WHAT IS LASSA FEVER?

LASSA FEVER

WHAT IS LASSA FEVER?
Lassa Fever is an acute viral haemorrhagic fever that was first discovered in the village of Lassa, Nigeria in 1969. It is an animal-borne or zoonotic illness. The animal reservoir for the Lassa Virus is the multimammate rat (Mastomys natalensis) which is very rampant in Sub Saharan Africa. Affected countries include Liberia, Sierra Lone, Guinea and most parts of Northern Nigeria.

HOW IS LASSA FEVER TRANSMITTED?
Lassa fever is zoonotic in characteristics. This means that it is transmitted from infected animals to humans. The animal vector in this case is the multimammate rat and this species of rat is very common in West Africa. Lassa Fever virus is shed through the faeces or urine of an infected rat and is transmitted through contaminated foods, soiled surfaces, ingestion, inhalation or exposure to cuts and sores. Person to person transmission is also common amongst health workers where proper protective personal equipment is not used or available. Transmission through sexual intercourse has also been documented.

SYMPTOMS OF LASSA FEVER
Symptoms usually appear between 3 – 21 days of infection. An estimated 75% of infections don’t produce significant symptoms although slight fever, weakness and malaise may occur. Symptoms can include;
 Fever
 Weakness
 Malaise
 Cough
 High temperature
 Vomiting (with blood)
 Abnormal heart rhythms
 Deafness (may be permanent)
 Pain in chest, back and abdomen
 Respiratory distress
 Hemorrhaging in gums, eyes, nose or other body orifices.
 Shock

DIAGNOSIS OF LASSA FEVER
The symptoms of Lassa Fever are varied and non-specific and as such clinical diagnosis is very difficult especially in the early stages of the disease. Laboratory based test are usually definitive. However, the specimens collected are usually hazardous and therefore tests are carried out in high containment laboratories with good laboratory practices. According to the WHO, Lassa Fever can be diagnosed definitively with the following tests;

 Reverse transcriptase polymerase chain reaction (RT-PCR) assay
 Antibody enzyme-linked immunosorbent assay (ELISA)
 Antigen detection tests
 Virus isolation by cell culture

PREVENTION OF LASSA FEVER
Primary transmission of the Lassa Fever virus is through infected rats. This can be prevented by keeping a clean home, office and environment. Store food and related items in rodent –proof containers, set rat traps and apply other safe extermination techniques and methods, keep a cat if you can. Person – Person transmission can be prevented by taking extreme care while handling sick people. Use of protective person equipment like masks, gloves, googles and surgical gowns while administering care will go a long way to preventing the spread of the Lassa Fever
virus. Avoid direct contact and watch out for splashes of bodily fluid when interacting with an infected person.
Proper enlightenment in how to reduce rodent population in “high risk areas” is also key in the prevention of Lassa Fever.

TREATMENT OF LASSA FEVER
The antiviral drug Ribavirin has proven successful in Lassa Fever Patients if administered at the early stages of the disease. However, Ribavirin is not useful in the prevention of Lassa Fever. Symptomatic treatments may increase the rate of survival also administering of supportive treatments like rehydration, balancing of electrolytes, oxygenation, and treatment of any other complicating infections may also help. There is no vaccine that protects against Lassa Fever for now.

CURRENT STATISTICS (NIGERIA)
The below statistics is according to the Nigeria Centre for Disease Control published from 3RD – 6TH February, 2020. Based on the recent outbreak of Lassa Fever in Nigeria
 1,708 suspected cases
 472 confirmed cases
 70 confirmed deaths
 14.8% fatality rate

GENERAL STATISTICS

 100,000 – 300,000 cases recorded annually
 5,000 deaths recorded annually
 Highly affected countries include Liberia, Sierra Leone, Guinea and Nigeria.
 High mortality rate (up to 80%) in pregnancies

WHAT ARE CORONAVIRUSES?

CORONAVIRUS

WHAT ARE CORONAVIRUSES?
Coronaviruses are a rather large family of viruses that can cause diseases. Many strains of the virus affect birds and mammals including humans. The coronavirus can cause illnesses such as common cold to more serious diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). Coronaviruses are usually zoonotic, that means they are transmitted between animals and people.

