Update #2 on Lassa Fever Outbreak in ESUT-TH Parklane, Enugu State

An emergency meeting of stakeholders was called by the CMD of ESUT-TH Parklane this morning to deliberate on the Lassa Fever Outbreak in the hospital.

In attendance were the acting C-MAC, Heads (and Consultants) of some departments/units, the Head of Nursing Services (HNS), MDCAN Chairman, Representatives of the State Ministry of Health and the President of Association of Resident Doctors (ARD) ESUT-TH Parklane. The following were the outcomes.

1. Official notification of a confirmed case of Lassa Fever in ESUT-TH Parklane. The State epidemiology Team has reported the outbreak to NCDC and Enugu State WHO.

The index case first presented at the A&E of ESUT-TH Parklane on Wednesday, 15/01/2020 (8 days ago) and was admitted into the Medical Ward/Annex on Friday, 17/01/2020, as a case of Pneumonia. The patient was then transferred to the ICU on Sunday, 19/01/2020 and later died on Tuesday, 21/01/2020.

The patient was designated as a suspected case of Lassa Fever a day after transfer to ICU (Monday, 20/01/202), but confirmed to be sero-positive for Lassa Fever roughly a day after death (today, Wednesday, 22/01/2020). The index patient was reported to have been buried today, without embalmment.

2. Disinfection of the affected hospital areas, namely A&E, ICU and Medical Ward Annex. This has been carried out as at the time of this update.

3. Commencement of contact tracing. All those that came in contact with the index case are required to submit their names and contact details to their HODs. These contacts (inclusive of Medical Doctors, Nurses, Lab Scientists, medical students, porters, and Ambulance drivers, Patients etc), who will be many, due to the prolonged contact period, will then be assigned Risk Categories The current plan is for high risk cases to submit blood samples to the Lab of ESUT-TH Parklane for baseline investigations, namely, FBC (including Platelet Count), LFT, Prothrombin Time and INR. So far, about 100 samples have been collected. The contacts will also receive thermometers, for daily measurement and recording of their body temperatures in designated sheets/formS. Logistics/modalities for these are currently being worked out, and ought to be finalized in the next 24 to 48 hours. The State Epidemiology Team will commence training of those to be involved in-hospital Contact Tracing by tomorrow. Local Government Disease Surveillance and Notification officers (LG-DSNOs) will undertake the contact Tracing for contacts who have already been discharged from the hospital.

4. Provision of infrared thermometers (for Triaging of patients), gloves, hand sanitizers and hand washing stations at the clinics/points of care. The CMD of ESUT-TH Parklane has promised to facilitate the purchase of these materials.

5. Provision of PPEs at strategic points of care, like ICU, to manage Suspected and Confirmed cases. The current stock of PPEs to by provided by the Enugu SMoH is not adequate.  Plans are said to have been made to increase the stock.

6. The State Epidemiology team has requested for more stock of PPE, tablets and IV of Ribavarin from NCDC, with anticipated turnaround time of 48 hours. The CMD of ESUT-TH is also making parallel efforts to get these available.

7. There will be a hospital-wide Lassa Fever Sensitization meeting, at the ESUT-TH Quadrangle, tomorrow, Thursday 23/01/2020 by 2pm.

8. The hospital Management (through the department of Community Medicine) will come up with a Domesticated Protocol for Lassa Fever Prevention and Management, tentatively by Monday, 27/01/2020

The situation of and response to the Lassa Fever Outbreak in ESUT-TH Parklane is still unfolding and the Exco will be monitoring it closely. We will keep our members updated regularly and take every necessary step to ensure that our members don't become victims. 

We will take a critical look and scrutiny at Contact Risk Categorization, Ribavarin prophylaxis as well as the above plans during our Emergency General Meeting (EGM) tomorrow by 8am.

Kindly reach me or any member of ARD ESUT-TH Exco if you need clarifications or assistance.

Thanks.

Dr. Chima Emmanuel Edoga
POTARD ESUT-TH Parklane
35/366
8:08pm | 22.01.2020