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Mostafavi E, Mohammadpour R, Esmaeili S, Mahmoudi A, Salehi-Vaziri M, Ghasemi A, Rohani M, Mohammadi A, Eybpoosh S, Baseri N, Denys C, Maurin M, Nicolas V, Lalis A, Hugot JP. The Epidemiological Investigation of Yersinia pestis, Francisella tularensis, and Arenavirus Infections in Small Mammals in Northwestern Iran. Vector Borne Zoonotic Dis 2024; 24:489-498. [PMID: 38775074 DOI: 10.1089/vbz.2023.0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024] Open
Abstract
Background: The control and prevention of rodent-borne diseases are mainly based on our knowledge of ecology and the infectious status of their reservoir hosts. This study aimed to evaluate the prevalence of Francisella tularensis, Yersinia pestis, and arenavirus infections in small mammals and to assess the potential of disease occurrence in East Azerbaijan, northwest of Iran, in 2017 and 2018. Methods: Spleen and lung samples were obtained from all trapped small mammals. The real-time quantitative PCR (qPCR) method was used to detect nucleic acid sequences of F. tularensis, Y. pestis, and arenaviruses. Serum samples were tested for antibodies indicating the host response to F. tularensis and Y. pestis infections using the standard tube agglutination test and enzyme-linked immunosorbent assay (ELISA), respectively. Results: A total of 205 rodents, four Eulipotyphla, and one carnivore were captured. The most common rodent species captured (123 of 205 rodents, 60%) belonged to the genus Meriones (mainly Persian jird, Meriones persicus). In total, 317 fleas were removed from trapped animals. Flea species belonged to Xenopsylla buxtoni, Xenopsylla nuttalli, Stenoponia tripectinata, Paraceras melis, Ctenophthalmus rettigi smiti, Rhadinopsylla bivirgis, Paradoxopsyllus grenieri, and Nosopsyllus iranus. Using the qPCR tests, five spleen samples from M. persicus were positive for F. tularensis. The qPCR tests were negative for the detection of Y. pestis and arenaviruses. Finally, all serum samples tested were negative for antibodies against Y. pestis and F. tularensis. Conclusions: F. tularensis was the only zoonotic agent detected in rodents captured in East Azerbaijan. However, the diversity of trapped rodents and fleas provides the potential for the spread of various rodent-borne viral and bacterial diseases in the studied areas.
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Affiliation(s)
- Ehsan Mostafavi
- National Reference Laboratory of Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Roya Mohammadpour
- National Reference Laboratory of Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Saber Esmaeili
- National Reference Laboratory of Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Ahmad Mahmoudi
- Department of Biology, Faculty of Science, Urmia University, Urmia, Iran
| | - Mostafa Salehi-Vaziri
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | - Ahmad Ghasemi
- Department of Microbiology, Research Center of Reference Health Laboratory, Ministry of Health and Medical Education, Tehran, Iran
| | - Mahdi Rohani
- National Reference Laboratory of Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
- Department of Microbiology, Pasteur Institute of Iran, Tehran, Iran
| | - Ali Mohammadi
- National Reference Laboratory of Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Sana Eybpoosh
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Neda Baseri
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Christiane Denys
- Institut de Sytématique, Evolution et Biodiversité (ISYEB), Muséum National d'Histoire Naturelle, CNRS, Sorbonne Université, EPHE-PSL, Université des Antilles, Paris, France
| | - Max Maurin
- Centre National de Référence Francisella tularensis, Institut de Biologie et Pathologie, Centre Hospitalier Universitaire Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Violaine Nicolas
- Institut de Sytématique, Evolution et Biodiversité (ISYEB), Muséum National d'Histoire Naturelle, CNRS, Sorbonne Université, EPHE-PSL, Université des Antilles, Paris, France
| | - Aude Lalis
- Institut de Sytématique, Evolution et Biodiversité (ISYEB), Muséum National d'Histoire Naturelle, CNRS, Sorbonne Université, EPHE-PSL, Université des Antilles, Paris, France
| | - Jean-Pierre Hugot
- Institut de Sytématique, Evolution et Biodiversité (ISYEB), Muséum National d'Histoire Naturelle, CNRS, Sorbonne Université, EPHE-PSL, Université des Antilles, Paris, France
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2
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Moore KA, Ostrowsky JT, Mehr AJ, Johnson RA, Ulrich AK, Moua NM, Fay PC, Hart PJ, Golding JP, Benassi V, Preziosi MP, Adetifa IM, Akpede GO, Ampofo WK, Asogun DA, Barrett ADT, Bausch DG, de Coster I, Emperador DM, Feldmann H, Fichet-Calvet E, Formenty PBH, Garry RF, Grant DS, Günther S, Gupta SB, Jaspard M, Mazzola LT, Okogbenin SA, Roth C, Schmaljohn CS, Osterholm MT. Lassa fever research priorities: towards effective medical countermeasures by the end of the decade. THE LANCET. INFECTIOUS DISEASES 2024:S1473-3099(24)00229-9. [PMID: 38964363 DOI: 10.1016/s1473-3099(24)00229-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/01/2024] [Accepted: 04/04/2024] [Indexed: 07/06/2024]
Abstract
In 2016, WHO designated Lassa fever a priority disease for epidemic preparedness as part of the WHO Blueprint for Action to Prevent Epidemics. One aspect of preparedness is to promote development of effective medical countermeasures (ie, diagnostics, therapeutics, and vaccines) against Lassa fever. Diagnostic testing for Lassa fever has important limitations and key advancements are needed to ensure rapid and accurate diagnosis. Additionally, the only treatment available for Lassa fever is ribavirin, but controversy exists regarding its effectiveness. Finally, no licensed vaccines are available for the prevention and control of Lassa fever. Ongoing epidemiological and behavioural studies are also crucial in providing actionable information for medical countermeasure development, use, and effectiveness in preventing and treating Lassa fever. This Personal View provides current research priorities for development of Lassa fever medical countermeasures based on literature published primarily in the last 5 years and consensus opinion of 20 subject matter experts with broad experience in public health or the development of diagnostics, therapeutics, and vaccines for Lassa fever. These priorities provide an important framework to ensure that Lassa fever medical countermeasures are developed and readily available for use in endemic and at-risk areas by the end of the decade.