THE ORIGIN OF 2019 NOVEL CORONAVIRUS (2019-nCoV).
According to the World Health Organization, the 2019 novel Coronavirus (2019-nCoV), a new strain that has not been previously identified in humans was first reported in Wuhan, China, on Dec. 31, 2019. Global health authorities are yet to pin point its exact origin but early hypothesis links this new strain to a sea market in Wuhan China. Recent information suggests that the first person got sick on Dec. 1, 2019.

HOW ARE THEY TRANSMITTED?
Early information suggests that majority of people infected in Wuhan had some form of contact at a sea market. However, recent cases include people who had no prior link with the sea market which suggest that it is transmitted from person to person via contact with infected bodily fluids like droplets from coughing or sneezing, contact with infected surfaces and also infected animals.

SYMPTOMS OF 2019-nCoV
Infected people exhibit cold or flu like symptoms within two to four days of contracting the
virus. The symptoms are usually mild but can be fatal in rare cases. Symptoms also varies
from person to person.
1. Sneezing
2. Coughing
3. Fatigue
4. Fever
5. Acute respiratory problems, organ failure and death (rare cases)

DIAGNOSIS
Physical diagnosis may prove difficult as the symptoms are quite similar to that of the flu or cold. However, proper diagnosis can be achieved with laboratory tests.

PREVENTION
1. Wash your hands thoroughly with soap and water for at least 20 seconds.
2. Use alcohol based sanitizer if water is not available.
3. Avoid contact with infected people, surfaces and animals.
4. Use facemasks and gloves when entering infected areas.
5. Keep all contact surfaces clean.

6.  Maintain strict hygiene at home.

TREATMENT
There is no cure yet for this strain of the coronavirus. However it can be managed by giving symptomatic cure (this means giving remedies to symptoms).

CURRENT STATISTICS (AFFECTED COUNTRIES, CONFIRMED CASES AND DEATHS)
This report is according to World Health Organization’s Situation Report as at Feb. 9, 2020
1. 26 Countries have reported at least one confirmed case of the 2019-nCoV.
2.  37,558 confirmed cases globally with 99.2% of cases in China.
3. 6,188 severe cases in China.
4. 812 deaths recorded globally with 99.9% in China.

CONTAINMENT PROCEDURES
The spread of this new strain of coronavirus is closely monitored by, Nigeria Centre for Disease Control (NCDC), and health organizations like El-Rapha Hospitals and Diagnostics. People arriving from affected countries are being screened at airports and in some cases placed under quarantine if they show symptomatic signs. There has been no reported case on the African continent. We will provide more update as we get them.

WORLD STROKE DAY

Stroke  is a sudden interruption in blood supply to the brain. This simply means that, for some reasons, blood suddenly stops flowing into the brain as it should, depriving the brain of oxygen and nutrient. This could be caused by an abrupt blockage of arteries that channels blood to the brain or bleeding into brain tissue when a blood vessel bursts.

When this happens, the brain cells start to die within minutes.  A stroke is therefore, a medical emergency, which requires prompt treatment in other to minimize brain damage and potential complications. If you suspect someone around you is having a stroke, here is how to confirm.

*Tell the person to smile .If the face droops to one side, it is most likely a stroke.

*Try to raise both arms; if one arm drifts downwards or is unable to raise one arm, call for emergency.

*Dialogue with the person. If you notice a slur in the speech, a stroke might be on its way.

*Ask the person basic questions; Stroke patients usually encounter confusions and  difficulty remembering and understanding speech.

*Hold up fingers and ask the patient to count. Blurred vision, doubled vision or blackened vision are signs of stroke.

*Try to make the person work a short distance. Sudden dizziness, loss of balance and loss of coordination depicts a stroke attack.

If you observe any of the above signs, please call for emergency immediately. Engage the person in a calm and reassuring conversation to keep the brain cells active and the patient conscious. Make sure they are breathing properly and keep them warm. Do not give them anything to  eat or drink and observe conditions to report to medical personnel when they arrive.

Stroke is avoidable, as well as many other conditions that could lead to medical emergencies. Finally, to prevent stroke, eat healthy, exercise daily, monitor your blood pressure and sugar level, and avoid excessive smoking and drinking. El-Rapha hospital and Diagnostics cares about you and your health. Book for and appointment to see a doctor today, take preventive measures and avoid Stroke.

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GESTATIONAL DIABETES (GDM)

Blood glucose control is key to having a healthy baby

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. In other words, gestational diabetes is diabetes detected during pregnancy.

