A cluster of nosocomial Lassa fever cases in a tertiary health facility in Nigeria: Description and lessons learned, 2018
Background: Lassa fever is an acute viral haemorrhagic disease endemic in Nigeria. The 2018 Lassa fever outbreak in Nigeria was unprecedented, with 8% of all cases occurring among healthcare workers (HCWs). A disproportionately high number of these infections occurred in HCWs working in a tertiary h...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-06-01
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| Series: | International Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971219301596 |
| _version_ | 1818446888209219584 |
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| author | Chioma C. Dan-Nwafor Oladipupo Ipadeola Elizabeth Smout Elsie Ilori Ayodele Adeyemo Chukwuma Umeokonkwo Damian Nwidi Williams Nwachukwu Winifred Ukponu Emeka Omabe Uchenna Anaebonam Nneka Igwenyi Gordon Igbodo Womi Eteng Ikemefule Uzoma Muhammed Saleh Joseph Agboeze Samuel Mutbam Tanyth de Gooyer Rosie Short Everistus Aniaku Robinson Onoh Emeka Ogah Patrick Nguku John Oladejo Clement Peter Olubunmi Ojo Chikwe Ihekweazu |
| author_facet | Chioma C. Dan-Nwafor Oladipupo Ipadeola Elizabeth Smout Elsie Ilori Ayodele Adeyemo Chukwuma Umeokonkwo Damian Nwidi Williams Nwachukwu Winifred Ukponu Emeka Omabe Uchenna Anaebonam Nneka Igwenyi Gordon Igbodo Womi Eteng Ikemefule Uzoma Muhammed Saleh Joseph Agboeze Samuel Mutbam Tanyth de Gooyer Rosie Short Everistus Aniaku Robinson Onoh Emeka Ogah Patrick Nguku John Oladejo Clement Peter Olubunmi Ojo Chikwe Ihekweazu |
| author_sort | Chioma C. Dan-Nwafor |
| collection | DOAJ |
| description | Background: Lassa fever is an acute viral haemorrhagic disease endemic in Nigeria. The 2018 Lassa fever outbreak in Nigeria was unprecedented, with 8% of all cases occurring among healthcare workers (HCWs). A disproportionately high number of these infections occurred in HCWs working in a tertiary health facility in Nigeria. This paper describes the cluster of Lassa fever infections among HCWs in a treatment centre and the lessons learnt. Methods: We analysed clinical, epidemiological and laboratory data from surveillance and laboratory records kept during the 2018 outbreak. Interviews were conducted with surviving HCWs using a questionnaire developed specifically for the investigation of Lassa fever infections in HCWs. Descriptive analysis of the data was performed in Microsoft excel. Results: The index case was a 15-year-old male who presented at the health facility with fever and uncontrolled nasopharyngeal bleeding, following a recent uvulectomy by a traditional healer. Overall, 16 HCWs were affected (15 confirmed and 1 probable) with five deaths (CFR-31.6%). Of the 15 confirmed cases, five (33.3%) were asymptomatic. Nine HCWs were direct contacts of the index case; the remaining six HCWs had no direct contact with the index case. HCW interviews identified a low index of suspicion for Lassa fever leading to inadequate infection prevention and control (IPC) practices as possible contributing factors to nosocomial transmission. Conclusion: Maintaining a high index of suspicion for Lassa fever in all patients, especially in endemic areas, is essential in adhering to adequate IPC practices in health facilities in order to prevent nosocomial transmission of Lassa fever among HCWs. There is a need to continually train and sensitise HCWs on strict adherence to IPC measures while providing care, irrespective of a patient’s provisional diagnosis. Keywords: Lassa fever, Healthcare workers, Nosocomial infection |
| first_indexed | 2024-12-14T19:54:53Z |
| format | Article |
| id | doaj.art-9cabc93da9bd409d88175ebb24c9ae84 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-14T19:54:53Z |
| publishDate | 2019-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-9cabc93da9bd409d88175ebb24c9ae842022-12-21T22:49:19ZengElsevierInternational Journal of Infectious Diseases1201-97122019-06-01838894A cluster of nosocomial Lassa fever cases in a tertiary health facility in Nigeria: Description and lessons learned, 2018Chioma C. Dan-Nwafor0Oladipupo Ipadeola1Elizabeth Smout2Elsie Ilori3Ayodele Adeyemo4Chukwuma Umeokonkwo5Damian Nwidi6Williams Nwachukwu7Winifred Ukponu8Emeka Omabe9Uchenna Anaebonam10Nneka Igwenyi11Gordon Igbodo12Womi Eteng13Ikemefule Uzoma14Muhammed Saleh15Joseph Agboeze16Samuel Mutbam17Tanyth de Gooyer18Rosie Short19Everistus Aniaku20Robinson Onoh21Emeka Ogah22Patrick Nguku23John Oladejo24Clement Peter25Olubunmi Ojo26Chikwe Ihekweazu27Nigeria Centre for Disease Control, Abuja, Nigeria; African Field Epidemiology Network, Nigeria; Corresponding author at: Nigeria Centre for Disease Control, Plot 801 Ebitu Ukiwe Street, Jabi, Abuja, FCT, Nigeria.Nigeria Centre for Disease Control, Abuja, NigeriaUK Public Health Rapid Support Team, United KingdomNigeria