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Affiliation(s)
- Kristine A Moore
- Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis, MN, USA.
| | - Julia T Ostrowsky
- Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis, MN, USA
| | - Angela J Mehr
- Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis, MN, USA
| | - Rebecca A Johnson
- Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis, MN, USA
| | - Angela K Ulrich
- Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis, MN, USA
| | - Nicolina M Moua
- Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis, MN, USA
| | - Petra C Fay
- Infectious Disease Strategic Programme, Wellcome Trust, London, UK
| | - Peter J Hart
- Infectious Disease Strategic Programme, Wellcome Trust, London, UK
| | | | | | | | | | - George O Akpede
- Ambrose Alli University, Ekpoma, Nigeria; Institute of Viral and Emergent Pathogens Control and Research (formerly, Institute of Lassa Fever Research and Control), Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | | | | | - Alan D T Barrett
- Sealy Institute for Vaccine Sciences and Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - Daniel G Bausch
- FIND, Geneva, Switzerland; Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Ilse de Coster
- Centre for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium
| | | | - Heinz Feldmann
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | | | | | - Robert F Garry
- Tulane University, New Orleans, LA, USA; Zalgen Labs, Frederick, MD, USA; Global Viral Network, Baltimore, MD, USA
| | - Donald S Grant
- Kenema Government Hospital, Ministry of Health and Sanitation, Freetown, Sierra Leone; College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Stephan Günther
- Bernhard-Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Swati B Gupta
- lnternational AIDS Vaccine Initiative, New York, NY, USA
| | - Marie Jaspard
- The Alliance for International Medical Action, Dakar, Senegal; Saint-Antoine Hospital, Infectious Disease Department, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM Unit 1136 Institut Pierre Louis D'Epidémiologie et de Sante Publique, Paris, France
| | | | | | - Cathy Roth
- UK Foreign, Commonwealth and Development Office, London, UK
| | - Connie S Schmaljohn
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, Frederick, Maryland, USA
| | - Michael T Osterholm
- Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis, MN, USA
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3
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Yimer SA, Booij BB, Tobert G, Hebbeler A, Oloo P, Brangel P, L'Azou Jackson M, Jarman R, Craig D, Avumegah MS, Mandi H, Endy T, Wooden S, Clark C, Bernasconi V, Shurtleff A, Kristiansen PA. Rapid diagnostic test: a critical need for outbreak preparedness and response for high priority pathogens. BMJ Glob Health 2024; 9:e014386. [PMID: 38688565 PMCID: PMC11085978 DOI: 10.1136/bmjgh-2023-014386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/30/2024] [Indexed: 05/02/2024] Open
Abstract
Rapid diagnostic tests (RDTs) are critical for preparedness and response against an outbreak or pandemic and have been highlighted in the 100 Days Mission, a global initiative that aims to prepare the world for the next epidemic/pandemic by driving the development of diagnostics, vaccines and therapeutics within 100 days of recognition of a novel Disease X threat.RDTs play a pivotal role in early case identification, surveillance and case management, and are critical for initiating deployment of vaccine and monoclonal antibodies. Currently available RDTs, however, have limited clinical sensitivity and specificity and inadequate validation. The development, validation and implementation of RDTs require adequate and sustained financing from both public and private sources. While the World Health Assembly recently passed a resolution on diagnostic capacity strengthening that urges individual Member States to commit resources towards this, the resolution is not binding and implementation will likely be impeded by limited financial resources and other competing priorities, particularly in low-income countries. Meanwhile, the diagnostic industry has not sufficiently invested in RDT development for high priority pathogens.Currently, vaccine development projects are getting the largest funding support among medical countermeasures. Yet vaccines are insufficient tools in isolation, and pandemic preparedness will be incomplete without parallel investment in diagnostics and therapeutics.The Pandemic Fund, a global financing mechanism recently established for strengthening pandemic prevention, preparedness and response, may be a future avenue for supporting diagnostic development.In this paper, we discuss why RDTs are critical for preparedness and response. We also discuss RDT investment challenges and reflect on the way forward.
