The scourge of COVID-19 disease which is caused by the above named virus (SARS-Cov-2) started initially in China late December, 2019 but has now spread up to the point of being termed ‘a Global Pandemic’ (disease that has spread across wide geographical region) with over 8,100 deaths. Hence, the needs to further raise the level of consciousness and awareness of staff, families and loved ones.

Locally, Nigeria has now confirmed five new cases (3 from US and 2 from UK) of Covid-19 making a total of eight (8) confirmed cases and one death in Ekiti State which further makes the situation a dire one.

Exponential rate of the disease spread (doubling of cases every three days) has made it necessary for everyone to practice ‘social distancing’ by avoiding public spaces and limiting movements.

Based on the above new cases, the Federal Government of Nigeria has restricted travel from these locations and some more, we at Medexia have also taken it upon us to help prevent the spread of Covid-19 by reemphasizing some method of prevention of the disease as well as tips/suggestions to stay well and unaffected.

Tips:
a) Stay off work when sick and call the appropriate authorities.
b) Confirm circulating information on social media from your doctor or from Authorized/reputable websites e.g WHO. Medexia.

Prevention:
a) Regular hand washing with soap and water

b) Avoid face touching
c) Use of alcohol based hand sanitizers when soap and water is unavailable, etc.
d) Provision of Banners to our Client which contains methods of prevention of the disease
Suggestions:
a) We recommend the purchase of infrared thermometers for use at the gate/reception and or entrance to the Company.
b) We also recommend hiring a temporary nurse who is trained and can manage/screen staff/visitors coming into the organization while also using the thermometer (logistics to be discussed where needed).
c) The coming days/weeks are crucial and as such, employees and loved ones should avoid public gathering and events.

Please remember to always maintain a high index of suspicion, protect yourself and loved ones at all time.

CORONA VIRUS

Corona viruses are a group of viruses that cause diseases in mammals, including humans and birds. In man, it usually causes respiratory infections which are typically mild but in rare cases can be lethal.

There are no vaccines or antiviral drugs that are approved for the prevention or treatment.

Coronaviruses primarily infect the upper respiratory and gastrointestinal tract of mammals and birds. They also cause a range of diseases in farm animals and domesticated pets some of which can be serious and are a threat to the farming industry.

In human, coronaviruses are believed to cause a significant percentage of all common colds in human adults and children. Coronaviruses cause colds with major symptoms like fever, throat swollen adenoids in humans primarily in the winter and early spring season, coronaviruses can cause pneumonia, either direct viral pneumonia or secondary bacteria pneumonia and they can also cause bronchitis.

SINGS AND SYMPTOMS

Common human coronavirus produces mild and moderate upper respiratory tract illness with the following symptoms;

• Runny nose
• Headache
• Cough
• Sore throat
• Fever
• General feeling of being unwell

However, some strains of human coronavirus which are known to cause severe symptoms are MERS-COV and SARS-COV. These are the ones responsible for some severe outbreaks.

Symptoms usually include fever, cough and shortening of breath which often progresses to pneumonia. About 3 or 4 every 10 patients have died

DIAGNOSIS

Definitive diagnosis is only by laboratory testing which is only available in specialized laboratories.

MODE OF TRANSMISSION

Human coronaviruses more commonly spreads from an infected person to others through:

• The air by sneezing and coughing
• Close personal contact, such as touching and shaking hands
• Touching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing your hands
• Rarely fecal contamination

PREVENTION

As earlier, there are currently no vaccines available to protect against having coronavirus infection.

However, risk is reduced by;

• Washing of hands often with soap and water for at least 20 seconds.
• Avoid touching your eyes, nose or mouth with unwashed hands.
• Avoid close contact with people who are sick.

To protect others, if you have cold-like symptoms;

• Stay home while you are sick
• Avoid close contact with others
• Cover your mouth and nose with a tissue when you sneeze or cough, then throw the tissue in the trash and wash your hands.

Clean and disinfect objects and surfaces

WHAT IS LASSA FEVER ?

Lassa fever is an acute viral illness that occurs in West Africa. The illness was discovered in 1969 when two missionary nurses died in Nigeria. The cause of the illness was found to be Lassa virus, named after the town in Nigeria where the first cases originated.

