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Ebola gave the world a major scare in 2014. That was the year of one of the largest Ebola outbreaks in West Africa and its impact was far-reaching even causing a panic in the United States after 11 Ebola patients were diagnosed there.
However, not many people are aware that there are similar diseases to Ebola which pose just as great a risk to international travel as well as the increased chances of another epidemic.
One such disease first came to light in 1969 when 3 American missionary nurses in Nigeria, West Africa were afflicted by severe symptoms. The symptoms included fever and weakness followed by a headache, body aches, sore throat, vomiting, diarrhoea and cough. In the most extreme of cases, the disease caused bleeding in the gums, eyes, and nose, and finally death. This unknown and deadly disease came to be known as Lassa Fever.
Discovery of the Lassa Fever Virus
Lassa is a small town in Nigeria. In 1969, the Church of the Brethren, USA, posted missionary nurse Laura Wine to Nigeria so that she could become the head of obstetrics at the Lassa Mission Hospital in the town of Lassa.
While working at the hospital, Laura Wine came into contact with a sick obstetrical patient and developed an unusual fever that would not respond to conventional treatments. As her symptoms worsened, she was immediately transferred to a larger hospital with better facilities.
A second missionary staff nurse at the larger hospital treated Laura Wine. This nurse had a cut on her finger and unintentionally used this finger to hold a gauze dressing to clear secretions from Laura Wine’s mouth. This was a big mistake and the second missionary staff nurse also ended up becoming sick from treating Laura Wine.
Both Laura Wine and the missionary staff nurse who treated her died. In a surprising chain reaction, a third missionary nurse became ill after conducting an autopsy on the dead bodies of the previous two missionary nurses.
The third nurse was immediately flown to the United States and placed in an isolation unit. She received care for more than nine weeks and fortunately survived.
In the meantime, blood and body fluid samples from all 3 nurses were transported to the Yale Arbovirus Research Unit where the virus was isolated and named as the Lassa Fever Virus (LAFV).
Origin of the Lassa Fever Virus
The Lassa Fever Virus originates from a rat called the Mastomys rat that is common to sub-Saharan and equatorial Africa. Countries in this region that are mostly at risk for Lassa Fever are Nigeria, Sierra Leone, Guinea, and Liberia.
People are infected when they come into contact with the Mastomys rat which is often found in homes and farms. When the rat is infected with the virus, it excretes it in urine and droppings. Touching or any exposure to these soiled objects can lead to infection.
People can also become infected by person-to-person transmission through exposure to virus in the blood, tissue, or excretion of a Lassa Fever infected individual. This was how the missionary nurses ended up being infected after treating a patient with Lassa Fever.
Personal protective equipment or PPE provided in hospitals for infectious diseases would have prevented the transmission of the virus from person to person. However, at the time, the virus was unknown and the missionary nurses would not have been cognizant of this.
There is no vaccine for Lassa Fever. Instead, treatment involves specific antiviral drugs which are most effective if taken in the early stages of the illness.
Risk and Controversy
The risk of Lassa Fever remains prevalent in the countries of Guinea, Sierra Leone, Liberia, and Nigeria. Surrounding countries which are host to the Mastomys rat are also at risk. Lassa Fever can be imported from people traveling to these countries.
Lassa Fever seems to be endemic to certain regions and so far hasn’t spread to other countries of the world. Outbreaks are mainly contained within the endemic regions.
However Lassa Fever continues to impact Nigeria severely. Even with the threat of Covid-19, a Lassa Fever outbreak was reported in Nigeria in 2020 causing at least 188 deaths. It is expected that the outbreaks may continue until strong environmental measures are taken to prevent direct and indirect contact between the Mastomys rat and humans.
As for the people of the town of Lassa and for most Nigerians, there was much controversy that a killer virus was named after their town. Many Nigerians questioned and doubted that such a virus could originate from their hometown and country.
There was a move to change the name of the virus and name it either after the first identifed Lassa Fever patient, Laura Wine, or the doctor who treated her. The case to change the nomenclature of the virus was put forth before the World Health Organization. However, it was unsuccessful.
Once a virus was scientifically named in the literature, it would be very difficult to change its original name.
The town of Lassa became stigmatized by being known as the origin of a killer virus. Doctors refused to be posted there, visitors stopped visiting and even the missionaries were reluctant to work in Lassa.
The town continues to have a reputation for being the origin of Lassa Fever.
I first heard about Lassa Fever when I lived in another town in Nigeria near Lassa. I have never been to Lassa myself but I had heard so much about it because I went to a school with American missionary kids and it was a subject that seemed to come up now and then.
For the Church of the Brethren mission, Lassa Fever will forever remain in their historical archives because their missionary Laura Wine was the first person to have ever been identified with the disease.
While Lassa Fever mainly seems to be a problem contained within West Africa, the risks for transmission to other countries of the world should not be underestimated.