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WHAT’S THE BIG DEAL ABOUT LASSA FEVER? 

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BACKGROUND:
Alan is 35 years and lives in the rural area. She is married to a farmer and together they have 5 children with her youngest child just clocking 8 months of age. Recently sleeping at night has been an issue for her family, as rats hold their council meetings in her home and all methods employed to deal with these creepy little mammals had so far proved abortive.

She sleeps with her 5 children and husband in one room. In her kitchen,she stores household food stuff and her ritual almost every morning was to clean rat faeces deposited by the rats during their night council meetings; yet every day the size of the droppings seemed to increase. She sometimes noticed these black droppings in her garri bag which was usually not properly closed as well as the rice bucket which had a broken cover but ignorant Alan ignored these all as she said “Dirty no dey kill African  man.”

“How can I discard a whole bag of garri and bucket of rice”, she murmured to herself; NO WAY!!!What will these children and mama eat? She throws her refuse at the back of her house and rats usually feasted on discarded food remnants all day long. One of the favourite pastimes of her children was killing these rats with their catapults and handling dead rats with their bare hands.

In fact many times they conducted mini rat killing tournaments and any one that killed the highest number of rats usually went home with the bragging rights.

Three weeks ago she suddenly started feeling weak and developed a fever. Her husband took her to the local chemist who gave her antimalarial and anti-typhoud medications as well as drugs for her fever, however her symptoms worsened as she soon started vomiting and passing watery stool. Her baby who was been breastfed also started having similar symptoms.

Seven days later,despite the earlier treatment the fever still persisted and she started having severe abdominal pain as well as difficulty in swallowing. She was then rushed to the General Hospital by her husband. By this time three of her other children were ill. She was investigated and again  treated for typhoid fever and despite the drugs she was on, her condition seemed to worsen.

Two days into the admission her eight months old baby who was been breastfed died by her side. While grieving for her baby she suddenly started vomiting blood and bleeding from her nostrils.

The doctor in charge of the health facility immediately became suspicious and reasoned he could probably be dealing with a viral haemorrhagic fever. Blood samples were taken from her and a call was put across to the State epidemiologist, who responded quickly. Few hours later Alan gave up the ghost.

Her blood sample was taken to the infectious disease laboratory and the fear of the doctor came true, when he received a call from the epidemiologist. His hospital had just handled a case of Lassa fever.

INTRODUCTION
Lassa fever also known as Lassa Hemorrhagic fever is an acute viral haemorrhagic illness which is caused by the Lassa virus a single-stranded RNA virus.

Lassa fever was first described in the 1950s, however the virus causing Lassa Fever was not identified until 1969 when two missionary nurses died in Lassa a town in Bornu State Nigeria. Lassa fever is endemic in parts of West Africa including Sierra Leone, Liberia, Guinea and Nigeria.
SIGNS AND SYMPTOMS
80% of people who come in contact with the virus either have no symptoms or come down with mild symptoms and are undiagnosed. The remaining 20% are symptomatic. Symptoms usually begin 6 – 21 days after contact with the virus.

Symptoms are non-specific and may include fever, general malaise and weakness as well as headache.
Symptoms may progress to include vomiting and stooling which may be bloody, stomach pain, difficulty in swallowing, unexplained bleeding, difficulty in breathing, chest pain and shock.

Some patients may also have hearing loss, seizures, meningitis and encephalitis. Death usually occurs as a result of multi-organ failure. Pregnant women in the 3rd trimester usually have high death rates;not forgetting high rates of spontaneous abortion. Because of how unspecific and variable the symptoms of Lassa fever are, it is usually difficult to diagnose clinically.

TRANSMISSION
Multimammate rat a rodent found in most homes and eaten as a delicacy in some areas is the host of Lassa Virus. When these rats
become infected with the Lassa Virus they do not become ill, but rather they shed the virus in their urine and faeces.

Humans become infected by direct contact with infected rats and their excrement. Contact with the virus can occur through inhalation of excrements which can occur during sweeping and dusting. It can also occur through eating contaminated food, exposure to cuts and open wound and touching of contaminated material. It can also be contacted directly by eating contaminated rats.

Person to Person transmission occurs via direct contact with body fluids and secretions of infected individuals. Sexual transmission of Lassa virus has been reported. The virus is excreted in urine for 3-9 weeks and in semen for 3 months. There is no evidence of airborne person to person transmission. Health workers and caregivers are at a very high risk of been infected.

