The unending threat of Lassa fever in Nigeria, what can be done; what should be done
Article Sidebar
Main Article Content
Abstract
Background: Lassa fever is known to be endemic in West African region, and Nigeria bears the most burden of the disease and case fatalities. It is worrisome and disheartening for an emerging infectious disease such as Lassa fever, to linger for 49 years but surge in incidence in a country such as Nigeria, endowed with both human and natural resources.
Methods: The sources of the information presented was obtained through detailed review of literatures using Medline, Ovid and PubMed (search terms Lassa fever, Arenaviridae and viral haemorrhagic fever), case analysis, and surveys undertaking from the field, and relevant websites (such as Nigeria Center for Disease Control, Nigerian Federal Ministry of Health, Centers for Disease Control and Prevention).
Results: The possibility of a large outbreak in Nigeria and other sub-Saharan Countries characterised by dearth of laboratory facilities for prompt diagnosis and personal protective equipment (PPE) and its potential use as a biological weapon has also raised the profile of this disease. Health education of the communities, improved funding through budgetary allocation for surveillance, prompt case management including laboratory facilities, training of health personnel, isolation of cases, barrier nursing, contact tracing, provision of antiviral drugs and vaccines that is effective against this disease and supply of PPE is not only necessary but also expedient in the light of the threat due to Lassa fever.
Conclusion: The weak health-care delivery system in Nigeria, would continue to impede effective control of emerging and re-emerging infectious diseases including Lassa fever. There is an urgent need to provide resources to effectively control and prevent Lassa fever.
Downloads
Article Details
The journal grants the right to make small numbers of printed copies for their personal non-commercial use under Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported License.
References
1. Frame JD, Baldwin JM Jr., Gocke DJ, Troup JM. Lassa fever, a new virus disease of man from West Africa. I. Clinical description and pathological findings. Am J Trop Med Hyg 1970;19:670‑6.
2. Keenlyside RA, McCormick JB, Webb PA, Smith E, Elliott L, Johnson KM, et al. Case‑control study of Mastomys natalensis and humans in Lassa virus-infected households in Sierra Leone. Am J Trop Med Hyg 1983;32:829‑37.
3. Monath TP, Newhouse VF, Kemp GE, Setzer HW, Cacciapuoti A. Lassa virus isolation from Mastomys natalensis rodents during an epidemic in Sierra Leone. Science 1974;185:263‑5.
4. Centers for Disease Control and Prevention (CDC). Lassa Fever. Atlanta: CDC, 2015. Available from: http://www.cdc.gov/vhf/lassa. [Last accessed on 2015 Oct 01].
5. Ogbu O, Ajuluchukwu E, Uneke CJ. Lassa fever in West African sub‑region: An overview. J Vector Borne Dis 2007;44:1‑1.
6. World Health Organization (WHO). Lassa Fever Fact Sheet (Fact Sheet No. 179). Geneva: WHO, 2015. Available from: http://www.who.int/
mediacentre/factsheets/fs179/en. [Last accessed on 2015 Oct 01].
7. World Health Organization (WHO). Lassa Fever – Nigeria. Geneva: WHO, 2016. Available from: http://www.who.int/csr/don/27‑january‑2016‑lassa‑fever‑nigeria/en/#. [Last accessed on 2016 Feb 08].
8. Auperin DD, Sasso DR, McCormick JB. Nucleotide sequence of the glycoprotein gene and intergenic region of the Lassa virus S genome RNA. Virology 1986;154:155‑67.
9. Auperin DD, McCormick JB. Nucleotide sequence of the Lassa virus (Josiah strain) S genome RNA and amino acid sequence comparison of the N and GPC proteins to other arenaviruses. Virology 1989;168:421‑5.
10. Clegg JC, Wilson SM, Oram JD. Nucleotide sequence of the S RNA of Lassa virus(Nigerian strain) and comparative analysis of arenavirus gene products. Virus Res 1991;18:151‑64.
11. Ter Meulen J, Koulemou K, Wittekindt T, Windisch K, Strigl S, Conde S, et al. Detection of Lassa virus antinucleoprotein immunoglobulin G (IgG) and IgM antibodies by a simple recombinant immunoblot assay for field use. J Clin Microbiol 1998;36:3143‑8.
