From bats to rats as Lassa takes off where Ebola stoped
An ironical twist of fate, West Africa has been declared free of the
two-year Ebola epidemic just as the sub-region is facing a renewed
disease epidemic threat in the guise of Lassa fever. For most West
Africans, particularly Nigerians that had an unpalatable taste of the
devastating Ebola outbreak, it isn’t yet time to heave a sigh of
relief. The West African Ebola outbreak was the worst in history.
Between December 2013 and November 2015, Ebola infected almost 29,000
people and claimed 11,315 lives across the sub-region and even beyond.Nigeria recorded nine deaths out of a total of 20 confirmed Ebola
cases. On Thursday, Liberia, the worst Ebola-hit country with 4,800
deaths, got the all-clear from the World Health Organisation. West
Africa is Ebola free, but no one can heave a sigh of relief because
Lassa fever is taking over where Ebola has left off. And it has begun
with Nigeria.
Like a bad dream, Lassa fever has turned up in Nigeria for the third
time within a decade. Since the last quarter of 2015, the country has
been battling the epidemic disorder, which at the last count, has
reached 10 states and killed 43 people. More than 400 suspected cases
have so far been recorded in the Borno, Gombe, Yobe, Taraba, Plateau,
Nasarawa, Ebonyi, Edo, Ondo, Rivers, Anambra, Lagos and the FCT out of
which around 90 cases have been confirmed.
Last week, the Federal government created the Lassa Fever Rapid
Response Committee, whose goal is to control and prevent the spread of
the disease. Public health officials have also asked Nigerians to stop
burning bushes as this drives rats out of the bush and into nearby
houses. Also just like Ebola, health care workers are predominantly
infected and likely to die from Lassa fever infection, most often due to
poor medical practices, late diagnosis, and treatment. The federal
government has quickly stepped in with series of measures.
GOVT BANS CONSUMPTION OF RATS
It has placed a ban on consumption of rats that are a delicacy common
to some states in the Middle Belt region of the country to curtail the
spread of the disorder. Now it’s from Ebola fever to Lassa fever. In
effect, what this translates to is from bats to rats! What can be good
about rats? Nothing is the simple straight answer, except if one
considers that they eat garbage. Rats are associated with dirty, smelly
and unhygienic environments such as compost heaps, gutters, sewers and
the like. When people think of rats what come to mind are pictures that
are disgusting, dirty, and creepy.
But, bad as rats are, they live right alongside humans, eating the
food, damaging household and office furniture, and leave droppings and
urine markings all over the place. Rats are parasites because they live
off humans without providing anything of worth”, in other words, rats
are good for nothing and nothing is good about rats.
ORIGIN
Unlike Ebola, Lassa fever is not new to Nigerians. The first ever
documented case of Lassa fever was reported in Nigeria in 1969 when two
missionary nurses died in a town called Lassa in the part of Nigeria now
known as Borno State . They had complaints of weakness, headaches,
fever and general malaise. An acute viral illness, Lassa fever has so
far claimed 43 lives from just under 100 reported cases in 10 states of
the country and the FCT.
Ebola fever and Lassa fever share so many common characteristics,
they could be described as siblings, however, they are essentially
different illnesses. They are classified as haemorrhagic fevers, because
they cause severe haemorrhaging in victims. Both are caused by viruses
that belong to the same Arenaviridae virus family. The Ebola and Lassa
viruses are zoonotic in nature and of Africa origin.
BETWEEN EBOLA AND LASSA
While the Ebola virus lives mainly in the fruit bat, it is the
“soft-furred rat” (multimammate rat) also known as Mastomys natalensis,
that carries the Lassa virus. These rats are widespread throughout the
West African region, breed frequently and bear many offspring,
increasing the potential for spread of the virus from rats to humans.
They are often found in human homes and transmission through
contaminated food is common, as the rats usually leave urine and
excrements in food stores.