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Affiliation(s)
| | | | - Gwen Tobert
- Coalition for Epidemic Preparedness Innovations, Oslo, Norway
| | - Andrew Hebbeler
- Coalition for Epidemic Preparedness Innovations, Washington, DC, USA
| | - Paul Oloo
- Coalition for Epidemic Preparedness Innovations, London, UK
| | - Polina Brangel
- Coalition for Epidemic Preparedness Innovations, London, UK
| | | | - Richard Jarman
- Coalition for Epidemic Preparedness Innovations, Washington, DC, USA
| | - Danielle Craig
- Coalition for Epidemic Preparedness Innovations, Washington, DC, USA
| | | | - Henshaw Mandi
- Coalition for Epidemic Preparedness Innovations, Oslo, Norway
| | - Timothy Endy
- Coalition for Epidemic Preparedness Innovations, Washington, DC, USA
| | - Stacey Wooden
- Coalition for Epidemic Preparedness Innovations, Washington, DC, USA
| | - Carolyn Clark
- Coalition for Epidemic Preparedness Innovations, Oslo, Norway
| | | | - Amy Shurtleff
- Coalition for Epidemic Preparedness Innovations, Washington, DC, USA
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4
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Kaboré L, Pecenka C, Hausdorff WP. Lassa fever vaccine use cases and demand: Perspectives from select West African experts. Vaccine 2024; 42:1873-1877. [PMID: 38369392 DOI: 10.1016/j.vaccine.2024.02.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/05/2024] [Accepted: 02/14/2024] [Indexed: 02/20/2024]
Abstract
Lassa fever (LF) is a zoonotic viral hemorrhagic disease endemic to several West African countries. Approximately 300-500,000 cases occur annually across all ages with 10-20% case fatality rates. A LF vaccine is a recognized public health priority, with several candidates entering clinical trials. However, the perspectives of regional experts regarding critical vaccine properties, ideal delivery methods, and priority target populations remain unclear. Using a mixed methods approach with a standardized questionnaire, we individually interviewed 8 West African stakeholders, each with extensive knowledge and experience of LF. They strongly favored the use of a mass, proactive campaign strategy to immunize a wide age range of people in high-risk areas, including pregnant women and health care workers. We estimated that these and other plausible delivery scenarios could result in an initial demand of anywhere from 1 to 100 million doses, with most demand coming from Nigeria. These findings may help inform LF vaccine development and deployment efforts.
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Affiliation(s)
- Lassané Kaboré
- PATH, Fann Résidence Rue Saint John Perse x F, Dakar, Senegal
| | - Clint Pecenka
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
| | - William P Hausdorff
- PATH, 455 Massachusetts Ave NW, Washington DC 20001, USA; Université Libre de Bruxelles, Brussels, Belgium.
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5
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Shaffer M, Fischer RJ, Gallogly S, Ginn O, Munster V, Bibby K. Environmental Persistence and Disinfection of Lassa Virus. Emerg Infect Dis 2023; 29:2285-2291. [PMID: 37877545 PMCID: PMC10617325 DOI: 10.3201/eid2911.230678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Lassa fever, caused by Lassa virus (LASV), is endemic to West Africa, where ≈300,000 illnesses and ≈5,000 deaths occur annually. LASV is primarily spread by infected multimammate rats via urine and fomites, highlighting the need to understand the environmental fate of LASV. We evaluated persistence of LASV Josiah and Sauerwald strains on surfaces, in aqueous solutions, and with sodium hypochlorite disinfection. Tested strains were more stable in deionized water (first-order rate constant [k] for Josiah, 0.23 days; for Sauerwald, k = 0.34 days) than primary influent wastewater (Josiah, k = 1.3 days; Sauerwald, k = 1.9 days). Both strains had similar decay rates on high-density polyethylene (Josiah, k = 4.3 days; Sauerwald, k = 2.3 days) and stainless steel (Josiah, k = 5.3 days; Sauerwald, k = 2.7 days). Sodium hypochlorite was highly effective at inactivating both strains. Our findings can inform future risk assessment and management efforts for Lassa fever.
