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Nigerians fear COVID-19, a deadly virus COVID-19 is more prevalent in Nigeria than in any other part of the world

Inside a Nigeria hospital ward treating Lassa, which is a virus that infects 100,000 – 300,000 people in West Africa every year.

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Nigeria: Owo As soon as Victory Ovuoreoyen found out he had Lassa virus, he was convinced it was the end of his life. The businessman was admitted to the Federal Medical Centre in Owo, a city in southwestern Nigeria, when he could barely walk and feared for his life. In addition to a high temperature, he also experienced nausea, vomiting, and watery, bloody diarrhea.

The malnourished patient had been confined to an isolation ward for four days, but he is now able to sit up straight on his hospital cot and is one of the few in the hospital who is well enough to communicate. Before my illness, I was not able to count my bones with such precision. I lost a lot of weight,” he says, pointing to his clavicles, which are exposed by his baggy mustard-colored shirt.

The 48-year-old man has been diagnosed with an acute haemorrhagic disease similar to Ebola, but doctors have assured him that he will recover. Lucky for him. According to the World Health Organization, the mortality rate among those who require hospitalization is 15%, despite the fact that 80% of those infected do not become very ill from the virus and most cases go undiagnosed. Severe symptoms may begin appearing as early as a week into the illness, after an incubation period of two to 21 days. It might be too late by then.

Lassa fever lowers the platelet count in the blood and its ability to clot, causing internal bleeding. Within a matter of days, organ failure can set in.

Early signs include a fever, sore throat, nausea, and muscle and head aches. Initially, they are indistinguishable from the symptoms of malaria, a common disease in the region. This Owo hospital’s lab is the only place in the state to run diagnostic blood tests for Lassa, and patients must wait two days for the results. This confluence of factors often results in the late diagnosis of Lassa, which limits treatment options.

More than 160 people have died since the Lassa outbreak began in January of this year, and its epicenter is an agricultural market center called Owo, located about 300 kilometers (186 miles) from the Nigerian capital Abuja. In March, when the number of cases was highest, the 38 beds in the isolation ward were insufficient, so 10 more cots were added. The Lassa virus is much more feared than the coronavirus in this region of Nigeria. Reasonably so: According to the hospital’s Infection Control and Research Centre, 171 people have died from Lassa in Ondo, the state where Owo is located, since 2020, while only 85 people have died from COVID-19.

You could spread it like wildfire, they said.

Nursing supervisor Josephine Funmilola Alabi monitors Ovuoreoyen’s intravenous drip of antiviral medication and fluids to combat the dehydration she experiences as a result of her Lassa fever. Alabi wears a full white hazmat outfit, complete with surgical cap, face mask, and face shield. This is the only acceptable form of attire for entering the “red zone,” the isolation ward for extremely contagious patients. She also has on two sets of surgical gloves and disinfected rubber boots. There is not a square millimeter of her skin exposed. We’re taking this virus very seriously. Alabi says, “We can’t even enter the ward without full PPE, which is what doctors and nurses wear when treating patients with extremely contagious diseases.” This year in Nigeria, four Lassa deaths have been healthcare workers.

Unfortunately, most of the world is still largely unaware of the disease’s existence despite its pervasiveness in West Africa. Lassa, a town in northern Nigeria about 1,000 kilometers (621 miles) from Owo, is where the virus was first discovered in 1969. Since then, at least five countries in West Africa have reported it as endemic. Up to a thousand new cases are reported each year in Nigeria, Africa’s most populous country. 211 cases were confirmed in Nigeria in the month of January alone this year, with 40 patients succumbing to the disease.

According to the Africa Centres for Disease Control, between 100,000 and 300,000 Africans contract Lassa fever annually, with thousands succumbing to the disease.

Bodily fluids from infected people can spread the disease. The fever is contagious between mothers and their children and is a leading cause of miscarriages. There is a six-month window where it can be found in breast milk. Scientists have expressed concern that the Lassa virus, like other viruses causing haemorrhagic fevers that have no cure and are easy to reproduce, could be used as a biological weapon.

“Diseases know no geographical limits.”

Clinical microbiologist Adebola Olayinka says that it is not spreading around the world at the same rate that COVID-19 did. She cautions, though, that this may soon change. She has extensive knowledge in the field of infectious diseases and currently works as the coordinator for Lassa fever research at the Nigeria Centre for Disease Control. As an example, she cites the Ebola outbreak. While it had been present in the DRC for decades, in 2014 it spread rapidly throughout West Africa, and then to England and the United States.

Olayinka claims that there are no effective treatments for Lassa fever and that there is also no vaccine against it. Ribavirin, an antiviral medication typically used to treat Hepatitis C, is currently the only drug used to combat Lassa fever. Pre-clinical studies and costly clinical trials are required to prove the drug’s efficacy against the Lassa virus, but its effectiveness has not been thoroughly researched to this point. She thinks the fact that Lassa is so uncommon in the West is to blame for the lack of study into the disease.