Most women are screened for gestational diabetes at 24-28 weeks gestation period during antenatal care. Sometimes, your doctor may screen you earlier if they have concerns. GDM is caused by hormonal changes associated inherently with actual pregnancy and can affect between 5% and 15%; globally, 1 in 7 women suffer from it.

SYMPTOMS

Patients do not usually notice any symptoms of gestational diabetes because the routine tests performed during pregnancy help identify the condition very early on.

Nevertheless, if it is not detected early, then the patient could notice symptoms associated with increased sugar levels (hyperglycaemia) such as an excessive weight gain by gestational age, thirst and increased urge to urinate.

RISK FACTORS * If you had gestational diabetes in a previous pregnancy
• If you’ve had a baby born weighing over 4kg
• If you are obese or overweight
• If you have a family history of diabetes.
• If you are being treated for HIV.

HOW BAD IS GESTATIONAL DIABETES?

1. It increases your risk of having type2 diabetes
2. You are more likely to have a large baby; this may cause discomfort during the last few months of pregnancy and this may lead to a cesarean section (C-section)
3. Prolonged labour

4. Pre-eclampsia

5. Postpartum haemorrhageCAN GESTATIONAL DIABETES BE PREVENTED?
Yes. Before getting pregnant, talk to your doctor about how to reduce your risk of gestational diabetes before becoming pregnant.

• Be physically active—Get at least 30 minutes of moderate-intensity physical activity five days a week.
• Eat a variety of foods that are low in fat and reduce your calorie intake per day.
• Maintain a healthy weight.

WHAT TO DO IF YOU ALREADY HAVE GDM

• Show up at all your prenatal visits.
• Follow your doctor’s recommendations on controlling your blood sugar. This can help reduce your risk of having a large baby.
• Stay physically active.
• Eat healthy food

You can reduce your chances of having gestational diabetes in the future by asking your doctor about type 2 diabetes prevention and care after delivery. You could also ask to see a dietitian or a diabetes educator to learn more about type 2 diabetes prevention.

FACTS ABOUT HPV AND CERVICAL CANCER

HPV IS COMMON

Most sexually active individuals will have HPV at some point.

TYPES

Some types of HPV can cause genital warts while some other different types are linked to cervical cell changes that, if not detected early, can increase a woman’s risk for cervical cancer. HPV also causes some cancers of the penis, anus, vagina, vulva, and throat. HPV infections are usually harmless, though, and most are cleared naturally by the body in a year or two.

HPV vaccines can help prevent infection from both high risk HPV types that can lead to cervical cancer and low risk types that cause genital warts. The CDC recommends all boys and girls

get the HPV vaccine at age 11 or 12, but vaccination is avail- able through age 26. The vaccine produces a stronger immune response when taken during the preteen years. For this reason, up until age 14, only two doses of the vaccine are required.

TRANSMISSION

HPV is usually passed by genital-to-genital and genital-to-anal contact (even without penetration). The virus can also be transmitted by oral to genital contact, although this probably occurs less often. Studies show that male condoms can reduce HPV transmission to females, although condoms only protect the skin they cover.

TESTING

A Pap test can find cell changes to the cervix caused by HPV. HPV tests find the virus and help healthcare providers know which women are at highest risk for cervical cancer. A Pap/ HPV co-test is recommended for women 30 and over. One HPV test has been approved for use as primary cervical cancer screening for women age 25 and older, followed by a Pap test for women with certain results.

TREATMENT

There’s no treatment for the virus itself, but healthcare providers have plenty of options to treat diseases caused by HPV.

RELATIONSHIPS

It can take weeks, months, or even years after exposure to HPV before symptoms develop or the virus is detected. This is why it is usually impossible to determine when or from whom HPV may have been contracted. A recent diagnosis of HPV does not necessarily mean anyone has been unfaithful, even in a long-term relationship spanning years.

PREGNANCY

Pregnant women with HPV almost always have natural deliveries and healthy babies—it is very rare for a newborn to get HPV from the mother.

We advise that you get vaccinated to reduce your chances of getting cervical cancer.

party culled from national cervical cancer coalition

WORLD DIABETES DAY 2018

Every year, on the 14th of November, the world diabetes day is celebrated worldwide. The theme for this year’s world diabetes day is “The family and diabetes”.

The primary aim of the World Diabetes Day and World Diabetes Month 2018–19 campaign is to raise awareness of the impact that diabetes has on the family and to promote the role of the family in the management, care, prevention and education of the condition.

