Monday, April 14, 2014

LASSA FEVER VIRUS- an insight

Lassa fever is a zoonotic, acute viral haemorrhagic fever that was named after Lassa town in Borno State, Nigeria. That was where the index case was first identified and referred to Evangel Hospital (now Bingham University Teaching Hospital) Jos in 1969 and where recent infections are still being reported as at 10th April 2014.




The bush rat may come contaminate foodstuff and stored products with their urine and faeces that may also be aerosolized and can be inhaled. This happens more often during dry harmattan season when bush burning cause rodents to seek refuge and food in human habitats. Human to human transmission of infection is rapid such that healthcare workers are at immediate risk of infection. Community transmission through close relatives and other contacts then result in large outbreaks.

While Lassa fever has no observable symptoms in about 80% of people infected with the virus, the remaining 20% may have severe illness with case-fatality rate reaching 50%. Clinical presentation follows an incubation period of about 6-21 days. These include abrupt fever that may be mistaken for malaria, nausea, pains, diarrhea and vomiting that are usually bloody. Vascular and endothelial damage leads to overt bleeding, shock, pulmonary edema followed by liver and renal failure. Multi organ failure usually results in death.
Upon infection, Lassa fever virus can be diagnosed from whole blood or serum by virological techniques like RT-PCR, antigen detection, and virus isolation or immunological techniques to detect IgG and IgM antibodies. However, all laboratory procedures must be carried out in a biosafety level 3 and 4 facility to avoid risk of exposure to personnel.
No vaccine has been developed for the control of Lassa fever virus but antiviral like ribavirin when given intravenously can ameliorate clinical condition and convalescent phase plasma has been used in the past to treat Lassa fever. Prevention is however better than cure, therefore avoiding contact with host vectors particularly in endemic region is important. Avoid unprotected contacts with rodents and protect food from their contamination. Persons that are at great risk of exposure such as animal researchers/handlers, healthcare workers must take special precautions and always observe biosecurity measures including the use personal protective equipments (PPE), regular hand washing, strict hygiene and barrier nursing while attending to suspected cases.
In conclusion, “onehealth” approach may offer a more effective control of incessant outbreaks of Lassa and other viral haemorrhagic fever virus in West Africa.  Understanding the ecology of animal reservoir hosts, human-animal disease interface and directing counter measures against the primary cause may be less costly, more, timely and safe many lives.


This piece was contributed by Dr. Clement Meseko, a seasoned veterinary doctor and internationally trained virologist

Sunday, April 13, 2014

Ebola virus-What you need to know

Ebola virus disease (EVD) also known as Ebola hemorrhagic fever is a fatal disease of humans caused by ebola viruses. Symptoms of the disease are usually observed from 2 days weeks after exposure to the virus.These symptoms include a fever, throat and muscle pains as well as headaches. Other signs include vomitting and diarrhoea. Also, there is a progression to kidney and liver failure. When this occurs, the affected individuals may begin to bleed profusely.It typically occurs in outbreaks and occurs in tropical regions of Sub-Saharan Africa. Between when it was first identified in 1976 and 2012 less than 1000 people a year have been infected. The disease was first identified in the Sudan and the Democratic Republic of the Congo.
How do people get  exposed to the virus?





Ebola disease is acquired through contact with blood or body fluids of an infected animal such as monkeys, bats, rodents e.t.c. Bats are known to carry the virus without showing signs and they can spread the disease without being affected by it. Once a person gets infected, the ndisease can easily be spread to in-contact people. Men who survive the disease are capable of transmitting the disease for close to 2 months after recovery

How is the disease diagnosed?

In order to diagnose this condition, diseases with similar symptoms such as malaria, leptospirosis, cholera, other viral haemorrhagic fevers must be ruled out. Tests are also carried out to detect viral genomic DNA or antibodies.


Prevention

 In order to prevent the disease, contact with infected animals including wildlife should be avoided. Veterinary authorities in a community at risk would do very well to carry out serological screening of animals. Any animal showing signs of the disease or those with detectable levels of antibodies against the virus should be promptly destroyed and properly disposed. When handling the disease, protective clothing should always be worn by veterinary and medical personnel.
Those living around infected persons should wear protective clothing and observe good principles of hygiene.Laboratory scientists and others who handle blood samples and body fluids from infected individuals should do it with a high degree of caution. Meat should be properly cooked before human consumption

Treatment


No specific treatment exists. The disease is treated symptomatically. The disease has a high fatality rate which may be as high as 90%. Although efforts are ongoing to develop a vaccine none exists however as of 2014