Lassa Outbreak in Nigeria..Months and counting

Medic-ALL (01-25-2016) DISEASE

by Kayode Kuku

Just less than 2 years after the Ebola virus hit the Nigeria and other countries in the West African region, Lassa fever, another viral hemorrhagic fever, with similar symptoms as Ebola broke out in the country.

Lassa fever is an acute viral illness first discovered in Nigeria in 1969 when 2 missionary nurses died from the disease. The virus was subsequently named after the town in Borno State, Nigeria where the first cases occurred. The virus belongs to the virus family, Arenaviridae, a single stranded RNA virus which is animal borne and usually associated with rodent transmitted diseases in humans.

It is endemic in parts of West Africa including Sierra Leone, Gambia, Liberia and Nigeria notably but the risk is spread throughout the region where the disease vector, the multimammate rat (Mastomys Natalensis) is distributed.

Lassa virus is transmitted to humans by contact with excreta or urine of infected rats.

Lassa virus is transmitted to humans by contact with food or household items which have been contaminated with excreta or urine of infected rats. Since the disease is endemic in rodent population, it tends to affect communities with poor sanitation and crowded living conditions the most. Hence it is sometimes referred to as a "disease of the poor".

The present outbreak of Lassa Fever broke out in Nigeria, August 2015 and reports show that it has claimed up to 63 lives as at the January, 24, 2016  out of over 200 suspected cases spread across 17 states in the country including the Federal Capital Territory, Abuja. Nigeria's Health Minister, Professor Isaac Adewole, stated that 212 suspected cases have been reported in the last 3 months.

While the world's most populous black nation was praised for its prompt containment of Ebola in 2014, things appear a little more complicated in the case of Lassa , as many stakeholders including specialists have raised concerns ranging from ignorance of the disease among the vulnerable communities, leading to under-reporting of the cases and under-mining the scale of the outbreak  , and even the capacity of the country's healthcare system to deal with the outbreak at this time.

These are valid concerns, considering the "skeletal" state of the country's primary health care system and the lack of access to adequate health care in the vulnerable regions. The country reported 112 deaths and over 1700 cases of Lassa fever in 2012, yet in a population of over 170 million people, there is only one research center in the country to cater for Lassa fever research.

As far as comparison with Ebola goes, Lassa fever is not necessarily as deadly, but it spreads faster.

Meanwhile, while Lassa fever has exposed the level of preparedness of the nation's health care system to cope with such outbreaks, the WHO and US CDC are working with Nigeria Health Ministry in containing the outbreak.

Medic-All Inc. 2016

Refs: CDC, Punch Nigeria

MERS Claims More Lives

Medic-ALL Health News (06:09:2015) South Korea on Tuesday reported its seventh death from Middle East Respiratory Syndrome (MERS) virus, and confirmed eight new cases in the deadly outbreak.

The latest fatality involved a 68-year-old woman who came into contact with a MERS patient at a hospital in Seoul on May 27 and 28, the health ministry said.

The ministry stressed all seven fatalities had pre-existing health problems before they contracted the virus, with the seventh suffering from a heart condition.

Eight new cases were also confirmed Tuesday, in comparison to 23 on the day before.

That brings the total number of infections to 95 from just four cases two weeks ago, in the largest outbreak of the disease outside Saudi Arabia.

The outbreak in South Korea, first confirmed on May 20, has sparked mounting public concern.

It has seen more than 2,500 people placed under quarantine orders and nearly 2,000 schools -- mostly in Seoul and surrounding Gyeonggi province -- closed down.

Courtesy : AFP

New Virus discovered in the U.S!

Medic-ALL (02:21:2015) DISEASE

The Centre for Disease Control and Prevention, CDC said on Friday, February 20 that the mysterious death of a man in Kansas, U.S last year appears to have been caused by a previously unknown virus.

Naming it the Bourbon virus after the county where the man had lived, researchers from the CDC, the Kansas Department of Health and Environment, and the University of Kansas classified the agent as a new member of the Thogotovirus genus, others of which are known to cause human disease.