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6
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Guterres A. Viral load: We need a new look at an old problem? J Med Virol 2023; 95:e29061. [PMID: 37638475 DOI: 10.1002/jmv.29061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/22/2023] [Accepted: 08/17/2023] [Indexed: 08/29/2023]
Abstract
The concept of viral load was introduced in the 1980s to measure the amount of viral genetic material in a person's blood, primarily for human immunodeficiency virus (HIV). It has since become crucial for monitoring HIV infection progression and assessing the efficacy of antiretroviral therapy. However, during the coronavirus disease 2019 pandemic, the term "viral load" became widely popularized, not only for the scientific community but for the general population. Viral load plays a critical role in both clinical patient management and research, providing valuable insights for antiviral treatment strategies, vaccination efforts, and epidemiological control measures. As measuring viral load is so important, why don't researchers discuss the best way to do it? Is it simply acceptable to use raw Ct values? Relying solely on Ct values for viral load estimation can be problematic due to several reasons. First, Ct values can vary between different quantitative polymerase chain reaction assays, platforms, and laboratories, making it difficult to compare data across studies. Second, Ct values do not directly measure the quantity of viral particles in a sample and they can be influenced by various factors such as initial viral load, sample quality, and assay sensitivity. Moreover, variations in viral RNA extraction and reverse-transcription steps can further impact the accuracy of viral load estimation, emphasizing the need for careful interpretation of Ct values in viral load assessment. Interestingly, we did not observe scientific articles addressing different strategies to quantify viral load. The absence of standardized and validated methods impedes the implementation of viral load monitoring in clinical management. The variability in cell quantities within samples and the variation in viral particle numbers within infected cells further challenge accurate viral load measurement and interpretation. To advance the field and improve patient outcomes, there is an urgent need for the development and validation of tailored, standardized methods for precise viral load quantification.
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Affiliation(s)
- Alexandro Guterres
- Laboratório de Hantaviroses e Rickettsioses, Instituto Oswaldo Cruz Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
- Laboratório de Tecnologia Imunológica, Instituto de Tecnologia em Imunobiológicos, Vice-Diretoria de Desenvolvimento Tecnológico, Bio-Manguinhos, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
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7
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Murphy HL, Ly H. Pathogenicity and virulence mechanisms of Lassa virus and its animal modeling, diagnostic, prophylactic, and therapeutic developments. Virulence 2021; 12:2989-3014. [PMID: 34747339 PMCID: PMC8923068 DOI: 10.1080/21505594.2021.2000290] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Lassa fever (LF) is a deadly viral hemorrhagic disease that is endemic to West Africa. The causative agent of LF is Lassa virus (LASV), which causes approximately 300,000 infections and 5,000 deaths annually. There are currently no approved therapeutics or FDA-approved vaccines against LASV. The high genetic variability between LASV strains and immune evasion mediated by the virus complicate the development of effective therapeutics and vaccines. Here, we aim to provide a comprehensive review of the basic biology of LASV and its mechanisms of disease pathogenesis and virulence in various animal models, as well as an update on prospective vaccines, therapeutics, and diagnostics for LF. Until effective vaccines and/or therapeutics are available for use to prevent or treat LF, a better level of understanding of the basic biology of LASV, its natural genetic variations and immune evasion mechanisms as potential pathogenicity factors, and of the rodent reservoir-vector populations and their geographical distributions, is necessary for the development of accurate diagnostics and effective therapeutics and vaccines against this deadly human viral pathogen.
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Affiliation(s)
- Hannah L Murphy
- Department of Veterinary & Biomedical Sciences, Comparative & Molecular Biosciences Graduate Program, College of Veterinary Medicine, University of Minnesota, Twin Cities
| | - Hinh Ly
- Department of Veterinary & Biomedical Sciences, Comparative & Molecular Biosciences Graduate Program, College of Veterinary Medicine, University of Minnesota, Twin Cities
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8
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Merson L, Bourner J, Jalloh S, Erber A, Salam AP, Flahault A, Olliaro PL. Clinical characterization of Lassa fever: A systematic review of clinical reports and research to inform clinical trial design. PLoS Negl Trop Dis 2021; 15:e0009788. [PMID: 34547033 PMCID: PMC8486098 DOI: 10.1371/journal.pntd.0009788] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/01/2021] [Accepted: 09/03/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Research is urgently needed to reduce the morbidity and mortality of Lassa fever (LF), including clinical trials to test new therapies and to verify the efficacy and safety of the only current treatment recommendation, ribavirin, which has a weak clinical evidence base. To help establish a basis for the development of an adaptable, standardised clinical trial methodology, we conducted a systematic review to identify the clinical characteristics and outcomes of LF and describe how LF has historically been defined and assessed in the scientific literature. METHODOLOGY Primary clinical studies and reports of patients with suspected and confirmed diagnosis of LF published in the peer-reviewed literature before 15 April 2021 were included. Publications were selected following a two-stage screening of abstracts, then full-texts, by two independent reviewers at each stage. Data were extracted, verified, and summarised using descriptive statistics. RESULTS 147 publications were included, primarily case reports (36%), case series (28%), and cohort studies (20%); only 2 quasi-randomised studies (1%) were found. Data are mostly from Nigeria (52% of individuals, 41% of publications) and Sierra Leone (42% of individuals, 31% of publications). The results corroborate the World Health Organisation characterisation of LF presentation. However, a broader spectrum of presenting symptoms is evident, such as gastrointestinal illness and other nervous system and musculoskeletal disorders that are not commonly included as indicators of LF. The overall case fatality ratio was 30% in laboratory-confirmed cases (1896/6373 reported in 109 publications). CONCLUSION Systematic review is an important tool in the clinical characterisation of diseases with limited publications. The results herein provide a more complete understanding of the spectrum of disease which is relevant to clinical trial design. This review demonstrates the need for coordination across the LF research community to generate harmonised research methods that can contribute to building a strong evidence base for new treatments and foster confidence in their integration into clinical care.