Just look at how quickly the COVID vaccine was developed, she exclaims. However, “if a contagious disease primarily affects the poor, it won’t receive as much attention as one that does.” The Access to Medicine Index took stock of the R&D efforts of the 20 largest pharmaceutical companies a year after the pandemic’s outbreak in 2020. There were 63 studies focused on coronaviruses, 5 on Ebola, and none on haemorrhagic viruses carried by rodents like Lassa, which are prevalent in Africa and Latin America.

The West is not safe from Lassa’s attacks. A couple in England was hit by the illness earlier this year. The man caught it in Mali and infected his pregnant wife there. At a hospital in Bedfordshire, their premature child tragically passed away from the virus. “The West needs to understand that a disease anywhere could be a disease everywhere,” Olayinka warns. The spread of disease “knows no geographical bounds.”

They were able to recognize the problem in time.

Owo’s head nurse, Alabi, is still making the rounds. Twenty of the available beds on this April day. Approximately 3.5 million people live in Ondo, a state roughly half the size of Belgium, but this is the only hospital treating Lassa fever in the entire region. There were no empty beds in the ward a month ago. And a few years ago there were so many cases that tents for patients had to be set up in the open grounds next to the bungalow where the Lassa ward is housed.

Alabi checks on IV drips and occasionally checks in on patients to see how they’re doing. Antiviral drugs are used, but patients also receive vitamin supplements, antibiotics for secondary bacterial infections, and malaria drugs if they test positive for that disease. To reduce the spread of disease, staff members are not permitted to remain in the “red” isolation zone for longer than one hour at a time. Doing rounds in an overcrowded ward can take up to two hours, which is unacceptable during an outbreak like this year’s. You have to take that chance for the benefit of the patients, she says matter-of-factly.

The “red zone” is filled with hospital beds with broken enamel bars. The cots have IV bags hung next to them. According to Alabi, the patients lay in the corridor so that the staff can hear their feeble cries for assistance. Around-the-clock, the medical staff’s protective footwear and goggles are sterilized. Used equipment is cleaned by being submerged in large tanks of chlorinated water and then being hung to dry in the tropical sun on wooden stands.

Under the marquee that lines the walkway up to the clinic’s front door, Dr. Sampson Omagbemi Owhin meets with patient Olaide Akinyola. They sit on plastic chairs outside in the fresh air and talk about her health.

Akinyola, a 38-year-old educator, came back to the Lassa ward this morning for a checkup. After being sick for a few days, she checked herself into the treatment center a month and a half ago. Initially, she attributed the blood loss to a particularly heavy menstrual flow, but when she became too dizzy to stand up straight, she decided to get tested for Lassa. After the clinic got the good news, she was admitted within hours.

The good news is that “they caught it in time,” as Akinyola’s doctor put it, so she can count herself among the fortunate. After a blood transfusion and ribavirin treatment, her condition improved.

In other words, information is a potent tool.

She claims that Akinyola, as a teacher, has ready access to data about the virus. I didn’t have a lot of anxiety about being admitted here,” she says. Since the virus was discovered so quickly, I was confident in my recovery.

Her doctor assures her that knowledge is a powerful tool in the fight against Lassa fever. A patient’s bleeding may not stop even after they’ve been sent home from the hospital. Haematologist Ohwin explains that the virus has been found in semen two years later, so even cured male patients are advised to use condoms. This is in addition to the persistent blood disorders that can occur.

In the afternoon, 42-year-old Kayode Omolayo shuffles out of the Lassa clinic’s patient exit and makes his way to the visitors’ area, a concrete floor covered by an orange aluminum roof shelter. A ditch runs through the middle of the platform below, dividing the sick from the healthy. There is a fenced-off area where visitors can safely greet patients who have recovered enough to leave bed by following the arrow on the metal sign planted in the grass.

After 10 days in Lassa, Omolayo knows how important it is to maintain cleanliness at home. “I’ll start by cleaning the place from top to bottom and looking for rat poop,” she says.

When Lassa ward head nurse Alabi leaves the “red zone,” she enters a station equipped with plastic barrels for disinfecting shoes and face masks before they are reused. The 50-year-old woman slowly reveals her worries about the future.

The nurse claimed that it was getting harder for non-governmental organizations to donate money to fight infectious diseases like Lassa fever. That means there is less bottled water for workers to drink after spending the day in hot moonsuits. Personal protective equipment shipments have slowed. She is worried that the medical center may run out of money and stop providing its current free care, as most Nigerians cannot afford the $1,000 fee for treatment.

Meanwhile, the team is getting ready for another influx of customers. Putting on her rectangular glasses, Alabi’s smile fades as she says somberly, “The next deadly Lassa outbreak is only a matter of time.”