DIAGNOSIS
Definitive diagnosis requires testing that is available in only specialized laboratories.

TREATMENT
At present there is no vaccine available that protects against Lassa fever. Ribavarin an antiviral drug has been found to be very useful in the treatment of Lassa fever patients especially when started early.

PREVENTION AND CONTROL
The role of community hygiene in the prevention of Lassa fever cannot be overemphasized. Foodstuff and grains should be stored in Rodent-proof containers; refuse thrown far from the house which must be properly cleaned. Placement of traps in and around homes can help reduce rodent population. Bear in mind that rats must not be handled or eaten and keeping of cats should be encouraged.

Family members should avoid touching body fluids while caring for sick persons. Hospital Staff should always apply universal safety precautions when handling patients.

In Nigeria, healthcare workers seeing a patient suspected to have Lassa fever should immediately contact the Local Government Disease Surveillance and Notification Officers (DSNOs) and/or epidemiologist in the State
Ministry of Health or call the Federal Ministry of Health using the following numbers: 08093810105, 08163215251, 08031571667 and 08135050005.

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Healthy Living

The Hebrew Women Tale

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By Ovundah Nyeche

One of the favourite parts of my health seminars in churches is ‘The Hebrew Women’ Table; in my slides I keep it last, because pepper soup should not be rushed, but taken slowly.

I start by going to the scripture, where this was lifted from…

The story starts, with a new king enthroned who did not know about Joseph, the Hebrew boy who became number 2 in Egypt and who was dead already, he was the reason the Israelites emigrated to Egypt and right now the new King was scared that with their number and might they could align with a foreign nation, mess them up and leave Egypt.

So the strategy was to make them slaves or 2nd class citizens and make life miserable for them by making them build cities, but ‘e be like say as the men went back home, small good morning’ and boom their wives were becoming pregnant and they were becoming more and more in number.

So the King devised another method, talk to the midwives who took care of their wives ‘Hebrew Women’ during delivery, and order them to kill all male children delivered, but spare the female children.

With less males there would be less Hebrew males, the population would be well controlled and the females would probably have been forced to marry amongst the Egyptians making it more difficult for them to leave Egypt.

A thing to note is that, Egypt was the peak of civilization at that period and for these women to deliver via midwives who had access to the most powerful king on earth should tell you a lot. Worthy of note is that these ‘Hebrew Women’ enjoyed specialized obstetric care at the best hands thousands of years ago.

The king’s order still stood, the 2 midwives had to kill all male children who were delivered, it was an order, “But Shiphrah and Puah had respect for God. They didn’t do what the king of Egypt had told them to do. They let the boys live. Then the king of Egypt sent for the women. He asked them, “Why have you done this? Why have you let the boys live?” The women answered Pharaoh, “Hebrew women are not like the women of Egypt. They are strong. They have their babies before we get there.”

Anyone that knows the Bible for himself or herself, will know that the use of the term ‘Hebrew Women’ to mean women who don’t undergo Cesarean Section or women who don’t have difficult delivery is contextually wrong.

The midwives actually lied to the King to save their own Iives and to spare the male children/ male population.

Don’t kill yourself for nothing, trying to prove what does not exist. Listen to your doctor and be more concerned about having a safe delivery with you and your baby/ies intact. Your testimony will not spoil if you said you had a CS, even if it is nobody’s business.

Wisdom is profitable to direct, faith is not the same thing as stupidity…don’t kill yourself for nothing; your children and your husband need you.

I said I should let you know…



#HearWord #OvdSpeaks #HearWordSeries

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Healthy Living

Pause

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By Ovundah Nyeche

So one day in a particular hospital, I was on call and was reviewing patients, when I got a call from someone to come to another part of the hospital immediately and leave anything I was doing.

To further indicate the seriousness there were people physically present to call me.

Rushed to the place and saw someone who just slumped…my mind was working like a pentium 4, what could this be…did all the preliminaries, did all I knew in the split second, but the hands were cold and the pupils were telling a story, a story which was saying a journey has started to eternity.

I broke the sad news and minutes later relatives showed up, they were also told the sad news, amidst cries, tears and prayers.