TRANSMISSION AND SYMPTOMS
Just like the Ebola virus, the Lassa virus is transmitted through
close contact with the virus host or the sweat, vomit, blood or other
bodily fluids of an infected person, or the recently deceased. Both
cause severe fever and muscle pain, weakness, vomiting and diarrhoea. In
many cases they shut down organs and cause unstoppable internal
bleeding. Patients often succumb within 3-21 days.
But unlike Ebola, Lassa is different because it is treatable with
Ribavirin – an antiviral drug, that is only effective if administered
within the first six days after the disease onset. Lassa fever patients
also benefit from careful monitoring of fluid, electrolyte and oxygen
levels.
People usually become infected with Lassa virus from exposure to
infected rodents. Person-to-person transmission occurs through direct
contact with sick patients in both community and health care settings.
Those at greatest risk are persons living in rural areas where Mastomys
are found. Health care workers are at risk if adequate infection control
practices are not maintained.
Last week, the Nigerian federal government created the Lassa Fever
Rapid Response Committee, whose goal is to control and prevent the
spread of the disease. Public health officials have also asked Nigerians
to stop burning bushes as this drives rats out of the bush and into
nearby houses.
Humans usually become infected with Lassa virus from exposure to
urine or faeces of infected Mastomys rats. Lassa virus may also be
spread between humans through direct contact with the blood, urine,
faeces, or other bodily secretions of a person infected with Lassa
fever. There is no epidemiological evidence supporting airborne spread
between humans. Person-to-person transmission occurs in both community
and health-care settings, where the virus may be spread by contaminated
medical equipment, such as re-used needles. Sexual transmission of Lassa
virus has been reported.
Lassa fever occurs in all age groups and both sexes. Persons at
greatest risk are those living in rural areas where Mastomys are usually
found, especially in communities with poor sanitation or crowded living
conditions. Health workers are at risk if caring for Lassa fever
patients in the absence of proper barrier nursing and infection control
practices.
The furry rat , once infected, is able to excrete virus in urine for
an extended time period, maybe for the rest of its life. The typical
rodents breed frequently, produce large numbers of offspring, and are
numerous in the savannas and forests of west, central, and east Africa.
They readily colonize human homes and areas where food is stored. It is
known that worldwide, rats spread diseases directly and indirectly. An
example of direct transmission is the rat’s habit of “urine marking” for
sexual advertisement and habitat labelling. This leaves tiny tell-tale
droplets all over surfaces.
RATS SHARE FOOD AND SHELTER WITH MAN
To sum it up in the words of the CDC: “Rodents destroy property,
spread disease, compete for human food sources, and are aesthetically
displeasing”. They are clearly not one of the most beloved animals. Rats
consume untold tons of refuse every year, leaving less waste. Some
estimates say there is one rat for every human in big cities like Lagos,
Abuja, Port Harcourt, and others. That may be too many rats to think
about, there are actually hundreds of millions roaming around Lagos
alone.
Rodents share food and shelter with man. They are parasites in the
workplaces, restaurants, hospitals, schools, food processing plants and
especially the homes. They share the food and the furniture and home.
They will use plumbing voids as well as circulation vents to travel from
one part of a home/building to another. It is this habit that assures
the spread of contaminated nesting material, faeces, and urine and body
hairs.
They destroy property, spread disease, compete for human food
sources, and are aesthetically displeasing. As long as there is garbage
to get rid of, man will not be getting rid of rats soon Rats have been
responsible for some of the most devastating disease outbreaks known.
Medical literature says rats and mice could spread about 55 different
diseases. Lassa fever Lyme disease, Typhus and the Plague are just a
few.
Human behaviour could be a major contributing factor in the
transmission of deadly infections such as Ebola and Lassa fever, based
on interactions between humans, domestic animals, wildlife and the
environment. A school of thought is convinced that humans need to not
just consider rats as the villains, because ultimately humans are just
as much the villains as rats. These are other factors could ultimately
contribute to the relatively efficient spread of Lassa virus from
infected rodents to humans. Oh yes, it’s hard to find anything good to
say about rats!
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