Nafissa Ikerodah is
both a detective and
diplomat of sorts. On
a Saturday morning
in early March, the
Disease Surveillance Officer in Edo
State area rushes to a household where
a man has just died of Lassa fever.
The young father left behind two
sons who show symptoms of the
infectious disease. Nafissa wants to get
the children to a hospital as quickly as
possible. One boy is so weak he can
barely stand.
She must also identify all the people
who recently came into physical con-
tact with the deceased father so they
can be monitored for signs of the viral
haemorrhagic fever.
Both jobs are difficult in a communi-
ty reeling from a recent death and fear
for their own lives.
“The first time you visit and tell them
you are a disease surveillance officer,
they are always scared,” says Nafissa.
Faith Ireye, the World Health Or-
ganization’s Edo State Coordinator,
accompanies Nafissa. They arrange for
an ambulance to pick up the boys and
ask the family to provide the names of
the deceased patients’ contacts within
the community.
“Contact tracing is the bedrock of
infectious disease outbreak control.
If contact tracing is not done, people
who come into contact with Lassa
fever patients stay in their homes,
become symptomatic, infect more
people, and make the outbreak bigger
and bigger,” says Faith.
Nafissa visits every identified contact
of the deceased father. She records
names, telephone numbers, and the
date of their last encounter with the
patient. She gives each a thermome-
ter for personal temperature checks
and arranges to call on the contacts
daily for the next 21 days to note their
temperature. If anyone is suspected of
having Lassa fever, they will be taken
to hospital for a confirmatory test and,
if positive, provided with care in a
special isolation unit.
By 18 March, 3675 contacts of the
376 confirmed Lassa fever cases in
Nigeria had been identified and more
than three-quarters had completed
their 21 days of monitoring.
In Edo state – where the outbreak
has been spreading particularly fast –
WHO, the Nigeria Centre for Disease
Control (NCDC) and the local govern-
ment are reaching out to communities
with a large-scale awareness raising
campaign.
Sensitization sessions will aim to
reach nearly 9,000 community lead-
ers, town announcers, headmasters,
herbalists, healthcare workers, cli-
nicians, church leaders, and women
who work in local markets.
The Lassa virus is transmitted to
humans mainly through handling in-
fected rats, food or household items
contaminated by the rats’ urine and
faeces. The virus can spread between
people through direct contact with
the body fluids of a person infected
with Lassa fever, as well as contami-
nated bedding and clothing.
Community members are being
advised of a range of preventive
measures including washing hands
regularly, storing food in containers
with lids, keeping their homes clean
and tidy to discourage rats from en-
tering and cooking foods thoroughly.
Garri, which is made from cassava
tubers, is a staple food in this part
of Nigeria. Traditionally, families
have left the crushed cassava outside
in the sun to dry out. During the
sensitization sessions, participants
are encouraged to dry garri through
frying over a hot stove, rather than
in the sun.
After one awareness raising session,
primary school teacher Mary Ena-
holo says she has learnt important
hygiene lessons that she will share.
“I will take the information that
I learnt today to my pupils so they
will take these messages back to their
homes,” she says.
But changing behaviours is no easy
task.
In one house, Faith and her team
find a basket full of rats being kept as
pets by a boy. Nearby, garri is being
dried in the sun. Faith quickly advis-
es the household to cover the food.
WHO is working with commu-
nities to deliver messages that will
encourage preventive actions and
ultimately save lives.