There are three main focus areas:

Discover diabetes
Prevent diabetes
Manage diabetes
Detecting diabetes early involves the family too

One in every two people with diabetes is undiagnosed. Early diagnosis and treatment is key to helping prevent or delay life-threatening complications. If type 1 diabetes is not detected early, it can lead to serious disability or death. Know the signs and symptoms to protect yourself and your family.

Preventing type 2 diabetes involves the family too
Many cases of type 2 diabetes can be prevented by adopting a healthy lifestyle. Reducing your family’s risk starts at home.

When a family eats healthy meals and exercises together, all family members benefit and encourage behaviours that could help prevent type 2 diabetes in the family.

If you have diabetes in your family, learn about the risks, the warning signs to look out for and what you can do to prevent diabetes and its complications.

Families need to live in an environment that supports healthy lifestyles and helps them to prevent type 2 diabetes.

Caring for my diabetes involves my family too

Managing diabetes requires daily treatment, regular monitoring, a healthy lifestyle and ongoing education. Family support is key. All health professionals should have the knowledge and skills to help individuals and families manage diabetes. Education and ongoing support should be accessible to all individuals and families to help manage diabetes. Essential diabetes medicines and care must be accessible and affordable for every family.

 

Culled from international diabetes federation

BREAST CANCER AWARENESS

October is breast cancer awareness month, a worldwide annual campaign involving thousands of organisations, to highlight the burden of breast cancer. In honour of the breast cancer awareness month, we are giving this helpful guide about breast cancer.

KEY MESSAGES

Breast cancer is the top cancer in women worldwide and is increasing particularly in developing countries where majority of cases are diagnosed in late stages.

1 in 8 women will be diagnosed of breast cancer in their lifetime.

Early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control.

Risk Factors:

  • Has abnormal genes, such as mutated BRCA-1, BRCA-2, or PALB-2 genes
  • Began her menstrual period before age 12 or began menopause after age 55
  • Used hormone replacement therapy (HRT) with estrogen and progesterone over a long period of time.
  • Has a family history of breast cancer, colorectal cancer or ovarian cancer
  • Has a personal history of ovarian cancer
  • Is currently using or has recently used birth control pills
  • Has never had children, or had her first child after age 30
  • Smokes or uses tobacco

You might be at an increased risk of breast cancer if you are a woman or man who:

  • Is overweight or obese
  • Is not physically active
  • Is over age 40
  • Has already had cancer in one breast
  • Has a family history of ovarian cancer
  • Has had radiation therapy close to his or her chest

SYMPTOMS

Don’t wait for symptoms to appear. Get screened according to guidelines. If you do notice any of the following symptoms, talk with your healthcare professional:

  • A lump, hard knot or thickening in the breast
  • A lump under your arm
  • A change in the size or shape of your breast
  • Nipple pain, tenderness or discharge, including bleeding
  • Itchiness, scales, soreness or rash on nipple
  • A nipple turning inward or inverted
  • A change in skin colour and texture (dimpling, puckering, or redness)
  • A breast that feels warm or swollen

PREVENTION

  • If you have babies, breastfeed them
  • Limit alcohol consumption
  • Exercise daily for 30 – 60 minutes
  • Maintain a healthy weight
  • Do not smoke, if you do quit.

EARLY DETECTION

  • In your 20s and 30s, have a clinical breast exam (CBE) by a healthcare professional at least every three years
  • Beginning at age 40, have an annual CBE and mammogram
  • If you are at high risk, talk with your healthcare professional about beginning annual mammograms at a younger age and/or having a magnetic resonance imaging (MRI)
  • If you have a family history of breast cancer, talk to your health care professional about genetic testing
  • When you reach menopause, talk with your healthcare professional about whether you should have hormone replacement therapy
  • Know what is normal for your breasts. (Breast self-exam is one way you can do this). If you notice changes, see your healthcare professional right away.

Exercise during Pregnancy Is it safe to exercise during pregnancy?

We talked a little about exercise in pregnancy in the previous post, you can check it out before getting into this. This post continues to answer the other questions you might have.

WHAT CHANGES OCCUR IN THE BODY DURING PREGNANCY THAT CAN AFFECT MY EXERCISE ROUTINE?