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Affiliation(s)
- Laura Merson
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Josephine Bourner
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Astrid Erber
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Alex Paddy Salam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Antoine Flahault
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Piero L. Olliaro
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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9
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Arruda LB, Haider N, Olayemi A, Simons D, Ehichioya D, Yinka-Ogunleye A, Ansumana R, Thomason MJ, Asogun D, Ihekweazu C, Fichet-Calvet E, Kock RA. The niche of One Health approaches in Lassa fever surveillance and control. Ann Clin Microbiol Antimicrob 2021; 20:29. [PMID: 33894784 PMCID: PMC8067790 DOI: 10.1186/s12941-021-00431-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 04/12/2021] [Indexed: 12/20/2022] Open
Abstract
Lassa fever (LF), a zoonotic illness, represents a public health burden in West African countries where the Lassa virus (LASV) circulates among rodents. Human exposure hinges significantly on LASV ecology, which is in turn shaped by various parameters such as weather seasonality and even virus and rodent-host genetics. Furthermore, human behaviour, despite playing a key role in the zoonotic nature of the disease, critically affects either the spread or control of human-to-human transmission. Previous estimations on LF burden date from the 80s and it is unclear how the population expansion and the improvement on diagnostics and surveillance methods have affected such predictions. Although recent data have contributed to the awareness of epidemics, the real impact of LF in West African communities will only be possible with the intensification of interdisciplinary efforts in research and public health approaches. This review discusses the causes and consequences of LF from a One Health perspective, and how the application of this concept can improve the surveillance and control of this disease in West Africa.
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Affiliation(s)
- Liã Bárbara Arruda
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK.
| | - Najmul Haider
- The Royal Veterinary College, University of London, Hatfield, UK
| | - Ayodeji Olayemi
- Natural History Museum, Obafemi Awolowo University, Ile Ife, Nigeria
| | - David Simons
- The Royal Veterinary College, University of London, Hatfield, UK
| | - Deborah Ehichioya
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria.,Department of Microbiology, Ambrose Alli University, Ekpoma, Nigeria
| | | | - Rashid Ansumana
- School of Community Health Sciences, Njala University, Bo, Sierra Leone
| | - Margaret J Thomason
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK
| | - Danny Asogun
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | | | | | - Richard A Kock
- The Royal Veterinary College, University of London, Hatfield, UK
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10
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MacLeod IJ, Rowley CF, Essex M. PANDAA intentionally violates conventional qPCR design to enable durable, mismatch-agnostic detection of highly polymorphic pathogens. Commun Biol 2021; 4:227. [PMID: 33603155 PMCID: PMC7892852 DOI: 10.1038/s42003-021-01751-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 12/21/2020] [Indexed: 02/06/2023] Open
Abstract
Sensitive and reproducible diagnostics are fundamental to containing the spread of existing and emerging pathogens. Despite the reliance of clinical virology on qPCR, technical challenges persist that compromise their reliability for sustainable epidemic containment as sequence instability in probe-binding regions produces false-negative results. We systematically violated canonical qPCR design principles to develop a Pan-Degenerate Amplification and Adaptation (PANDAA), a point mutation assay that mitigates the impact of sequence variation on probe-based qPCR performance. Using HIV-1 as a model system, we optimized and validated PANDAA to detect HIV drug resistance mutations (DRMs). Ultra-degenerate primers with 3' termini overlapping the probe-binding site adapt the target through site-directed mutagenesis during qPCR to replace DRM-proximal sequence variation. PANDAA-quantified DRMs present at frequency ≥5% (2 h from nucleic acid to result) with a sensitivity and specificity of 96.9% and 97.5%, respectively. PANDAA is an innovative advancement with applicability to any pathogen where target-proximal genetic variability hinders diagnostic development.
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Affiliation(s)
- Iain J MacLeod
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA, USA.
