COVID-19 and Lassa fever in Africa: a double crisis

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A motorcyclist drives past a road sign for the Institute of Lassa Fever Research and Control at the Irrua Specialist Teaching Hospital in Irrua, Edo state, midwestern Nigeria, on March 6, 2018. PIUS UTOMI EKPEI / AFP via Getty Images
  • A recent article in the diary by Medical virology discusses the dual effects of Lassa fever and COVID-19 in Africa.
  • The authors say the emergence of COVID-19 has diverted resources away from other infectious diseases, including Lassa fever.
  • To contain the disease, they recommend a mix of public hygiene information, increased research, and the development of treatments and vaccines.

Lassa fever is an infectious disease that can be transmitted from rodents to humans. CA 2 million people develop Lassa fever each year, causing 5,000 to 10,000 deaths. The disease is endemic in West African countries like Guinea, Liberia, Nigeria and Sierra Leone.

One of the biggest challenges in diagnosing the disease is how similar they are Symptoms, including sore throat, joint pain, and weakness, with many other diseases such as dengue and typhoid.

Because of this, the condition is often underdiagnosed and misdiagnosed.

The emergence of COVID-19 has made the disease more difficult to identify and manage due to the added burden on public health systems around the world.

Earlier this year, an international team of researchers published an article highlighting the post-COVID-19 post-COVID-19 situation of Lassa fever and public health strategies to contain it.

“Lassa fever is endemic in West Africa” Matt Price, Ph.D., told Medical news today. Dr. Price is the director of epidemiology at the International AIDS Vaccine Initiative (IAVI) and Clinical Assistant Professor of Epidemiology and Biostatistics at the University of California San Francisco (UCSF). He was not involved in the article.

“However, past reporting of the disease has not been systematic and our understanding of epidemiology is incomplete. For the past few years, Nigeria has been the epicenter for annual outbreaks of the disease, with case numbers peaking in 2020, ”he added.

“There is active disease surveillance in Nigeria and large population-based epidemiological studies are ongoing in Sierra Leone, Guinea, Liberia and Benin. This work will help us better understand the epidemiology of Lassa fever, ”he said.

The article appears in the diary medical virology.

Currently, early diagnosis of Lassa fever is key to effective treatment. Doctors recommend ribavirin, an antiviral drug, within 6 days of contracting the virus. If left untreated, the disease can lead to:

  • swollen airways
  • Abdominal pain
  • diarrhea
  • Vomit
  • Respiratory symptoms
  • Hearing loss
  • acute hemorrhagic fever
  • Multiple organ failure
  • death

Following the declaration that COVID-19 is a pandemic, medical resources have been turned to COVID-19, resulting in impaired supplies of infectious diseases higher death rateslike Lassa fever.

“In the middle of Epidemiological Week 9 of 2020, when the first confirmed case of COVID-19 was registered in Nigeria, the number of confirmed cases was increasing [Lassa fever] Cases, ”write the researchers.

“In fact, with continued care and treatment with ribavirin, the death toll was still 24–33% in tertiary clinics […] whereas almost 13.5% of survivors [had] Sensorineural hearing loss. Likewise, [Lassa fever] accounts for nearly 22% of maternal deaths in hospitals in endemic areas, ”they add.

When asked how COVID-19 has affected the treatment of Lassa fever in Africa,Dr. Price said:

“Lassa fever is a cause for concern because of the severity of symptoms, the risk of death and concerns about the virus’ potential as a biological weapon. After the Ebola crisis of 2014-2016, the international community provided funds to develop a safe and effective vaccine against Lassa fever. “

“As part of the effort to prepare for clinical trials of Lassa fever vaccines, large-scale, population-based epidemiological studies in endemic areas were planned to facilitate the selection of clinical trial sites – to ensure that the vaccines were tested where they were were most needed, “he said MNT.

“Unfortunately, these studies were only just getting started when the COVID-19 pandemic began.”