Your body goes through many changes during pregnancy. It is important to choose exercises that take these changes into account:

  • Joints— the hormones made during pregnancy cause the ligaments that support your joints to become relaxed. This makes the joints more mobile and at risk of injury. Avoid jerky, bouncy, or high-impact motions that can increase your risk of being hurt.
  • Balance— during pregnancy, the extra weight in the front of your body shifts your centre of gravity. This places stress on joints and muscles, especially those in your pelvis and low back. Because you are less stable and more likely to lose your balance, you are at greater risk of falling.
  • Breathing—when you exercise, oxygen and blood flow are directed to your muscles and away from other areas of your body. While you are pregnant, your need for oxygen increases. As your belly grows, you may become short of breath more easily because of increased pressure of the uterus on the diaphragm (a muscle that aids in breathing). These changes may affect your ability to do strenuous exercise, especially if you are overweight or obese.

WHAT PRECAUTIONS SHOULD I TAKE WHEN EXERCISING DURING PREGNANCY?

There are a few precautions that pregnant women should keep in mind during exercise:

  • Drink plenty of water before, during, and after your workout. Signs of dehydration include dizziness, a racing or pounding heart, and urinating only small amounts or having urine that is dark yellow.
  • Wear a sports bra that gives lots of support to help protect your breasts. Later in pregnancy, a belly support belt may reduce discomfort while walking or running.
  • Avoid becoming overheated, especially in the first trimester. Drink plenty of water, wear loose-fitting clothing, and exercise in a temperature-controlled room. Do not exercise outside when it is very hot or humid.
  • Avoid standing still or lying flat on your back as much as possible. When you lie on your back, your uterus presses on a large vein that returns blood to the heart. Standing motionless can cause blood to pool in your legs and feet. Both of these positions can decrease the amount of blood returning to your heart and may cause your blood pressure to decrease for a short time.

WHAT ARE SOME SAFE EXERCISES I CAN DO DURING PREGNANCY?

Whether you are new to exercise or it already is part of your weekly routine, choose activities that experts agree are safest for pregnant women:

  • Walking—brisk walking gives a total body workout and is easy on the joints and muscles.
  • Swimming and water workouts— Water workouts use many of the body’s muscles. The water supports your weight so you avoid injury and muscle strain. If you find brisk walking difficult because of low back pain, water exercise is a good way to stay active.
  • Stationary bicycling—because your growing belly can affect your balance and make you more prone to falls, riding a standard bicycle during pregnancy can be risky. Cycling on a stationary bike is a better choice.
  • Modified yoga and modified Pilates—Yoga reduces stress, improves flexibility, and encourages stretching and focused breathing. There are even prenatal yoga and Pilates classes designed for pregnant women. These classes often teach modified poses that accommodate a pregnant woman’s shifting balance. You also should avoid poses that require you to be still or lie on your back for long periods.

If you are an experienced runner, jogger, or racquet-sports player, you may be able to keep doing these activities during pregnancy. Discuss these activities with your health care professional before getting into them.

Glossary

Anaemia: Abnormally low levels of blood or red blood cells in the bloodstream. Most cases are caused by iron deficiency or lack of iron.

Cerclage: A procedure in which the cervical opening is closed with stitches in order to prevent or delay preterm birth.

Cervical Insufficiency: Inability of the cervix to retain a pregnancy in the second trimester.

Caesarean Delivery: Delivery of a baby through surgical incisions made in the mother’s abdomen and uterus.

Complications: Diseases or conditions that occur as a result of another disease or condition. An example is pneumonia that occurs as a result of the flu. A complication also can occur as a result of a condition, such as pregnancy. An example of a pregnancy complication is preterm labour.

Deep Vein Thrombosis: A condition in which a blood clot forms in a vein in the leg or other areas of the body.

Dehydration: A condition that results from loss of water from the body.

Gestational Diabetes: Diabetes that arises during pregnancy.

Hormones: Substances made in the body by cells or organs that control the function of other cells or organs. An example is an oestrogen, which controls the function of female reproductive organs.

Oxygen: A gas that is necessary to sustain life.

Placenta Previa: A condition in which the placenta lies very low in the uterus so that the opening of the uterus is partially or completely covered.

Preeclampsia: A disorder that can occur during pregnancy or after childbirth in which there are high blood pressure and other signs of organ injury, such as an abnormal amount of protein in the urine, a low number of platelets, abnormal kidney or liver function, pain over the upper abdomen, fluid in the lungs, or a severe headache or changes in vision.

Preterm: Born before 37 completed weeks of pregnancy.

Uterus: A muscular organ located in the female pelvis that contains and nourishes the developing foetus during pregnancy.

 

Culled from the ACOG website