- Botswana-Harvard AIDS Institute Partnership, Private Bag, Gaborone, Botswana.
| | - Christopher F Rowley
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA, USA
- Botswana-Harvard AIDS Institute Partnership, Private Bag, Gaborone, Botswana
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - M Essex
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA, USA
- Botswana-Harvard AIDS Institute Partnership, Private Bag, Gaborone, Botswana
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11
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Suu-Ire RD, Obodai E, Bonney JHK, Bel-Nono SO, Ampofo W, Kelly TR. Viral Zoonoses of National Importance in Ghana: Advancements and Opportunities for Enhancing Capacities for Early Detection and Response. J Trop Med 2021; 2021:8938530. [PMID: 33574853 PMCID: PMC7860970 DOI: 10.1155/2021/8938530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 01/05/2021] [Indexed: 12/20/2022] Open
Abstract
Zoonotic diseases have devastating impacts on human and animal health, livelihoods, and economies. Addressing the complex web of interrelated factors leading to zoonotic disease emergence and spread requires a transdisciplinary, cross-sectoral approach, One Health. The One Health approach, which considers the linkages between the health of people, animals, and their shared environment, presents opportunities to reduce these impacts through a more holistic coordinated strategy to understanding and mitigating disease risks. Understanding the linkages between animal, human, and environmental health risks and outcomes is critical for developing early detection systems and risk reduction strategies to address known and novel zoonotic disease threats. Nearly 70 countries across the world, including Ghana, have signed on to the Global Health Security Agenda (GHSA), which is facilitating multisectoral approaches to strengthen country capacities in the prevention and early detection of and respond to infectious disease threats. Currently, Ghana has not yet formalized a national One Health policy. The lack of a clearly defined multisectoral platform and limited collaboration among key Ghanaian Ministries, Departments, and Agencies has impacted the country's ability to effectively mitigate and respond to emerging and reemerging zoonoses. Many of these emerging zoonoses are caused by viruses, which, because of their diversity and evolutionary properties, are perceived to pose the greatest threat to global health security. Here, we review viral zoonoses of national importance and priority in Ghana, highlight recent advancements in One Health capacities, and discuss opportunities for implementing One Health approaches to mitigate zoonotic disease threats.
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Affiliation(s)
| | - Evangeline Obodai
- Noguchi Memorial Institute for Medical Research, University of Ghana, Off Akilagpa Sawyerr Road, Legon, Accra, Ghana
| | - J. H. Kofi Bonney
- Noguchi Memorial Institute for Medical Research, University of Ghana, Off Akilagpa Sawyerr Road, Legon, Accra, Ghana
| | | | - William Ampofo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Off Akilagpa Sawyerr Road, Legon, Accra, Ghana
| | - Terra R. Kelly
- One Health Institute, University of California, Davis, 1089 Veterinary Medicine Drive, CA 95616, USA
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12
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Samuels RJ, Moon TD, Starnes JR, Alhasan F, Gbakie M, Goba A, Koroma V, Momoh M, Sandi JD, Garry RF, Engel EJ, Shaffer JG, Schieffelin JS, Grant DS. Lassa Fever among Children in Eastern Province, Sierra Leone: A 7-year Retrospective Analysis (2012-2018). Am J Trop Med Hyg 2020; 104:585-592. [PMID: 33241780 PMCID: PMC7866338 DOI: 10.4269/ajtmh.20-0773] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/01/2020] [Indexed: 01/09/2023] Open
Abstract
Pediatric Lassa fever (LF) usually presents as a nonspecific febrile illness, similar to other endemic diseases in countries like Sierra Leone, where LF is considered to be hyperendemic. The nonspecificity of presentation and lack of research have made it difficult to fully understand best practices for pediatric management. We aim to describe clinical characteristics of hospitalized pediatric patients suspected or diagnosed with LF and assess factors associated with hospital outcomes among those with LF antigen-positive results. We conducted a 7-year retrospective cohort study using routine data for all children younger than 18 years admitted at the Kenema Government Hospital's LF ward. A total of 292 children with suspected or confirmed LF were analyzed. Overall, mortality was high (21%). Children with antigen-positive results had a high case fatality rate of 63% (P < 0.01). In univariate analyses, children who presented with unexplained bleeding (odds ratio [OR]: 3.58; 95% CI: 1.08-11.86; P = 0.040) and confusion (altered sensorium) (OR: 5.37; 95% CI: 1.34-21.48; P = 0.020) had increased odds of death. Abnormal serum levels of alanine aminotransferase (P = 0.001), creatinine (P = 0.004), and potassium (P = 0.003) were associated with increased likelihood of death in these children. Treatment with ribavirin was not significantly associated with survival (P = 0.916). Our findings provide insights into current pediatric LF clinical presentation and management. More evidence-based, high-quality research in creating predictive algorithms of antigen-positivity and hospital outcomes is needed in the management of pediatric LF.
