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Lassa fever: Ghana Health Service issues alert

The Ghana Health Services (GHS) has cautioned all Divisional Directors, Regional Deputy Directors of the Service and public health care facilities of the likelihood of outbreaks of Lassa fever in the country.

The GHS in a release explained the disease has already affected several countries in West Africa with over 300 cases and 31 deaths in Nigeria and this has necessitated urgent spontaneous national response actions among all neighboring countries.
The GHS recommend the following to all health workers and institutions:
1. Surveillance on Lassa fever and Acute Haemorrhagic Fevers in general (using case definitions) should be enhanced.
2. Suspected cases of Lassa fever should be managed in specific isolation conditions
3. Health workers should adhere to regular Infection Prevention and Control (IPC) measures to prevent and protect against possible nosocomial transmission
4. Blood sample from suspected case(s) should be taken and safely packaged and sent to Noguchi Memorial Institute for Medical Research (NMIMR) for laboratory investigations
5. All levels (National, Regions, Districts and Facilities) are requested to update their preparedness and response plans for Lassa fever and VHF in general, sensitize the respective staff and create necessary public awareness.
GENERAL INFORMATION ON LASSA FEVER
Lassa fever is an Acute Viral Haemorrhagic Fever illness which is endemic in the West Africa. The incubation period is 6-21 days. The onset of LF illness is often gradual, with non-specific signs and symptoms and commonly presents with fever, general weakness and malaise at the early onset.
After a few days, headache, sore throat, muscle pain, chest pain, vomiting, diarrhoea and abdominal pain may follow. Severe cases may progress to show facial swelling, and bleeding tendencies (from mouth, nose, vagina or gastrointestinal tract, and low blood pressure. Shock, seizures, disorientation, and coma may be seen in the late stages. Complications include: deafness, transient hair loss and gait disturbance may occur during recovery. About 80 % of Lassa Fever infections are mild or asymptomatic.
• Lassa fever virus is transmitted to humans via contact with food or household items contaminated with the urine, saliva faeces, and blood of the rodent (Multi-mammate rat).
• Person-to-person infections and laboratory transmission can also occur, particularly in hospitals lacking adequate infection prevent and control measures.
• The disease is endemic in the rodent population in parts of West Africa and the multi-mammate rat serve as reservoir for the virus.
• Lassa fever is known to be endemic in Benin, Guinea, Liberia, Mali, Sierra Leone and parts of Nigeria, but probably exists in other West African countries as well.
• Ghana recorded first confirmed case(s) in 2011 and two districts, one each in Ashanti and Eastern regions then confirmed outbreaks of Lassa fever.
• Early use of Ribavarine (within seven days of disease onset), supportive care with re-hydration and symptomatic treatment improves survival.
• There is no effective vaccine for the disease at the moment.

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