The middle aged man had presented in the late spring of 2014 with fever and fatigue. Laboratory examinations revealed thrombocytopenia (low level of platelets) and leukopenia( low level of white blood cells). He reported numerous tick bites in the days prior to falling ill. He was consequently treated with doxycycline, but there was no improvement and he shortly developed multi-organ failure, dying of cardiopulmonary arrest 11 days after symptom onset.

His blood was tested for known tickborne diseases ( Lyme's , Rocky Mountain spotted Fever) but these were negative. However, the investigators reported, "testing of a specimen for antibodies against Heartland virus indicated the presence of another virus."

Electron microscopy revealed virus particles unlike those of known tickborne pathogens in the U.S.; the research team classified them as within the Orthomyxoviridae family, and with further study as a previously unknown Thogotovirus.

The researchers indicated that they would now look to see if Bourbon virus has been present in other human infections. They also plan to "explore its potential geographic distribution and confirm tick as been the vectors.

The discoveries of Bourbon virus, Heartland virus, and similar tickborne diseases in recent years "suggest that the public health burden of these pathogens has been underestimated," the researchers concluded.

Via Mepage Today
Edited by Kayode Kuku for Medic-ALL blog 

Medic-ALL Inc 2015

Chikungunya: Yet Another Virus!

Medic-ALL  (24:10:2014) by Kayode Kuku MB;BS

At a time when the world is agog with the now very popular but deadly "Ebola virus disease", its outbreak in parts of West Africa and recent spread to the United States and Spain, some other parts of the world are having to contend with "Yet Another Viral" disease without a known cure.

The Chikungunya (pronunciation:/ chi-ken-gun-ye: meaning, that which bends over in the "Makonde" language of Tanzania and Mozambique) disease is caused by a mosquito-borne virus (meaning it is transmitted to people by mosquitoes).

The chikungunya virus was documented for the first time, last December in the islands of St Martin in the Caribbeans, even though it is believed to have existed in parts of Africa, Europe and Asia-Pacific regions for decades. The major symptoms of the disease include fever (usually over 39°C) and severe joint pain (causing infected persons to bend over), others may include muscle pain, headache, joint swelling, nausea, fatigue or rash. Occasional cases of eye, neurological, heart and gastrointestinal complications have been reported.

According to Dr Lyle Petersen of the Centre for Disease Prevention and Control (CDC), the virus has an incubation period (time between exposure to manifestation of first symptom) of about 3-7 days, with a range of about 2-12 days. The acute symptoms could resolve within 7 to 10 days but some patients could develop complications in the coming months.

Nearly 800,000 people have been infected with the Chikungunya virus in the Caribbeans, majority in the Dominican Republic. Jamaica declared a state of emergency last weekend with estimated reports of about 60 percent of the country's population down with the virus and almost 200 persons are documented to be infected with the disease in Canada according to Canadian Health officials. The United States recently reported its first locally-acquired case of the disease in a man in Florida.

                                                Distribution map of Chikungunya in the Americas

As of October 17, 2014, local transmission have been identified in 36 countries or territories in the Caribbeans, Central America, North America and South America, with a total of 759,742 suspected and 14,035 laboratory-confirmed cases have been reported from these areas (Updated data from Pan-American Health Organization).

The fear is that the disease may likely continue to spread throughout the Americas through infected people and mosquitoes as the mosquito which carries the virus in found in many parts of the region including the United States. Moreso, the chikungunya virus is new to the continent and many are not immune to it.

Furthermore, as has been the case with the "traveling Ebola" there is definitely the risk of the virus been imported to new areas by infected travelers. There is presently no vaccine nor medicine to prevent or treat the chikungunya virus disease. Travelers are advised to protect themselves when traveling to countries with the virus by preventing mosquito bites with use of insect repellents, insecticide-treated nets, wearing of long sleeves and pant and stay in places with air-conditioning or that use window or door screens.

Though it is estimated that up to 72%-97% of persons infected with the Chikungunya virus will develop clinical symptoms, Mortality is rare, except in older patients with underlying conditions!....not necessarily "Good" news ,but "Better" news.

Refs:
1.Centre for Disease Control and Prevention
2.CBC News

Resource: Dr. Patience Akahara