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Affiliation(s)
- Robert J Samuels
- Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone.,Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Troy D Moon
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Joseph R Starnes
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Foday Alhasan
- Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Michael Gbakie
- Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Augustine Goba
- Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Veronica Koroma
- Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Mambu Momoh
- Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - John Demby Sandi
- Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Robert F Garry
- Department of Immunology and Microbiology, School of Medicine, Tulane University, New Orleans, Louisiana.,Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Emily J Engel
- Department of Pediatrics and Internal Medicine, Sections of Pediatric and Adult Infectious Diseases, School of Medicine, Tulane University, New Orleans, Louisiana
| | - Jeffrey G Shaffer
- Department of Global Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - John S Schieffelin
- Department of Pediatrics and Internal Medicine, Sections of Pediatric and Adult Infectious Diseases, School of Medicine, Tulane University, New Orleans, Louisiana.,Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
| | - Donald S Grant
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone
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13
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Balogun OO, Akande OW, Hamer DH. Lassa Fever: An Evolving Emergency in West Africa. Am J Trop Med Hyg 2020; 104:466-473. [PMID: 33236712 PMCID: PMC7866331 DOI: 10.4269/ajtmh.20-0487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/13/2020] [Indexed: 11/07/2022] Open
Abstract
Lassa fever remains endemic in parts of West Africa and continues to pose as a quiescent threat globally. We described the background on Lassa fever, factors contributing to its emergence and spread, preventive measures, and potential solutions. This review provides a holistic and comprehensive source for academicians, clinicians, researchers, policymakers, infectious disease epidemiologists, virologists, and other stakeholders.
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Affiliation(s)
- Oluwafemi O. Balogun
- Massachusetts Department of Public Health, Boston, Massachusetts
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
| | - Oluwatosin W. Akande
- Department of Epidemiology and Community Health, University of Ilorin Teaching Hospital, Ilorin, Kwara
| | - Davidson H. Hamer
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
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14
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Naidoo D, Ihekweazu C. Nigeria's efforts to strengthen laboratory diagnostics - Why access to reliable and affordable diagnostics is key to building resilient laboratory systems. Afr J Lab Med 2020; 9:1019. [PMID: 32934913 PMCID: PMC7479428 DOI: 10.4102/ajlm.v9i2.1019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 05/27/2020] [Indexed: 11/03/2022] Open
Affiliation(s)
- Dhamari Naidoo
- WHO Health Emergency Program, Infectious Hazard Management, World Health Organisation, Abuja, Nigeria
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15
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Kenmoe S, Tchatchouang S, Ebogo-Belobo JT, Ka'e AC, Mahamat G, Guiamdjo Simo RE, Bowo-Ngandji A, Demeni Emoh CP, Che E, Tchami Ngongang D, Amougou-Atsama M, Nzukui ND, Mbongue Mikangue CA, Mbaga DS, Kenfack S, Kingue Bebey SR, Amvongo Adjia N, Efietngab AN, Tazokong HR, Modiyinji AF, Kengne-Nde C, Sadeuh-Mba SA, Njouom R. Systematic review and meta-analysis of the epidemiology of Lassa virus in humans, rodents and other mammals in sub-Saharan Africa. PLoS Negl Trop Dis 2020; 14:e0008589. [PMID: 32845889 PMCID: PMC7478710 DOI: 10.1371/journal.pntd.0008589] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/08/2020] [Accepted: 07/13/2020] [Indexed: 12/27/2022] Open
Abstract
Accurate data on the Lassa virus (LASV) human case fatality rate (CFR) and the prevalence of LASV in humans, rodents and other mammals are needed for better planning of actions that will ultimately reduce the burden of LASV infection in sub-Saharan Africa. In this systematic review with meta-analysis, we searched PubMed, Scopus, Africa Journal Online, and African Index Medicus from 1969 to 2020 to obtain studies that reported enough data to calculate LASV infection CFR or prevalence. Study selection, data extraction, and risk of bias assessment were conducted independently. We extracted all measures of current, recent, and past infections with LASV. Prevalence and CFR estimates were pooled using a random-effect meta-analysis. Factors associated with CFR, prevalence, and sources of between-study heterogeneity were determined using subgroup and metaregression analyses. This review was registered with PROSPERO, CRD42020166465. We initially identified 1,399 records and finally retained 109 reports that contributed to 291 prevalence records from 25 countries. The overall CFR was 29.7% (22.3-37.5) in humans. Pooled prevalence of LASV infection was 8.7% (95% confidence interval: 6.8-10.8) in humans, 3.2% (1.9-4.6) in rodents, and 0.7% (0.0-2.3) in other mammals. Subgroup and metaregression analyses revealed a substantial statistical heterogeneity explained by higher prevalence in tissue organs, in case-control, in hospital outbreak, and surveys, in retrospective studies, in urban and hospital setting, in hospitalized patients, and in West African countries. This study suggests that LASV infections is an important cause of death in humans and that LASV are common in humans, rodents and other mammals in sub-Saharan Africa. These estimates highlight disparities between sub-regions, and population risk profiles. Western Africa, and specific key populations were identified as having higher LASV CFR and prevalence, hence, deserving more attention for cost-effective preventive interventions.
