Stella Dimoko Emergency Room Series: Lassa Fever Case


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Thursday, January 25, 2018

Emergency Room Series: Lassa Fever Case

Lassa Fever is real and scary.

It's killing people and most especially health workers now and it reminds me of one time we had an hemorrhagic fever case at the ER

It was a girl in her preteen. She was brought to the ER by her parents. She was said to have been running a persistent fever which was worse at night, body weakness, headache, vomiting, stooling, and muscle pains.

On admission, her blood pressure was low, respiration was high, pulse was high, her temperature was well over 40°c and the oxygen saturation wasnt so good. Her blood samples were taken for testing to know what the problem was. The mother told the doctor that the symptoms started about 4days ago and she had been taking antimalarials thinking it was malaria fever or so. Little did we know what we were into. 

I set up and IV access and she had IV fluids and electrolytes to replace the ones she lost while vomiting and stooling. She had broad spectrum antibiotics and antipyretics for the high temperature while we waited for the test results. When the test results came out, there was nothing unusual asides low white blood cell count and thrombocytopenia (low platelets). The malaria test showed 'few parasites' which was insignificant and couldn't cause the symptoms she presented with. 

The doctors were baffled. We even took samples for HIV, hepatitis B and C and pregnancy test. They were all negative. 

The temperature wouldn't go down, nothing seemed to be working for it. The stooling persisted too. We had to used an underlay for her and passed a urinary catheter, Then the unexpected happened. A line of blood flowed out of a nostril. A nurse was around her at the time. The nurse cleaned the nose and waited to be sure it was blood. Few seconds later, the nostril bled again, this time it was more, the other nostril followed. She quickly called for a doctor who at first thought it was hemorrhage that was coming from the brain or somewhere else. He called for a neurologist who changed the line of management (fluids, drugs and all). 

Few minutes later, she soiled the sheets again. As I turned her to the side to change the underlay, I noticed blood , I though it was menses and cleaned her up. I then asked the parents to get her pad and they asked what for and that she hadn't started her period. At that point I could feel all my body hair standing.

 It could only mean one thing. Hemorrhagic fever!

I informed the doctor who immediately told the security to shut all the entrance doors. Nobody was allowed to go in or out. The unit head called someone in the state health office who called another hospital to prepare an isolation unit/ward. I was so scared. Although I was sure I used glove all through, one can never be so sure of these things. We weren't sure if it was Lassa Fever or not but she was moved away to make sure others were safe. 

We were also kept under close watch. We all tested negative. Her blood tests would subsequently be taken and sent to a Virology Reference Laboratory.

Lassa fever is caused by exposure to rats. Either by their contaminated food or their urine.

The onset of the disease, when it is symptomatic, is usually gradual, starting with fever, general weakness, muscle and joint pains, prostration and malaise. After a few days, headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and abdominal pain may follow. In severe cases facial swelling, fluid in the lung cavity, bleeding from the mouth, nose, vagina or gastrointestinal tract and low blood pressure may develop.

Its important we keep our environment clean to prevent rats from breeding around us. We should learn to always cover our meals especially in the kitchen. Avoid placing food items on the kitchen floor (I know its a norm to place yam tubers on the floor in the kitchen, please stop). 

Please guys, be vigilant.


  1. It is just really serious. May God Almighty help us to do the right thing.

    I also put my spoons, forks etc inside the fridge. I dont want to hear stories.

    It is well with our country.

    1. And you pack your bag of rice and garri and yam tubers inside fridge too?

    2. I do exactly that too. Spoons, knives, few plates. May God continue to protect us all

    3. God help us as we try to help ourselves.

  2. Replies
    1. This is scary oh. Lassa fever pack and go out of Nigeria abeg.

  3. Lassa fever is spreading by the day in Nigeria but it seems individuals don't take it seriously.some people are so used to having rats around,they think Lassa fever is a joke. You hear things like nothing de happen na God de save. I discussed with my sister and mom last night, even if we protect our items at home,how do we manage things we buy from stores. Let's all be careful. Thanks for the wonderful ER stories

  4. This is serious oo.
    Lord have mercy

  5. I heard its like Ebola and has no cure too

  6. Lord knows why they bleed from the nose and mouth. Its interesting how a small animal can damage the body like that. Pure evil.

  7. Jesus
    U just scared the shit out of me..all the rats in my compound are dead now..

    1. Pls be careful with the way u go about killing them

  8. Thanks for educating us all on the symptoms, May God keep you guys safe.

  9. Spreads by Rat urine in food too. This one weak me o

  10. Pls how did u guys test for lassa fever coz at many general hosps they don't have d kits not to talk of ppe. This country sef

  11. Lord av mercy ooo. I still get some rats for my kitchen, tried mixing indosid with rice yesterday for dem but d yeye rats refused to eat it

    1. Don't you know naija rats can now smell poison. Hahahha

  12. Wow!! Really scary. May God help us


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