Lagos State Ministry of Health Update on Lassa Fever Outbreak in Lagos State as at January 27the 2016

I.Preamble
Lagos State has recorded twenty (20) suspected cases of Lassa Fever as at January 26, 2016, since the outbreak of the disease in the Country in November, 2015.

Fourteen (14) suspected cases tested negative, four (4) suspected cases were confirmed positive of Lasssa Fever, while the results of two (2) suspected cases are pending. One (1) case was confirmed on the 15th January 2016, two (2) cases were confirmed on 18th January 2016 and one (1) case was confirmed on 26th January, 2016.

The Ministry has line-listed 537 contacts of the confirmed cases and 534 (99%) of the contacts are currently being monitored.

The last confirmed case was a 27 years old Lady, who travelled to Edo State on December 24 2015 and returned to Lagos on January 2, 2016. She became ill on January 14, 2016 and received care in one private hospital and three churches before she was referred on January 23, 2016 to Ijede General Hospital with fever, vomiting, diarrhoea and body weakness. The patient died within a few hours of admission. The case was confirmed as Lassa Fever on January 26, 2016.

The remains of the patient has been kept in the morgue in leak proof body bag. She is to be buried after due consultation with her family.
Ninety (90) persons have been line-listed as contacts of the last confirmed case as at January 26, 2016 and contact tracing is on-going.

II. Information for the General Public
Route of Transmission of Lassa Fever
Members of the public are being sensitized to note that Lassa fever can be contacted through:
1. Ingestion of foods and drinks contaminated by the saliva, urine and faeces of infected rats
Catching and preparing infected rats as food
2. Inhaling tiny particles in the air contaminated with infected rat urine or droppings.
3. Direct contact with a sick person’s blood or body fluids, through mucous membranes, like eyes, nose or mouth.
People at greater risk of Infection with Lassa Fever
Those at highest risk of Lassa Fever include:
4. Families and friends of an infected person in the course of feeding, holding and caring for them.
5. Health workers who have attended to infected persons.

Manifestations of Lassa Fever
Residents are urged to watch out for following signs and symptoms of Lassa fever which typically occur within 1-3 weeks after the patient comes into contact with the virus.
1. Early symptoms of the disease include fever, headache, chills, diarrhea, nausea, vomiting, sore throat, backache, and joint pains.
2. Late symptoms include bleeding from the eyes, ears and nose, bleeding from the mouth and rectum, eye swelling, swelling of the genitals and rashes all over the body that often contain blood. It could progress to coma, shock and death.
How to prevent spread of Lassa Fever
Towards prevention of spread of Lassa Fever, residents are enjoined to:
1. Observe a high level of personal and environmental hygiene.
2. Ensure proper environmental sanitation (Using appropriate methods of collection and disposal of waste, avoid open defecation).
3. Wash hands properly before and after cooking of foods.
4. Eliminate rats from dwellings, avoid consumption of rat meat, protect food items from rodents by storing them in plastic containers with covers and cover all foods (including left-overs) and water properly.

III. Information for Health Workers (Public and Private).
Health workers are advised to:
1. Be at alert to ensure early detection Lassa fever and other viral hemorrhagic fever in patients with high fever.
2. Report any suspected case to the Primary Health Department of LGAs or the Ministry of Health.

I need to emphasise that to prevent spread of infection from a patient to a health worker, Doctors, Nurses, Laboratory Scientists, Pharmacists and other health workers in both public and private health facilities must:

1. Observe universal safety precautions when attending to all patients.
· See body fluids of all patients as possible sources of infection. These include blood, secretions, excretions and other body fluids.
· Regular hand washing with soap and water.
· Wear appropriate hand gloves
· Protect the eyes and noses.
· Wear gowns, protective clothing and caps.
· Sterilise all instruments
· Decontaminate linen and laundry.
· Dispose of medical wastes appropriately

2. Wear appropriate PPEs when attending to suspected/confirmed cases.
· Hand gloves
· Goggles
· Face masks
· Overall (gown).
· Apron
· Booths
3. Wash their hands with soap and water regularly.

IV. Information for Mortuary Personnel
All mortuary personnel are enjoined to follow strict Infection Prevention Control measures when handling dead bodies. All mortuary personnel must wear elbow-length gloves, gowns, overall, goggles, face masks, booths when attending to corpses.

V. General Information on how to identify and report Suspected Cases
Cases to be suspected are:

1. Any person with persistent high fever not responding to standard treatment for malaria and typhoid fever.

2. Any person with positive history of contact with an infected person or health worker who had treated either suspected or confirmed cases, who suddenly become ill.

VI. Measures put in place by the Government
The government, towards preventing and controlling the spread of Lassa Fever in the State, has:

1. Established an Emergency Operations Centre (EOC) at the Ministry of Health (Conference Room) to coordinate response.
2. Rapid response teams have been set up to carry out the following interventions:
· Collect blood samples from suspected cases for investigation.
· Transfer suspected and confirmed cases to separate isolation ward for observation and management.
· Contact identification, listing and monitoring.
· Case management.
· Decontamination
3. Embarked on intensive awareness and sensitization campaigns through meetings with different stakeholders (market women, school teachers, religious leaders etc), radio jingles, media appearances and distribution of IEC materials.
4. Supplied Personal Protective Equipment (PPE) to all General Hospitals, infection prevention commodities (PPEs, Lea Proof Body Bags etc) and antiviral drugs.
5. Intensified Disease Surveillance activities for prompt detection of any new case.
6. Mobilised professional from the Lagos State Ministry of Health (LSMH) and its agencies, Federal Ministry of Health (FMOH), Lagos University Teaching Hospital (LUTH), Lagos State University Teaching Hospital (LASUTH), Association of Public Health Physician

VII. Conclusion
In conclusion, I wish to reiterate the need for the citizenry to follow the general health promotion and disease prevention measures.

These measures include:
1. Basic environmental sanitation, including proper disposal of refuse, avoiding open defecation etc.
2. Regular hand washing with soap and water
3. Maintaining personal hygiene.
4. Adequate nutrition

I hereby state again with great emphasis that:

1. All health workers must have high index of suspicion in cases with high fever not responding to treatment, especially those with positive history of contact with infected person and adhere strictly to infection control measures while providing health care to the people

2. Mortuary personnel must wear elbow-length gloves, face mask, gowns and other personal protective equipment while attending to the remains of dead patients.

3. The public should report suspected cases.

Suspected cases should be reported to the nearest public health facility or notify the Ministry of Health on the following lines[b] 08037170614, 08022234273, 08022241768 08033065303, 08033086660, 08055281442 and 08023169485.[/b]
The Lagos State Government, under the leadership of the Governor, His Excellency, Mr. Akinwunmi Ambode will continue provide quality, affordable and accessible health care to the good people of the State towards achieving universal health care to all.

Thank you for your attention.

Itesiwaju Ipinle Eko lo je wa logun!