12. Demby AH, Chamberlain J, Brown DW, Clegg CS. Early diagnosis of Lassa fever by reverse transcription‑PCR. J Clin Microbiol 1994; 32: 2898‑903.
13. Günther S, Emmerich P, Laue T, Kühle O, Asper M, Jung A, et al. Imported Lassa fever in Germany: Molecular characterization of a new Lassa virus strain. Emerg Infect Dis 2000;6:466‑76.
14. Gilsdorf A, Morgan D, Leitmeyer K. Guidance for contact tracing of cases of Lassa fever, Ebola or Marburg Haemorrhagic fever on an airplane: Results of a European expert consultation. BMC Public Health 2012;12:1014.
15. McCormick JB, Webb PA, Krebs JW, Johnson KM, Smith ES. A prospective study of the epidemiology and ecology of Lassa fever. J Infect Dis 1987;155:437‑44.
16. Lukashevich IS, Clegg JC, Sidibe K. Lassa virus activity in Guinea: Distribution of human antiviral antibody defined using enzyme‑linked
immunosorbent assay with recombinant antigen. J Med Virol 1993;40:210‑7.
17. Tomori O, Fabiyi A, Sorungbe A, Smith A, McCormick JB. Viral hemorrhagic fever antibodies in Nigerian populations. Am J Trop Med Hyg 1988;38:407‑10.
18. Fichet‑Calvet E, Rogers DJ. Risk maps of Lassa fever in West Africa. PLoS Negl Trop Dis 2009;3:e388.
19. Division of Public Health, Surveillance and Response, NICD‑NHLS. The Current Lassa Fever Outbreak. Vol. 15. Nigeria: Communicable
Diseases Communiqué, 2016; 1‑4. Available from: http://www. outbreak@nicd.ac.za. [Last accessed on 2017 Mar 12].
20. ACAPS. ACAPS Briefing Note: Nigeria – Lassa Fever 2016. Available from: http://www.reliefweb.int/sites/reliefweb.int/files/resources/
start‑acaps‑nigeria‑lassa‑epidemic‑briefing‑note.pdf. [Last accessed on 2016 Jan 20].
21. Kunz S. Receptor binding and cell entry of Old World arenaviruses reveal novel aspects of virus‑host interaction. Virology 2009;387:245‑9.
22. Dylla DE, Michele DE, Campbell KP, McCray PB Jr. Basolateral entry and release of new and Old World arenaviruses from human airway
epithelia. J Virol 2008;82:6034‑8.
23. Schlie K, Maisa A, Freiberg F, Groseth A, Strecker T, Garten W, et al. Viral protein determinants of Lassa virus entry and release from polarized epithelial cells. J Virol 2010;84:3178‑88.
24. Lukashevich IS, Maryankova R, Vladyko AS, Nashkevich N, Koleda S, Djavani M, et al. Lassa and Mopeia virus replication in human monocytes/macrophages and in endothelial cells: Different effects on IL‑8 and TNF‑alpha gene expression. J Med Virol 1999;59:552‑60.
25. Yun NE, Walker DH. Pathogenesis of Lassa fever. Viruses 2012;4:2031‑48.
26. McCormick JB, Fisher‑Hoch SP. Lassa fever. Curr Top Microbiol Immunol 2002;262:75‑109.
27. Cummins D, McCormick JB, Bennett D, Samba JA, Farrar B,Machin SJ, et al. Acute sensorineural deafness in Lassa fever. JAMA 1990;264:2093‑6.
28. Kitching A, Addiman S, Cathcart S, Bischop L, Krahé D, Nicholas M, et al. A fatal case of Lassa fever in London, January 2009. Euro Surveill
2009;14(6)pii=19117. Available from: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19117. [Last accessed on 2017 Mar 04].
29. Moraz ML, Kunz S. Pathogenesis of arenavirus hemorrhagic fevers. Expert Rev Anti Infect Ther 2011;9:49‑59.
30. Sabeti PC, Varilly P, Fry B, Lohmueller J, Hostetter E, Cotsapas C, et al. Genome‑wide detection and characterization of positive selection in
human populations. Nature 2007;449:913‑8.