Lassa fever is known to be endemic (that is constantly present) in Guinea, Liberia, Sierra Leone and parts of Nigeria. The number of Lassa virus infections per year in West Africa is between 300000 to 500000 cases with about 5000 deaths

Lassa fever is a Zoonotic disease (human become infected from contact with infected animals). The host is a rodent commonly known as the “multimammate rat”. Rats infected with Lassa virus do not become ill, but they can shed the virus in their excreta (urine and feaces).

Lassa fever occurs in all age group and in both men and women. Persons at greater risk are:-

(a)  Those living in rural areas where rodents are usually found.

(b) Those living in areas of poor sanitation or crowded living condition

(c)    Health care workers.

How do human get Lassa Fever?

• Human usually becomes infected with Lassa virus from direct exposure to excreta of infected rats (touching the excreta) and also person-to-person transmission occurs through direct contact with the blood, urine, feaces or other body fluids of a person with Lassa fever.
• Sexual transmission of Lassa virus has been reported.
• Contact with the virus also can occur when a person inhales air contaminated with rodent excretions.

What are the symptoms of Lassa fever?

About 80% of human infected with the virus do not have any symptoms. The remaining cases have multi-system disease where the virus affects several organs in the body such as the Liver, Spleen and Kidneys.

usually gradual starting with fever and weakness. After few days, headache, sore throat, muscle pain, chest pain, vomiting, diarrhea, cough and abdominal pain may follow.

Severe cases may progress to facial swelling, fluid in the lungs, bleeding from nose, mouth, vagina and low blood pressure, Shock, seizures, tremor, disorientation and coma may be seen in later stages.

How is the disease diagnosed?

Because the symptoms of Lassa fever are so varied and non – specific, clinical diagnosis is difficult. It is difficult to distinguish from many other diseases which cause fever including malaria, typhoid fever and yellow fever.

Definitive diagnosis requires testing that is available only in highly specialized laboratory.

How is Lassa Fever treated?

RIBAVIRIN an antiviral drug is effective if given early in the course of the illness.

How is Lassa Fever prevented?

1. Promotion of good “community hygiene” to discourage rodents from entering homes and reduce its population.
2. Storing grain and food stuffs in rodent proof containers.
3. Disposing of garbage far from home
4. Maintain clean households and keep cats

Because rodents are so abundant, It is not possible to completely eliminate them from the environment.

Family members and health care workers should always be careful to avoid contact with blood or body fluids while caring for sick persons to prevent person-person transmission of Lassa Fever.

KNOW YOUR NUMBERS – With a goal of increasing high blood pressure (BP) awareness in all populations around the world.
The Heart is a pump designed to force blood through the body and blood is pumped from the Heart through the arteries out to our muscles and organs.
Pumps work by generating pressure and the pressure is a measure of the force that the blood applier to the walls of the arteries.

Blood Pressure depends on a combination of 2 (two) factors.
– How forceful the heart pumps blood around the body
– How narrowed or relaxed the arteries are.
Hypertension (High Blood Pressure) occurs when blood is forced through the arteries at an increased pressure.
Blood Pressure is Measured using two numbers written as 120/80mmHg
– The First Figure is the Systolic Blood Pressure – the maximum pressure in the arteries when the heart contracts (beats) and pushes blood out into the body.
– The Second Figure is the Diastolic Pressure – the minimum pressure in the arteries between hearts when the heart relaxes to fill with blood.
What is classified as high?
In general terms, people with Systolic Pressure consistently above 130mmHg and/or a Diastolic Pressure over 80mmHg are classified as having Hypertension or High Blood Pressure.
Hypertension (HTN) is a chronic medical condition in which the blood pressure is consistently elevated. A typical normal blood pressure would be 120/180mmHg.
Anyone can suffer from High Blood Pressure, but certain factors can seriously aggravate Hypertension and increase the risk of complications.

Factors that Aggravate Hypertension and Increase the Risk of Complication
– A tendency in the family to suffer Hypertension
– Obesity
– Smoking
– High Alcohol Intake
– Excessive Salt Intake
– Lack of Exercise
– Diabetes
– Kidney Disease
– Certain Medicine such as Steroids, Contraceptive Pills.

