Conference abstract

A case report of Lassa fever in a military cantonment, Kaduna state, April 2017

Pan African Medical Journal - Conference Proceedings. 2018:8(44).05 Dec 2018.
doi: 10.11604/pamj-cp.2018.8.44.626

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Keywords: Lassa fever, mastomys natalensis, ribavirin, surveillance, Kaduna State
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A case report of Lassa fever in a military cantonment, Kaduna state, April 2017

Aisha Abubakar-Sadiq1,&, Nnomzie Charles Atama2, Usman Adekanye2

1Epidemiology Unit, Ministry of Health of Kaduna State, Nigeria, 2National Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria

&Corresponding author
Aisha Abubakar-Sadiq, Epidemiology Unit, Ministry of Health of Kaduna State, Nigeria

Abstract

Introduction: Lassa fever (LF) is a viral haemorrhagic illness caused by an Arenavirus. Humans get infected via contact with feces, urine and blood of infected rats (Mastomys natalensis). The disease is endemic in West Africa with 300,000 - 500,000 cases and 500 deaths annually. In Nigeria, LF outbreaks occurred continuously from Oct 2016 - April 2017 in 16 States with a total of 242 suspected cases, 58 confirmed cases and 46 deaths (Case Fatality Rate: 79.3%) recorded. On the 27th of March 2017, a suspected case was reported at military cantonment Jaji, Kaduna state. We investigated to confirm the diagnosis, determine the magnitude and institute public health measures.

Methods: we reviewed hospital records and line-listed all contacts. A confirmed case of LF was defined as any person with fever and at least one of; sore-throat, bloody diarrhea, vomiting blood, bleeding from nose, gum, eyes, and history of travel to affected areas or epidemiologically-linked to a laboratory confirmed (PCR or positive IgM antibody) case. Two blood samples were collected and tested for LF using PCR and antigen detection. All contacts were enlisted in surveillance for 21 days.

Results: the case, a 47 years old male had travelled to Ebonyi State and was in contact with a suspected case of LF before returning to Kaduna State. He presented at the cantonment clinic on 27th March 2017, with fever, headache, fatigue and a history of failed response to anti-malarial. He subsequently developed abdominal pain, dysphagia, hematemesis and epistaxis. Laboratory results were positive on PCR and antigen detection for Lassa virus. None of the primary (16) and secondary (6) contacts (mean age: 40.5 7.4 years) developed signs or symptoms of LF within the surveillance period.

Conclusion: the suspected case was confirmed, isolated and managed with Ribavirin, and discharged on April 17th, 2017 after a repeat blood test. We provided health education on preventive measures within the cantonment. Personal protective equipment and infra-red thermometers were provided to health workers. We recommended improved surveillance and environmental sanitation in the State for early detection and control.