31. Baize S, Pannetier D, Faure C, Marianneau P, Marendat I, Georges‑Courbot MC, et al. Role of interferons in the control of Lassa virus replication in human dendritic cells and macrophages. Microbes Infect 2006;8:1194‑202.
32. Baize S, Kaplon J, Faure C, Pannetier D, Georges‑Courbot MC, Deubel V, et al. Lassa virus infection of human dendritic cells and macrophages is productive but fails to activate cells. J Immunol 2004;172:2861‑9.
33. Baize S, Marianneau P, Loth P, Reynard S, Journeaux A, Chevallier M, et al. Early and strong immune responses are associated with control
of viral replication and recovery in Lassa virus-infected cynomolgus monkeys. J Virol 2009;83:5890‑903.
34. Hayes MW, Carrion R Jr., Nunneley J, Medvedev AE, Salvato MS, Lukashevich IS, et al. Pathogenic Old World arenaviruses inhibit TLR2/Mal‑dependent proinflammatory cytokines in vitro. J Virol 2012;86:7216‑26.
35. Mahanty S, Bausch DG, Thomas RL, Goba A, Bah A, Peters CJ, et al. Low levels of interleukin‑8 and interferon‑inducible protein‑10 in serum are associated with fatal infections in acute Lassa fever. J Infect Dis 2001;183:1713‑21.
36. Mahanty S, Hutchinson K, Agarwal S, McRae M, Rollin PE, Pulendran B, et al. Cutting edge: Impairment of dendritic cells and adaptive immunity by Ebola and Lassa viruses. J Immunol 2003;170:2797‑801.
37. Meulen Jt, Badusche M, Satoguina J, Strecker T, Lenz O, Loeliger C, et al. Old and new world arenaviruses share a highly conserved epitope in
the fusion domain of the glycoprotein 2, which is recognized by Lassa virus‑specific human CD4+ T‑cell clones. Virology 2004;321:134‑43.
38. ter Meulen J, Badusche M, Kuhnt K, Doetze A, Satoguina J, Marti T, et al. Characterization of human CD4(+) T‑cell clones recognizing
conserved and variable epitopes of the Lassa virus nucleoprotein. J Virol 2000;74:2186‑92.
39. Jahrling PB, Frame JD, Smith SB, Monson MH. Endemic Lassa fever in Liberia. III. Characterization of Lassa virus isolates. Trans R Soc Trop Med Hyg 1985;79:374‑9.
40. Walker DH, McCormick JB, Johnson KM, Webb PA, Komba‑Kono G, Elliott LH, et al. Pathologic and virologic study of fatal Lassa fever in man. Am J Pathol 1982;107:349‑56.
41. Knobloch J, McCormick JB, Webb PA, Dietrich M, Schumacher HH, Dennis E, et al. Clinical observations in 42 patients with Lassa fever.
Tropenmed Parasitol 1980;31:389‑98.
42. McCormick JB, Walker DH, King IJ, Webb PA, Elliott LH, Whitfield SG, et al. Lassa virus hepatitis: A study of fatal Lassa fever in humans. Am J Trop Med Hyg 1986;35:401‑7.
43. Geisberg TW, Jahrling PB. Exotic emerging viral diseases: Progress and challenges. Nat Med 2004;10:S110‑21.
44. Lange JV, Mitchell SW, McCormick JB, Walker DH, Evatt BL, Ramsey RR, et al. Kinetic study of platelets and fibrinogen in Lassa virus-infected monkeys and early pathologic events in Mopeia virus‑infected monkeys. Am J Trop Med Hyg 1985;34:999‑1007.
45. Seregin A, Yun N, Paessler S. Lymphocytic choriomeningitis, lassa fever, and the South American hemorrhagic fevers. In: Bennett JE, Dolin R, Blaser M, editors. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases. 8th ed. Philadelphia: Elsevier Saunders, 2015; 2031-7.