What can I do once I am Hypertensive?
– Know your numbers – Height, Weight, Blood Pressure and Cholesterol Levels.
– Change your lifestyle.
– Stop Smoking

Lose Weight
– Exercise Regularly
– Cut down on Alcohol
– Eat Healthy Diet
– Cut down on Coffee and high Caffeine drinks such as Cola.
– Reduce Stress in your life to prevent Short-term rises in blood pressure – Try relaxation technique.
Hypertension is not curable and if the blood pressure requires medical treatment, one will probably have to take medicines on a regular basis.

What can the Doctor do?
– Pinpoint risk factors and help change the life-style to reduce blood pressure.
– Offer medication for the reduction of blood pressure and arrange regular monitoring. You may require more than one drug on regular basis to get good blood pressure control.
– Targets for blood pressure control are Systolic pressure of less than 140mmHg and Diastolic Pressure of than 85mmHg

By treating Hypertension well, complications such as:
1 Angina (Chest pain caused by reduced blood flow).
2 Stroke (Bleeding or blood clot in the brain).
3 Heart Failure (Reduced pumping ability)
4 Kidney Failure
5 Eye damage

Can be avoided and average life expectancy will remain almost normal. Without treatment, life expectancy may well be reduced due to the risk of developing complications.
The Medical, Economic and Human Costs of untreated and inadequate control high and inadequately controlled high blood pressure are enormous

a) Health Care Providers face many obstacles to achieving blood pressure control from their patients, including resistance to taking multiple medications to reach blood pressure goals.
b) Patients also face challenges of adhering to medicine schedules and making lifestyle changes.
Nonetheless, the achievement of blood pressure goals is possible and most importantly, lowering blood pressure significantly reduces the risk of death, development of other debilitating conditions and the cost associated with advanced medical care.

Autism or Autism Spectrum Disorder refers to a wide range of symptoms characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication. Autism spectrum disorder affects children of all races and nationalities.

SYMPTOMS
Children with autism spectrum disorder usually show some signs of delayed development before age 2 years. Some show signs in early infancy, such as reduced eye contact, lack of response to their name or indifference to caregivers. Others may develop normally for the first few months or years of life, but then suddenly become withdrawn or aggressive or lose language skills they’ve already acquired.
Each child with autism spectrum disorder is likely to have a unique pattern of behavior and level of severity — from low functioning to high functioning.

Social communication and interaction
• Fails to respond to his or her name or appears not to hear you at times.
• Resists cuddling and holding, and seems to prefer playing alone, retreating into his or her own world.
• Has poor eye contact and lacks facial expression.
• Doesn’t speak or has delayed speech, or loses previous ability to say words or sentences
• Can’t start a conversation or keep one going, or only starts one to make requests or label items.
• Repeats words or phrases verbatim, but doesn’t understand how to use them.
• Doesn’t appear to understand simple questions or directions.
• Doesn’t express emotions or feelings and appears unaware of others’ feelings.
• Doesn’t point at or bring objects to share interest.
• Doesn’t respond with a smile or happy expression by 6 months
• Doesn’t mimic sounds or facial expressions by 9 months
• Doesn’t babble or coo by 12 months
• Doesn’t gesture — such as point or wave — by 14 months
• Doesn’t say single words by 16 months
• Doesn’t play “make-believe” or pretend by 18 months
• Doesn’t say two-word phrases by 24 months
• Loses language skills or social skills at any age

Causes/Risk factors
There is no known cause for autism spectrum disorder, but a number of factors have been implicated in increasing the risk of developing this condition. These include:
• Genetics. Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or fragile X syndrome. For other children, genetic changes (mutations) may increase the risk of autism spectrum disorder. Still other genes may affect brain development or the way that brain cells communicate, or they may determine the severity of symptoms. Some genetic mutations seem to be inherited, while others occur spontaneously.

• Environmental factors. Researchers are currently exploring whether factors such as viral infections, medications or complications during pregnancy, or air pollutants play a role in triggering autism spectrum disorder.
• Your child’s sex. Boys are about four times more likely to develop autism spectrum disorder than girls are.
• Family history. Families who have one child with autism spectrum disorder have an increased risk of having another child with the disorder. It’s also not uncommon for parents or relatives of a child with autism spectrum disorder to have minor problems with social or communication skills themselves or to engage in certain behaviors typical of the disorder.

