Doctor die of Lassa fever in Abakaliki

Doctor die of Lassa fever in Abakaliki
Source: The Nation


A Doctor has reportedly died of the Viral Hemorrhagic Fever, otherwise known as Lassa fever, in Ebonyi State.

Some other doctors are being treated for the disease at the Federal Teaching Hospital (FTH), Abakaliki.
Though no official confirmation has been made by the Ministry of Health, doctors have raised the alarm over the outbreak of the disease.

Some doctors at the FTH, who spoke to our reporter, regretted the outbreak of the disease, adding that doctors are prone to it since they are exposed to infected patients.

The doctors called for the quick intervention of the Federal Ministry of Health to forestall the spread of the disease.

The outbreak of Lassa fever was first reported in the state in 2008. Several people died. They included two doctors and other health workers. 

Last year, four persons said to be residing at the Military cantonment, Nkwoagu, near Abakaliki also died of the disease.

The government said it has set up an emergency response team for the treatment and control of outbreak of communicable diseases, such as Lassa fever, gastroenteritis and meningitis, usually associated with dry season.

The Commissioner for Health, Sunday Nwangele, said this while addressing stakeholders in Abakaliki.
Nwangele said epidemiologists from the ministry had been deployed to health facilities in the state to check the possible spread of the disease.

He urged the people to report any suspected case to a hospital or the epidemiology unit of the ministry.
The commissioner said the ministry had procured drugs for the treatment of the disease, adding that more was still expected from the Federal Ministry of Health.

Polio In Nigeria

Polio in Nigeria

Source: Bill and Melinda GatesFoundation.

Map: Global Polio Eradication Initiative

Nigeria’s thirty-six Executive Governors and the Federal Capital Territory have signed up for the Nigeria Immunization Challenge. The Nigeria Immunization Challenge is an initiative launched October last year by the Bill and Melinda gates Foundation.

The challenge was launched in conjunction with the Nigeria Governor’s Forum and calls on Governors and Local Government Area Chairmen to be proactive in their campaign against polio eradication, release funds in a timely manner for immunization and to work closely with traditional leaders to ensure that all children are vaccinated. 

The performance of each state will be assessed on a monthly and quarterly basis. The state that meets all the necessary threshold criteria by the end of 2012 will be awarded a $500,000 grant from the Bill and Melinda Gates Foundation to support their top health priorities. This could include priority initiatives in public health such as malaria and tuberculosis, HIV prevention and treatment or safe drinking water and hygiene promotion.

Fifty-one cases of wild poliovirus (WPV) were reported in eight Nigerian states for the year 2011 compared to 21 cases in 2010. The most recent case was a WPV1 with onset of paralysis on 27 November, 2011 in Niger state.  This is approximately a 59% increase showing that progress made in 2010 was not sustained in 2011.

 Figure: Showing cases of Wild Poliovirus in Nigeria for the year 2011.

“In 2012, Nigeria will need to redouble its efforts to finally get rid of this devastating disease,” said A.B. Okauru, the forum’s director general. Each state is also expected to achieve more than 90% coverage and this will be verified through an independent monitoring system managed by the World Health Organization.

“The sooner we end polio, the sooner we can ensure that our children, and the children of the world, stop suffering from this debilitating disease,” said Hon. Chibuike Rotimi Amaechi, Governor of Rivers State and Chair, Nigeria Governors’ Forum. “Meeting this Challenge will enable us to focus on other health priorities and also help Nigeria to join other countries that have eliminated this disease.”

Food-borne Trematodiasis

Food-borne Trematodiasis

Trematodes or flukes are flatworms belonging to the Phylum Platyheminthes. They are small parasitic flatworms that use vertebrates as their definitive host and mollusc as their intermediate host.

Trematode infections such as schistosomiasis have emerged as important tropical infections. An estimated 200 million people in the tropical belts of the world may have schistosomal infection. This makes Schistosoma infection the second most prevalent tropical infectious disease in areas such as sub-Saharan Africa after malaria.

