, Benue and Gombe as well as the Federal Capital Territory (FCT).
As stated in the Lassa Fever Situation Report by the NCDC released on April 4, 2020, Ebonyi State accounts for 8 per cent of the total 963 confirmed cases nationwide. In other words, 77 Ebonyi residents have been confirmed with Lassa fever in 2020. This makes Ebonyi the third state with the highest number of cases (prevalence) in the country, after Edo and Ondo.
The NCDC, in its Week 14 Report of Lassa fever, also said Nigeria recorded 12 new cases of the disease with three deaths between March 30 and April 5, 2020.
According to the report shared by the agency on its official Twitter handle on April 9, the new cases were reported in Edo, Ondo, Ebonyi, Bauchi and Sokoto states. Although the NCDC stated that there was a decline in the number of cases for four consecutive times, a total of nine persons died in a week. Official reports showed that no fewer than 179 deaths have been recorded through Lassa fever outbreak in Nigeria.
The NCDC report stated that 19 cases were reported for Week 13, compared to 28 reported for Week 12. These cases were reported from eight states, Edo, Ondo, Ebonyi, Bauchi, Taraba, Plateau, Kogi and Delta. The decline in new cases, according to the NCDC, might be explained by the beginning of rainfall in some parts of the country.
Meanwhile, the disease has continued to claim the lives of many Ebonyi residents, including health workers. In January 2018, the University Graduates of Nursing Association stated that no fewer than 40 health workers have been killed by Lassa fever in Ebonyi State, between 2005 and 2018.
Troubled by the situation, the management of the Alex Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA), Ebonyi State, recently raised the alarm over the increasing casualty rates of the virus in Ebonyi. It said the hospital recorded 81 new cases of Lassa fever virus between January and March 2020.
Chief medical director of the hospital, Dr. Emeka Onwe, noted that people still doubted the fact that Lassa fever was prevalent in the state.
He spoke at the Lassa Fever Virology Centre within the hospital premises while inaugurating a Lassa Fever Caretaker Centre built by Médecins Sans Frontières (MSF), also known as Doctors Without Borders, an organisation that has been partnering with the hospital to combat the virus.
He said: “In the next two years, these doctors will leave. How will the institution cope? Imagine where we didn’t have MSF, what would have happened this year? There would have been a very serious crisis.
“Some people here did not know that there is an outbreak of Lassa fever in Ebonyi State. If you go to the town and talk of Lassa fever, they will doubt what you are saying. They will ask, is it still in existence?
“As at three days ago, the total number of confirmed cases from January was 81. Some people now sacrifice their time and money to pay for every patient. They pay for whatever thing that the patient has enjoyed here. At times, they will even buy coffin for the burial of those that died. It is something we need to reflect on. If people will leave the comfort of their homes to come and save us, it is something we have to reflect on and rethink on what we will give to the society.”
Onwe lamented that the fight against the disease was weakened by lack of equipment used in treating patients: “Now, we have the manpower, but lacking the machine or equipment to work. There are other things that, if we have it here, I think we will have better outcomes. The room for the dialysis; the space is very small and very inconveniencing. We need things like ventilator. We need more dialysis machines; we need things like table ultra-sound; we need mobile x-ray. But our government needs to be supporting us. We are supposed to be encouraged because of our commitment. We will be very pleased if such things are factored in and MSF comes to our rescue. Those things will help us to improve lives.
“It is our people that are sick. Those that are sick have not committed any offence, they should not die. So, if government is not giving us adequate support here, we will look for a way of helping our people. Whatever thing you do for a patient, God will reward you. We are really blessed because, in January/February 2018, we had three deaths within 48 hours.”
Leader of MSF team, Dr. Andrew Mills commiserated with the hospital over the loss of some medical workers in 2018, stating that the pathetic situation motivated their intervention.
He said, “We heard with sadness in Abuja about the state of the medical workers in this teaching hospital that were killed by Lassa fever in the state in 2018. So, we came to support the Federal Government in the fight against the disease and also to support the teaching hospital.
“Since that time, we have been doing our best and the collaboration has been yielding the desired results. What we have seen in the last two years have been so encouraging. I remember the laboratory, when we first came in early 2018. It took 10 days to get results, if it had to be sent out to Irua Virology Hospital in Edo State. Now, I learnt that it is now five hours to get result in the laboratory that is here in this Federal Teaching Hospital.
“We have seen number of babies born in the last three months that have all proved negative and their mothers have since be treated and become negative.”
And as Lassa fever ravages Ebonyi, a public health expert, Dr. Laz Eze, has stated that its fatality rate was even more dangerous that the dreaded COVID-19. He urged the authorities in Ebonyi and the 26 other states where cases have been reported to pay due attention to the disease so as to contain it.
In his words, massive awareness creation on prevention methods, especially personal hygiene practices, should be upscaled.
“This should be community-based, led by town unions and supervised by local government authorities. The prevention messages should be relayed in the simplest language the people understand using pictures, drama in schools and churches as well as media jingles.”
Eze also harped on environmental sanitation and proper waste management, urging the local and state governments to ensure this practice became a habit in all communities.
The public health advocate advised: “The multimammate rats that transmit Lassa virus to humans thrive in filthy environments. Bush burning also chases them out of their natural habitats to our homes. So, there should be effective behavioural change communication and establishment of waste management plants for refuse packing and management.
“Employ adequate number of healthcare workers and deploy to primary health care centres and general hospitals. Train them on case identification and referrals as well as strengthen the referral pathway to the Virology Centre at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki.
“Strengthen public health departments at the state and local government level to carry out routine surveillance for early case detection and management. For the above to happen, adequate funding and competent personnel must be engaged to operationalise them.”
Meanwhile, the state government has assured residents that it has not left anything to chance in the fight against Lassa fever.
It was gathered that the administration of Governor David Umahi, about three years ago, built a virology centre clearly for Lassa fever and handed the facility over to the Federal Teaching Hospital, Abakaliki. The laboratory was recently upgraded as a testing centre for the coronavirus serving the South-East and South-South.
It was also gathered that, aside from mounting enlightenment campaigns, Governor Umahi recently assented to the Ebonyi State Coronavirus and other Dangerous Infectious Diseases Law, known as Law 005 of 2020, which was passed and presented to him by the Ebonyi State House of Assembly.
Analysts have noted that, with these, the state government now has a clear-cut policy and strategy not only against COVID-19, but Lassa fever and other contagious infections.