• Other disorders. Children with certain medical conditions have a higher than normal risk of autism spectrum disorder or autism-like symptoms.
• Present structured social and communication interactions to your child and score the performance
• Use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association
• Include other specialists in determining a diagnosis
• Recommend genetic testing to identify whether your child has a genetic disorder such as Rett syndrome or fragile X syndrome

Treatment
There is no cure for autism spectrum disorder and treatment is often multidisciplinary.
The main aim of treatment is to maximize the child’s ability to function by reducing the symptoms and supporting development and learning. Intensive and early intervention can make a big difference in the lives of these children.
Treatment options may include:

• Behavior and communication therapies. Many programs address the range of social, language and behavioral difficulties associated with autism spectrum disorder. Some programs focus on reducing problem behaviors and teaching new skills. Other programs focus on teaching children how to act in social situations or communicate better with others.
• Educational therapies. Children with autism spectrum disorder often respond well to highly structured educational programs. Successful programs typically include a team of specialists and a variety of activities to improve social skills, communication and behavior. Preschool children who receive intensive, individualized behavioral interventions often show good progress.
• Inappropriately approaches a social interaction by being passive, aggressive or disruptive
• Has difficulty recognizing nonverbal cues, such as interpreting other people’s facial expressions, body postures or tone of voice.

Patterns of Behaviour
• Performs repetitive movements, such as rocking, spinning or hand flapping
• Performs activities that could cause self-harm, such as biting or head-banging
• Develops specific routines or rituals and becomes disturbed at the slightest change
• Has problems with coordination or has odd movement patterns, such as clumsiness or walking on toes, and has odd, stiff or exaggerated body language
• Is fascinated by details of an object, such as the spinning wheels of a toy car, but doesn’t understand the overall purpose or function of the object
• Is unusually sensitive to light, sound or touch, yet may be indifferent to pain or temperature
• Doesn’t engage in imitative or make-believe play
• Fixates on an object or activity with abnormal intensity or focus
• Has specific food preferences, such as eating only a few foods, or refusing foods with a certain texture.

When to see a doctor
If you are concerned about your child’s development or you suspect that your child may have autism spectrum disorder, discuss your concerns with your doctor. The symptoms associated with the disorder can also be linked with other developmental disorders.

Signs of autism spectrum disorder often appear early in development when there are obvious delays in language skills and social interactions. Your doctor may recommend developmental tests to identify if your child has delays in cognitive, language and social skills, if your child:

Examples include fragile X syndrome, an inherited disorder that causes intellectual problems; tuberous sclerosis, a condition in which benign tumors develop in the brain; and Rett syndrome, a genetic condition occurring almost exclusively in girls, which causes slowing of head growth, intellectual disability and loss of purposeful hand use.

• Extremely preterm babies. Babies born before 26 weeks of gestation may have a greater risk of autism spectrum disorder.
• Parents’ ages. There may be a connection between children born to older parents and autism spectrum disorder, but more research is necessary to establish this link.

Complications
Problems with social interactions, communication and behavior can lead to:
• Problems in school and with successful learning
• Employment problems
• Inability to live independently
• Social isolation
• Stress within the family
• Victimization and being bullied

Prevention
There is no way to prevent autism spectrum disorder, but treatment options are available. Early diagnosis and intervention is most helpful and can improve behavior, skills and language development. However, intervention is helpful at any age. Though children usually don’t outgrow autism spectrum disorder symptoms, they may learn to function well.

Diagnosis
There isn’t a specific medical test to determine the disorder since autism spectrum disorder varies widely in symptoms and severity. Therefore, making a diagnosis may be difficult. The specialist may:
• Observe your child and ask how your child’s social interactions, communication skills and behavior have developed and changed over time
• Give your child tests covering hearing, speech, language, developmental level, and social and behavioral issues.

• Family therapies. Parents and other family members can learn how to play and interact with their children in ways that promote social interaction skills, manage problem behaviors, and teach daily living skills and communication.
• Other therapies. Depending on your child’s needs, speech therapy to improve communication skills, occupational therapy to teach activities of daily living, and physical therapy to improve movement and balance may be beneficial. A psychologist can recommend ways to address problem behavior.
• Medications. No medication can improve the core signs of autism spectrum disorder, but specific medications can help control symptoms.