I observed the event closely…the family members seemed the most broken…to others the corpse was just a dead body, or perhaps a dead friend or colleague or perhaps just another dead person or even a firewood. But to the relatives it was a dead family member, a benefactor, a sibling, a parent, a caregiver etc.

In days if the deceased work in a facility that needs attention, a new worker would be employed to fill the gap and life will continue as if nothing happened, whilst family and close friends mourn their loss.

In this past few days, I have seen a lot of ailments many terminal and as always, I would advise you to please take care of yourself, REST (note to self), cancel appointments if necessary, go for check up, check your blood pressure, do a full workup, see a doctor (even if you are one), take a break from stressors (including social media), detoxify your mind, see a psychiatrist, see your pastor, unload, take a retreat, vacation, eat right, run from things that would damage your body, delegate, go on leave, take life je-je, spend quality and quantity time with family etc.

This life no get duplicate, and if anything happens na your family members go suffer am…as life moves on…even if you die in any office, it is very likely the office will not end and the sun will still rise and set.

It is sad seeing people carrying bombs as BP and carrying values of check that are either too high or too low.

Take care of yourself and pause where you need to pause…it pays

Everything is not about gathering, gathering, gathering. Struggling, struggling, struggling…

May this instruct you.

#HearWord #ovdspeaks #HearWordseries

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Healthy Living

Dealing with stress in the face of a pandemic.

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Ovundah Nyeche

A few days ago, during a Zoom meeting, I mentioned that; ‘we are not just dealing with a pandemic, but also an infodemic’, which is an excessive amount of information concerning a problem such that the solution is made more difficult. Little was known about COVID-19, 5 months ago, but right now it is in the lips, ears and minds of a lot of people worldwide. Considering the amount of updates, especially fake news, with the level of uncertainty, with the level of loss of control, with dwindling fortunes in many quarters… Fear and anxiety is at an all-time high.

This is the period when having a cough, fever, catarrh or difficulty in breathing can increase the worry hormones. This is also a period where a lot of people are worried about their own health and the health of their loved ones especially those that are more vulnerable to COVID-19.

And to keep up to speed with the news, a lot of people are having issues with their sleep and having changes in their eating patterns. Many are having issues with concentrating, as bad news hits left, right and center. Worsening chronic health problems stare us at the face. There is also worsening of mental health conditions and increased use of alcohol, tobacco and drugs this period, as people find ways to deal with stress and fear.

So how do you cope with stress

*Get news only from verified sources, trust me ‘e get why’. That ‘salt and pepper’ that brings out the dopamine in you, may not be good for your health. Professionals report having your health in mind, while many sources report with sensationalism and the overwhelming need to get more clicks at the back of their mind. Also it is important you get the right information, so that you may be properly equiped.

* Take breaks from watching reading or listening to news stories, including social media, it will do you a great good.

* Take care of your body needs by eating healthy; a nutritious diet will do you a whole lot of good. You will also need to exercise regularly; you can tailor-make the exercises you do, so as not to break the physical distancing rule. Get adequate sleep; sleeping well does not in any way connote laziness, a good refreshed sleep is very important. Avoid alcohol, cigarettes and drugs this period.

* This is also a time to meditate, pray, listen to wholesome/soul lifting messages, it will do you a whole lot of good.

* Learn something new this period, the fact that it looks as though things are on hold, does not in any way mean your life should be on hold. You can learn something new, but come on, it doesn’t have to be a competition.

* Give back to society in your own capacity, you may think your effort will be considered too small, but you can be a voice for someone or something this period, you can be a reason someone says thank you and wishes to live one more day.

* Do something you enjoy this period, of course something that would not put your health at risk or expose others to harm.

* Connect with others. As you know Physical distancing does not mean you should cut off from people, call your parents, call friends on phone, ask people how they are doing, care about others, and be willing to respond to other people’s need, it will also not be a sacrilege to receive help from other people. No one is a superman or superwoman. Find out how others are doing, and do not be embarrassed if people ask you how you are doing.

* Play your part to stop the spread of fake news, be careful what you share, if you are not sure and it is malicious, you may as well not share even if it sounds so sweet. Never allow fake news and rumors spread in your hands.

* We should also play our part to reduce stigma and stigmatization of people during this period.

Do have a great day ahead, we will overcome this. Let’s play our part to flatten the curve, it is in our hands.

Credits: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html

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