46. Bausch DG, Hadi CM, Khan SH, Lertora JJ. Review of the literature and proposed guidelines for the use of oral ribavirin as postexposure
prophylaxis for Lassa fever. Clin Infect Dis 2010;51:1435‑41.
47. Branco LM, Boisen ML, Andersen KG, Grove JN, Moses LM, Muncy IJ, et al. Lassa hemorrhagic fever in a late term pregnancy from Northern Sierra Leone with a positive maternal outcome: Case report. Virol J 2011;8:404.
48. McCarthy M. USA moves quickly to push biodefence research. Lancet 2002;360:732.
49. U.S. Department of Health and Human Services (U.S. HHS), Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH). Biosafety in Microbiological and Biomedical Laboratories. 5th ed. Washington, DC: Government Printing Office, 2009.
50. Update on Lassa fever in West Africa. Wkly Epidemiol Rec 2005;80:86‑8.
51. McCormick JB. Arenaviruses. In: Fields BN, Knipe DM, editors. Fields Virology. New York: Raven Press, 1990; 1245‑67.
52. Fleischer K, Köhler B, Kirchner A, Schmid J. Lassa fever. Med Klin (Munich) 2000;95:340‑5.
53. Burns JW, Buchmeier MJ. Glycoproteins of the arenaviruses. In: Salvato MS, editor. The Arenaviridae. New York: Plenum Press, 1993;17-35.
54. Lunkenheimer K, Hufert FT, Schmitz H. Detection of Lassa virus RNA in specimens from patients with Lassa fever by using the polymerase chain reaction. J Clin Microbiol 1990;28:2689‑92.
55. Trappier SG, Conaty AL, Farrar BB, Auperin DD, McCormick JB, Fisher‑Hoch SP, et al. Evaluation of the polymerase chain reaction for
diagnosis of Lassa virus infection. Am J Trop Med Hyg 1993;49:214‑21.
56. Southern PJ. Arenaviridae: The viruses and their replication. In: Fields BN, Knipe DM, Howley PM, editors. Fields Virology. Philadelphia: Lippencott‑Raven, PaRaven, 1996; 1505‑19.
57. McCormick JB, King IJ, Webb PA, Johnson KM, O’Sullivan R, Smith ES, et al. A case-control study of the clinical diagnosis and course of Lassa fever. J Infect Dis 1987;155:445‑55.
58. Wulff H, Lange JV. Indirect immunofluorescence for the diagnosis of Lassa fever infection. Bull World Health Organ 1975;52:429‑36.
59. Van der Waals FW, Pomeroy KL, GoudsmitJ, Asher DM, Gajdusek DC. Hemorrhagic fever virus infections in an isolated rainforest area of
central Liberia. Limitations of the indirect immunofluorescence slide test for antibody screening in Africa. Trop Geogr Med 1986;38:209‑14.
60. Ivanov AP, Tkachenko EA, van der Groen G, Butenko AM, Konstantinov OK. Indirect immunoenzyme method for the laboratory diagnosis of Lassa and Ebola hemorrhagic fevers. Vopr Virusol 1986;31:186‑90.
61. Jahrling PB, Niklasson BS, McCormick JB. Early diagnosis of human lassa fever by ELISA detection of antigen and antibody. Lancet 1985; 1:250‑2.
62. Niklasson BS, Jahrling PB, Peters CJ. Detection of lassa virus antigens and lassa virus‑specific immunoglobulins G and M by enzyme‑linked
immunosorbent assay. J Clin Microbiol 1984;20:239‑44.
63. Bausch DG, Demby AH, Coulibaly M, Kanu J, Goba A, Bah A, et al. Lassa fever in guinea: I. Epidemiology of human disease and clinical
observations. Vector Borne Zoonotic Dis 2001;1:269‑81.
64. McCormick JB, King IJ, Webb PA, Scribner CL, Craven RB, Johnson KM, et al. Lassa fever. Effective therapy with ribavirin. N Engl J Med 1986; 314:20‑6.
65. Olschläger S, Flatz L. Vaccination strategies against highly pathogenic arenaviruses: The next steps toward clinical trials. PLoS Pathog 2013; 9:e1003212.