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 Table of Contents  
LETTER TO EDITOR
Year : 2016  |  Volume : 2  |  Issue : 3  |  Page : 135-136

Responding to the Public Health Threat of Lassa Fever in West Africa


Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Ammapettai, Chennai, Tamil Nadu, India

Date of Web Publication2-Feb-2017

Correspondence Address:
Saurabh R Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, 3rd Floor, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram 603108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2423-7752.199295

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How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Responding to the Public Health Threat of Lassa Fever in West Africa. J Earth Environ Health Sci 2016;2:135-6

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Responding to the Public Health Threat of Lassa Fever in West Africa. J Earth Environ Health Sci [serial online] 2016 [cited 2018 Dec 18];2:135-6. Available from: http://www.ijeehs.org/text.asp?2016/2/3/135/199295

Sir,

Lassa fever is an acute viral hemorrhagic condition, resulting because of exposure to the Lassa virus, which accounts for the disease outbreaks across West Africa.[1] It is a zoonotic disease, with rodent (Mastomys natalensis) being the primary reservoir, which is present in the entire sub-Saharan Africa, whereas the virus is present exclusively in West Africa.[1],[2] In fact, the disease is found to be endemic in seven nations of the region, and since the beginning of 2016, two outbreaks of the disease have been reported in Nigeria and Benin.[1] In addition, there is a potential risk of transmission of the disease from the endemic regions to other nonendemic nations through travelers.[2],[3]

The epidemiological assessment of the disease suggests that it has no predilection for any specific age group or sex; nevertheless, risk of fatality is high in pregnant women infected with the virus in the third trimester.[1] The risk of infection is extremely high among the people residing in rural areas in unsanitary or overcrowded conditions, with the primary reservoir being simultaneously present.[1],[2],[3] Furthermore, the infected rodents do not become ill and continue to shed the virus in their urine and feces.[2]

The virus is transmitted to humans primarily when they come in contact with the food/fomites contaminated with the urine or feces of the infected reservoir.[2] However, transmission of infection between humans through direct contact with bodily secretions of an infected person has been reported when they do not comply with standard barrier nursing or infection prevention and control measures.[3],[4] Further, it has been observed that four-fifth of the infected patients have no symptoms, while the remaining patients present with a severe form of the disease with involvement of multiple organs like liver, spleen, and kidneys.[2],[3] Though the disease has an overall case fatality rate of 1%, it may increase up to 15% in severe cases, and even to 80% in the last trimester of antenatal women (with poor fetal outcome as well).[1]

As the clinical presentation of the disease is quite variable and nonspecific (similar to other hemorrhagic fevers), reaching to a clinical diagnosis is quite difficult, with confirmation of the disease being dependent on serological tests or virus isolation.[5] From the treatment perspective, ribavirin is an effective treatment for the disease in the initial stage of the disease.[3] The outcome of the disease in terms of survival rates can be further improved by the prompt symptomatic treatment and hydration support.[2],[3] However, amidst absence of an effective vaccine for the disease, the outbreaks can be significantly prevented by the prompt isolation of the infected people, standard infection prevention and control measures, and rigorous contact tracing.[1]

As it is not possible to completely eliminate rodents from the region, interventions to prevent their entry into homes by ensuring storage of grains/food items in rodent-proof containers, disposal of garbage away from the home, maintenance of clean households, or by keeping cats in the home play a defining role.[1],[2] In addition, health workers, laboratory staff, and family members of the infected people should be sensitized about the modes of transmission of the disease and prophylactic measures (such as hand hygiene, personal protective equipments, safe injection practices, or burial practices) required to prevent the acquisition of infection.[2],[3]

Furthermore, measures like formulating national prevention strategies, improving surveillance of the disease, strengthening laboratory capacity for the promotion of prompt diagnosis, training of the health or laboratory staff in aspects of clinical management or laboratory techniques, encouraging outreach activities, and environmental control measures to control rodent populations will also play a significant role in reducing the incidence of the disease.[1],[2],[3],[4],[5]

To conclude, Lassa fever is a serious hemorrhagic disease in West Africa, and owing to the risk of high preponderance in the rural region, there is a great need to coordinate the efforts of different concerned sectors, to ensure that the disease ceases to be a public health threat.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
World Health Organization. Lassa Fever − Fact Sheet; 2016. Available from: http://who.int/mediacentre/factsheets/fs179/en/. [Last accessed on 2016 Mar 19].  Back to cited text no. 1
    
2.
Makinde OA. As Ebola winds down, Lassa Fever reemerges yet again in West Africa. J Infect Dev Ctries 2016;10:199-200.  Back to cited text no. 2
    
3.
Shaffer JG, Grant DS, Schieffelin JS, Boisen ML, Goba A, Hartnett JN et al. Lassa fever in post-conflict Sierra Leone. PLoS Negl Trop Dis 2014;8:e2748.  Back to cited text no. 3
    
4.
Mylne AQ, Pigott DM, Longbottom J, Shearer F, Duda KA, Messina JP et al. Mapping the zoonotic niche of Lassa fever in Africa. Trans R Soc Trop Med Hyg 2015;109:483-92.  Back to cited text no. 4
    
5.
Olowookere SA, Fatiregun AA, Gbolahan OO, Adepoju EG. Diagnostic proficiency and reporting of Lassa fever by physicians in Osun State of Nigeria. BMC Infect Dis 2014;14:344.  Back to cited text no. 5
    




 

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