“With the downtime and service interruptions caused by COVID-19,” continued Dr. Price continued, “There is a potential for incomplete or infrequent reporting of Lassa fever cases or interruptions in care and service for those reporting to health centers with symptoms of Lassa fever.”

“While we know that SARS-CoV-2 infection can be complicated by pre-existing conditions like obesity and diabetes, we don’t know how this virus interacts with Lassa fever.”

– Dr. price

When asked how similar Lassa fever is to COVID-19, Robert F. Garry, Jr., Ph.D., Professor of microbiology and immunology at Tulane Medical School in New Orleans, LA, said MNT:

“Both are animal viruses that spread to humans, RNA viruses with envelopes (spikes), [have a] large transmission of respiratory components / aerosols and cause economic and social disruption. “

However, this may be the point where the similarities end. Dr. Price added, “These are very different viruses. Lassa fever is an acute viral hemorrhagic fever caused by a single-stranded RNA virus known as Lassa virus – a member of the Arenaviridae Family.”

“The infection occurs through ingestion or inhalation,” explained Dr. Price. “Incidental contact, for example skin-to-skin, does not spread the virus. It is mainly transmitted through contact with urine and feces Mastomys Rodents (the multimammate rat). “

“Some of the transmission can be through body fluids, but this is not the primary route of transmission and is not blamed for many cases.”

“SARS-CoV-2 is a respiratory virus, one of the few coronaviruses that infect people. It is highly contagious and is easily transmitted from person to person via aerosol droplets. Coronaviruses, including SARS-CoV-2, are also RNA viruses; However, they are a different family of viruses than Lassa fever and their genetic makeup is very different, ”he explained.

The authors of the article say that Lassa fever prevention can “only” be achieved [by] Education of people who live in Endemic areas about ways to protect yourself. ”

They emphasize the importance of the good. “Community hygiene“By using rodent-safe containers inside households and creating landfills outside of homes.

They add that healthcare professionals should ensure that people with a fever are given COVID-19 polymerase chain reaction (PCR) tests to confirm whether or not they have COVID-19, and that laboratory staff working with potentially infectious samples trained and should work in appropriately equipped laboratories.

The authors go on to say that COVID-19 health care funding should be used to create long-term health frameworks.

“National control and prevention strategies should be implemented by providing effective and affordable diagnostics and treatment for [Lassa fever] and COVID-19, which improves laboratory diagnostics, clinical management, environmental control and research, ”the researchers write.

“The involvement of the affected communities is strongly recommended, and developing an effective and affordable vaccine would be the cornerstone of absolute management of [Lassa fever], especially in the challenging times of the COVID-19 pandemic. Therefore, in addition to early diagnosis and treatment, it is of the utmost importance to raise awareness of the availability of vaccines and make them easily available to one [Lassa fever]-free society, ”they add.

Dr. Garry agreed to prioritize vaccines and drugs against Lassa fever. However, he stated that fair distribution was crucial.

Dr. Price also agreed to prioritize vaccines: “The most effective control measures will use a safe and effective vaccine against Lassa fever. Improved surveillance will also play a role as it will be important to detect outbreaks quickly so that additional vaccinations and other control measures can be implemented quickly, ”he added.

“There are several vaccine candidates in development, including one that IAVI is developing. We have had excellent support from the international community, with funding from the [The European & Developing Countries Clinical Trials Partnership (EDCTP)], [The Coalition for Epidemic Preparedness Innovations (CEPI)], and Wellcome (the latter funding for observational epidemiology, separate from work on a vaccine against Lassa fever). ”

Dr. Price also highlighted the importance of public hygiene information: “After all, good old-fashioned information and public health will also play an important role. Helping communities understand what Lassa fever is, what the signs and symptoms are, and what to do when they see a case – and what can be done to help communities reduce their risk of exposure (e.g., the To reduce exposure to the animal vector). “

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