Depending on the habitat in the infected host, flukes can be classified as blood flukes, liver flukes, lung flukes or intestinal flukes.

 

Blood flukes include Schistosoma haematobium, Schistosoma mansoni, Schistosoma japonicum, Schistosoma mekongi, and Schistosoma intercalatum.

Liver flukes include Fasciola hepatica, Fasciola gigantica, C sinensis, Opisthorchis felineus, O viverrini, Dicrocoelium dendriticum, and Dicrocoelium hospes.

Pancreatic flukes include Eurytrema pacreaticum, Eurytrema coelomaticum, and Eurytrema ovis.

Lung flukes include Paragonimus westermani, Paragonimus mexicana, and Paragonimus skrjabini.

Intestinal flukes include F buski, M yokogawai, Echinostoma ilocanum, Watsonius watsoni, H heterophyes, and Gastrodiscoides hominis.

In The Lancet Infectious Disease, Thomas Fürst and colleagues conducted a systematic review and meta-analysis to determine the global burden of human food-borne trematodiasis. Food-borne trematodiasis is a cluster/group of disease transmitted by the consumption of undercooked aquatic food contaminated with the larval stage of the fluke (i.e the metacercariae). The species of significant importance that affect human health are Clonorchiasis (infection with Clonorchis sinensis), Opisthorchiasis (infection with Opisthorchis viverrini or O.felineus) and Fasciolasis (infection with Fasciola hepatica or F. gigantic), which affect the liver and Paragonimiasis (infection with Paragonimus spp), which affect the lungs.

Food-borne trematodes have a complex life cycle which entails definitive hosts (humans and animal species that act as reservoirs of infection), a first intermediate host (a freshwater snail) and a second intermediate host (a fish or a crustacean) in which the infective metacercariae develop. Fasciola spp. is however an exception as the metacercariae are found attached to water plants or float freely in fresh water.

  Life Cycle of Five Different Food-borne Trematodes.

Fürst and colleagues used quantitative and qualitative data on prevalence, incidence, infection intensity, remission, mortality and duration to develop three simplified disease model and estimated the global burden of food-borne trematodiasis.

From their investigation they estimated that in 2005, 56.2 million people were infected with food-borne trematodes, 7.9 million people had severe sequelae and 7158 people died, while the global burden of the disease was 665 352 DALYs – 351 026 years lived with disability and 314 326 years of life lost. They also reported more men than women were infected by Clonorchis sinensis, Opisthorchis spp, all intestinal flukes and Paragonimus spp, whereas more women than men were infected by Fasciola spp.

 

These are findings are quite interesting as they show food-borne trematode infections as an emerging neglected disease. These infections occur in parts of the world where poverty persists, especially in East Asia, Southeast Asia and South America. However within a country, infection is usually focal and limited to specific regions or geographical areas. Many factors contribute to these high prevalence rate and they include: lack of education, malnutrition, poor sanitation, inability to recognise asymptomatic infections and neglect by local and international health authorities.

In their study, Fürst and colleagues highlighted several limitations one of which was high quality data. As such the global burden of food-borne trematodiasis might be much higher than reported by Fürst and colleagues. Therefore as Fürst and colleagues said, “the ultimate goal for future assessments of the burden of food-borne trematodiasis is to minimise the gap between actual and reported prevalence and between the complex natural histories of the diseases and the simplified models as applied in our calculations” .

Note:

Opisthorchis viverrini and Clonorchis sinensis have been designated carcinogens by the International Agency for Research Cancer.

Source:

Thomas Fürst, Jennifer Keiser und Jürg Utzinger.

Global burden of human food-borne trematodiasis: a systematic review and meta-analysis.

Lancet Infectious Diseases, Published online 21 November 2011,

doi:10.1016/S1473-3099(11)70294-8.

WHO: Initiative to estimate the Global Burden of Food-borne Diseases, 2011 http://www.who.int/foodsafety/foodborne_disease/ferg/en/index.html. (Accessed Sept 30, 2011)