Centre for Disease Control, Abuja, NigeriaeHealth Africa, Abuja, NigeriaFederal Teaching hospital Abakiliki Ebonyi State, NigeriaFederal Teaching hospital Abakiliki Ebonyi State, NigeriaNigeria Centre for Disease Control, Abuja, Nigeria; African Field Epidemiology Network, NigeriaUniversity of Maryland Abuja, Nigeria; Nigeria Centre for Disease Control, Abuja, NigeriaFederal Teaching hospital Abakiliki Ebonyi State, NigeriaWorld Health Organization, Abuja, NigeriaFederal Teaching hospital Abakiliki Ebonyi State, NigeriaNigeria Centre for Disease Control, Abuja, NigeriaNigeria Centre for Disease Control, Abuja, NigeriaNigeria Centre for Disease Control, Abuja, NigeriaNigeria Centre for Disease Control, Abuja, NigeriaFederal Teaching hospital Abakiliki Ebonyi State, NigeriaWorld Health Organization, Abuja, NigeriaWorld Health Organization, Abuja, NigeriaWorld Health Organization, Abuja, NigeriaNigeria Centre for Disease Control, Abuja, NigeriaFederal Teaching hospital Abakiliki Ebonyi State, NigeriaFederal Teaching hospital Abakiliki Ebonyi State, NigeriaAfrican Field Epidemiology Network, NigeriaNigeria Centre for Disease Control, Abuja, NigeriaWorld Health Organization, Abuja, NigeriaNigeria Centre for Disease Control, Abuja, NigeriaNigeria Centre for Disease Control, Abuja, NigeriaBackground: Lassa fever is an acute viral haemorrhagic disease endemic in Nigeria. The 2018 Lassa fever outbreak in Nigeria was unprecedented, with 8% of all cases occurring among healthcare workers (HCWs). A disproportionately high number of these infections occurred in HCWs working in a tertiary health facility in Nigeria. This paper describes the cluster of Lassa fever infections among HCWs in a treatment centre and the lessons learnt. Methods: We analysed clinical, epidemiological and laboratory data from surveillance and laboratory records kept during the 2018 outbreak. Interviews were conducted with surviving HCWs using a questionnaire developed specifically for the investigation of Lassa fever infections in HCWs. Descriptive analysis of the data was performed in Microsoft excel. Results: The index case was a 15-year-old male who presented at the health facility with fever and uncontrolled nasopharyngeal bleeding, following a recent uvulectomy by a traditional healer. Overall, 16 HCWs were affected (15 confirmed and 1 probable) with five deaths (CFR-31.6%). Of the 15 confirmed cases, five (33.3%) were asymptomatic. Nine HCWs were direct contacts of the index case; the remaining six HCWs had no direct contact with the index case. HCW interviews identified a low index of suspicion for Lassa fever leading to inadequate infection prevention and control (IPC) practices as possible contributing factors to nosocomial transmission. Conclusion: Maintaining a high index of suspicion for Lassa fever in all patients, especially in endemic areas, is essential in adhering to adequate IPC practices in health facilities in order to prevent nosocomial transmission of Lassa fever among HCWs. There is a need to continually train and sensitise HCWs on strict adherence to IPC measures while providing care, irrespective of a patient’s provisional diagnosis. Keywords: Lassa fever, Healthcare workers, Nosocomial infectionhttp://www.sciencedirect.com/science/article/pii/S1201971219301596 |
| spellingShingle | Chioma C. Dan-Nwafor Oladipupo Ipadeola Elizabeth Smout Elsie Ilori Ayodele Adeyemo Chukwuma Umeokonkwo Damian Nwidi Williams Nwachukwu Winifred Ukponu Emeka Omabe Uchenna Anaebonam Nneka Igwenyi Gordon Igbodo Womi Eteng Ikemefule Uzoma Muhammed Saleh Joseph Agboeze Samuel Mutbam Tanyth de Gooyer Rosie Short Everistus Aniaku Robinson Onoh Emeka Ogah Patrick Nguku John Oladejo Clement Peter Olubunmi Ojo Chikwe Ihekweazu A cluster of nosocomial Lassa fever cases in a tertiary health facility in Nigeria: Description and lessons learned, 2018 International Journal of Infectious Diseases |
| title | A cluster of nosocomial Lassa fever cases in a tertiary health facility in Nigeria: Description and lessons learned, 2018 |
| title_full | A cluster of nosocomial Lassa fever cases in a tertiary health facility in Nigeria: Description and lessons learned, 2018 |
| title_fullStr | A cluster of nosocomial Lassa fever cases in a tertiary health facility in Nigeria: Description and lessons learned, 2018 |
| title_full_unstemmed | A cluster of nosocomial Lassa fever cases in a tertiary health facility in Nigeria: Description and lessons learned, 2018 |
| title_short | A cluster of nosocomial Lassa fever cases in a tertiary health facility in Nigeria: Description and lessons learned, 2018 |
| title_sort | cluster of nosocomial lassa fever cases in a tertiary health facility in nigeria description and lessons learned 2018 |
| url | http://www.sciencedirect.com/science/article/pii/S1201971219301596 |
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