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MANAGEMENT OF LASSA FEVER

Lassa fever

INTRODUCTION

Lassa fever is an infection or disease caused by a virus that lives in the blood causing fever to the infected person.

The first out break known was in the year 1950’s but the virus was only identified in 1969. When two nurses who were missionaries died from it in a town called Lassa (hence the name “Lassa”) in Nigeria.

The virus can cause thousands of death, even when an infected person recovers the virus still remain in the body fluids of the person including the semen.

SYMPTOMS OF LASSA FEVER

The period it takes before the signs and symptoms manifest varies from 6 – 21 days, during this period there is usually body weakness, fatigue, generally it starts with fever. After a few days, other symptoms manifest such as headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhea, cough and abdominal pain may follow.

In severe case, the following symptoms are manifested;

  • Facial swelling.
  • Fluid in the lung cavity
  • Bleeding through vital body parts such as; the mouth, the nose, the vagina or the gastrointestinal tract and also low blood pressure may develop.

In the later stage; proteins may be found in the urine and also severe tremor, shock, disorientation and coma may be seen.

After this period, deafness occurs in 25% of patients who survive the disease and in half of the cases hearing returns partially after 1 – 3 month and also gradual hair loss and gout disturbances may occur during the recovery period.

In fatal cases, death occurs within 14 days of onset, the disease is very severe in late pregnancy with lot of maternal death or foetal loss occurring in more than 80% of cases during the third trimester.

TREATMENT

The drug of choice in the treatment of Lassa fever is “Ribavirin”, on administration it is given through the vein (intravenous) or through the mouth (orally). Intravenous administration is almost twice as effective as when taken orally (mouth) and when done earlier during the course of the illness is better than treatment.

Also, in the course of treatment, support of fluid and electrolyte. Oxygenation and blood pressure is needed.

The treatment reduces the death rate from 50% to 5% when given early in serious illness.

The adverse effect include rupture of the red blood cells if the drug is infused too quickly.

PREVENTION AND CONTROL
Currently there is no vaccine that can prevent against Lassa fever as well there are no evidence supporting the role of Ribavirin as post-exposure preventive treatment against Lassa fever.

Prevention of Lassa fever can be accomplished by generally promoting good community hygiene, such as ensuring to keep a clean environment that will discourage rodents from entering homes and storing grains and other food stuffs in rodents’ proof container, disposing of garbage far from home keeping of cats can also help.

In areas where rodents are so abundant, people need to be careful to avoid contact with blood and body fluids while caring for the sick.

Also for health personnel’s, standard infection prevention and control precaution should be employed when caring for patients. These include the use of personal protective equipment, safe injection practices, basic hand hygiene and safe burial practices.

In cases of patients suspected to have Lassa fever, the health care provider should apply extra infection control measures to prevent contact with patients’ body fluids and blood as well as contaminated materials and surfaces and when in close contact, that is within 1 mile, face protection should be won and a clean, non-sterile long sleeves gown and gloves.

For laboratory workers handling patients’ samples for investigation, should be handled by trained professionals and it should be processed in suitably equipped laboratory under maximum biological containment condition.

Travellers are also at risk of transporting the disease to other countries when they travel to countries with history of Lassa fever. Diagnosis of Lassa fever should be considered in feverish patients’ returning from West Africa.

Conclusion

Lassa fever as a disease has raised more concern in recent years, due to its high death rates. It can be contained where high standard medical practices are available and the drug Ribavirin can be used for its treatment. More so, preventive measures are highly encouraged to be practiced to prevent its contamination from rodents. Health care providers which are at the greatest risk are advised to carry out a standard infection control measures and also when seeing a suspected patients to contact immediately local and national experts for advised and to arrange for laboratory testing.

By James B. Hope

Student Pharmacist






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