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A 21-Year-Old Student with Fever and Profound Jaundice

  • Samson Ejiji Isa mail,

    ejijisa@yahoo.com

    Affiliations: Infectious Diseases Unit, Department of Medicine, Jos University Teaching Hospital, Jos, Plateau State, Nigeria, Faculty of Medical Sciences, University of Jos, Jos, Plateau State, Nigeria

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  • Kenneth Ikenna Onyedibe,

    Affiliations: Faculty of Medical Sciences, University of Jos, Jos, Plateau State, Nigeria, Department of Medical Microbiology, Jos University Teaching Hospital, Jos, Plateau State, Nigeria

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  • Mark Ojogba Okolo,

    Affiliations: Faculty of Medical Sciences, University of Jos, Jos, Plateau State, Nigeria, Department of Medical Microbiology, Jos University Teaching Hospital, Jos, Plateau State, Nigeria

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  • Abiayi Elmina Abiba,

    Affiliation: Leptospirosis Unit, Central Diagnostics Laboratories National Veterinary Research Institute, Vom, Plateau State, Nigeria

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  • Johnson Simon Mafuka,

    Affiliation: Infectious Diseases Unit, Department of Medicine, Jos University Teaching Hospital, Jos, Plateau State, Nigeria

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  • Gomerep Samuel Simji,

    Affiliations: Infectious Diseases Unit, Department of Medicine, Jos University Teaching Hospital, Jos, Plateau State, Nigeria, Faculty of Medical Sciences, University of Jos, Jos, Plateau State, Nigeria

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  • Shehu Yakubu Nathan,

    Affiliation: Infectious Diseases Unit, Department of Medicine, Jos University Teaching Hospital, Jos, Plateau State, Nigeria

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  • Ubong Aniefok Udoh,

    Affiliation: Department of Medical Microbiology, Jos University Teaching Hospital, Jos, Plateau State, Nigeria

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  • Sati Klein Awang,

    Affiliation: Infectious Diseases Unit, Department of Medicine, Jos University Teaching Hospital, Jos, Plateau State, Nigeria

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  • Daniel Zanyu Egah,

    Affiliations: Faculty of Medical Sciences, University of Jos, Jos, Plateau State, Nigeria, Department of Medical Microbiology, Jos University Teaching Hospital, Jos, Plateau State, Nigeria

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  • Edmond Banle Banwat,

    Affiliations: Faculty of Medical Sciences, University of Jos, Jos, Plateau State, Nigeria, Department of Medical Microbiology, Jos University Teaching Hospital, Jos, Plateau State, Nigeria

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  • Melanie Newport,

    Affiliations: Department of Infectious Diseases, Brighton and Sussex University Hospital, Brighton, Southeast England, United Kingdom, Global Health Programme, Brighton and Sussex University, Brighton, Southeast England, United Kingdom

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  • Ahmed Ahmed

    Affiliation: Royal Tropical Institute, KIT Biomedical Research, WHO/FAO/OIE and National Collaborating Center for Reference and research on Leptospirosis, Meibergdreef, Amsterdam, The Netherlands

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  • Published: January 09, 2014
  • DOI: 10.1371/journal.pntd.0002534

Reader Comments (1)

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A leap forward for One Health and the Zoonotic Infectious Disease Agenda in Nigeria

Posted by deenvet on 10 Jan 2014 at 08:20 GMT

The authors and PLOS NTD must be commended for publishing this work on clinical leptospirosis in Nigeria. Zoonotic infections, including rabies, are undoubtedly under-reported in Nigeria; one is hopeful and optimistic that this report could provide the much needed leap from rhetoric to action

It is not unlikely that previous cases of zoonotic leptospirosis in the human population were missed or misdiagnosed as malaria. To maximize the One Health benefit, the authors in collaboration with relevant local authorities should have included a thorough environmental survey. This might have provided more data on the animal source(s); additionally, animal isolates may have further enriched the molecular data and analysis included in the study. Lastly, such a study may have led to the detection of other students or persons infected either with leptospirosis or other flood or vector borne infections. It is urged that the government fully support this group to elucidate data gaps and thus provide evidence to support expected preventive efforts.

Apart from YF, the authors (and readers) should consider Rift Valley fever and Dengue as possible differential diagnoses given the post flood situation [1]. Although evidence of RVF and Dengue being endemic in Nigeria has existed for decades [2, 3, and 4], these infections remain clinically or under-reported. As the authors described rat infestations in the student's hostel, rat flea borne murine typhus could also be considered for febrile patients in that setting. Lassa fever should not be the only rodent-borne febrile- infection Nigerian clinicians and public health workers consider in similar settings.

1: Al-Hazmi et al. Epidemic Rift Valley fever in Saudi Arabia: a clinical study of severe illness in humans. Clin Infect Dis. 2003 Feb 1;36(3):245-52. Epub 2003 Jan 17. PubMed PMID: 12539063.

2: Olaleye OD, Tomori O, Schmitz H. Rift Valley fever in Nigeria: infections in domestic animals. Rev Sci Tech. 1996 Sep;15(3):937-46. PubMed PMID: 9025143.

3: Tomori O, Fabiyi A, Sorungbe A, Smith A, McCormick JB. Viral hemorrhagic fever antibodies in Nigerian populations. Am J Trop Med Hyg. 1988 Mar;38(2):407-10. PubMed PMID: 3128130.

4: Fagbami AH, Monath TP, Fabiyi A. Dengue virus infections in Nigeria: a survey for antibodies in monkeys and humans. Trans R Soc Trop Med Hyg. 1977;71(1):60-5. PubMed PMID: 404737.


Shamsudeen Fagbo, DVM, MSc

No competing interests declared.