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Affiliation(s)
- Sebastien Kenmoe
- Department of Virology, Centre Pasteur of Cameroon, Yaoundé, Cameroon
| | | | - Jean Thierry Ebogo-Belobo
- Medical Research Centre, Institut of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | - Aude Christelle Ka'e
- Virology Department, Chantal Biya International Reference Centre, Yaoundé, Cameroon
| | - Gadji Mahamat
- Department of Microbiology, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | | | - Arnol Bowo-Ngandji
- Department of Microbiology, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | | | - Emmanuel Che
- Vaccinology and Biobank, Chantal Biya International Reference Centre, Yaounde, Cameroon
| | - Dimitri Tchami Ngongang
- Department of Microbiology, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | - Marie Amougou-Atsama
- Department of Virology, Centre Pasteur of Cameroon, Yaoundé, Cameroon
- Medical Research Centre, Institut of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | - Nathalie Diane Nzukui
- School of Health Sciences-Catholic University of Central Africa, Department of Medical Microbiology, Yaoundé, Cameroon
| | | | - Donatien Serge Mbaga
- Department of Microbiology, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | - Sorel Kenfack
- Department of Microbiology, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | | | - Nathalie Amvongo Adjia
- Medical Research Centre, Institut of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | - Atembeh Noura Efietngab
- Medical Research Centre, Institut of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | - Hervé Raoul Tazokong
- Department of Microbiology, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | - Abdou Fatawou Modiyinji
- Department of Virology, Centre Pasteur of Cameroon, Yaoundé, Cameroon
- Department of Animals Biology and Physiology, Faculty of Science, The University of Yaoundé I, Yaoundé, Cameroon
| | - Cyprien Kengne-Nde
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Yaoundé, Cameroon
| | | | - Richard Njouom
- Department of Virology, Centre Pasteur of Cameroon, Yaoundé, Cameroon
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16
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Distinct Molecular Mechanisms of Host Immune Response Modulation by Arenavirus NP and Z Proteins. Viruses 2020; 12:v12070784. [PMID: 32708250 PMCID: PMC7412275 DOI: 10.3390/v12070784] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 12/12/2022] Open
Abstract
Endemic to West Africa and South America, mammalian arenaviruses can cross the species barrier from their natural rodent hosts to humans, resulting in illnesses ranging from mild flu-like syndromes to severe and fatal haemorrhagic zoonoses. The increased frequency of outbreaks and associated high fatality rates of the most prevalent arenavirus, Lassa, in West African countries, highlights the significant risk to public health and to the socio-economic development of affected countries. The devastating impact of these viruses is further exacerbated by the lack of approved vaccines and effective treatments. Differential immune responses to arenavirus infections that can lead to either clearance or rapid, widespread and uncontrolled viral dissemination are modulated by the arenavirus multifunctional proteins, NP and Z. These two proteins control the antiviral response to infection by targeting multiple cellular pathways; and thus, represent attractive targets for antiviral development to counteract infection. The interplay between the host immune responses and viral replication is a key determinant of virus pathogenicity and disease outcome. In this review, we examine the current understanding of host immune defenses against arenavirus infections and summarise the host protein interactions of NP and Z and the mechanisms that govern immune evasion strategies.
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17
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B. Yeh K, M. Fair J, Smith W, Martinez Torres T, Lucas J, Monagin C, Winegar R, Fletcher J. Assessing Climate Change Impact on Ecosystems and Infectious Disease: Important Roles for Genomic Sequencing and a One Health Perspective. Trop Med Infect Dis 2020; 5:E90. [PMID: 32503239 PMCID: PMC7345041 DOI: 10.3390/tropicalmed5020090] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/22/2020] [Accepted: 06/01/2020] [Indexed: 01/21/2023] Open
Abstract
Changes in the Earth's climate and weather continue to impact the planet's ecosystems, including the interface of infectious disease agents with their hosts and vectors. Environmental disasters, natural and human-made activities raise risk factors that indirectly facilitate infectious disease outbreaks. Subsequently, changes in habitat, displaced populations, and environmental stresses that affect the survival of species are amplified over time. The recurrence and spread of vector-borne (e.g., mosquito, tick, aphid) human, animal, and plant pathogens to new geographic locations are also influenced by climate change. The distribution and range of humans, agricultural animals and plants, wildlife and native plants, as well as vectors, parasites, and microbes that cause neglected diseases of the tropics as well as other global regions are also impacted. In addition, genomic sequencing can now be applied to detect signatures of infectious pathogens as they move into new regions. Molecular detection assays complement metagenomic sequencing to help us understand the microbial community found within the microbiomes of hosts and vectors, and help us uncover mechanistic relationships between climate variability and pathogen transmission. Our understanding of, and responses to, such complex dynamics and their impacts can be enhanced through effective, multi-sectoral One Health engagement coupled with applications of both traditional and novel technologies. Concerted efforts are needed to further harness and leverage technology that can identify and track these impacts of climate changes in order to mitigate and adapt to their effects.
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Affiliation(s)
- Kenneth B. Yeh
- Global Health Surveillance and Diagnostics, MRIGlobal, Gaithersburg, MD 20878, USA; (T.M.T.); (J.L.); (R.W.)
| | - Jeanne M. Fair
- Biosecurity and Public Health, Los Alamos National Laboratory, Los Alamos, NM 87545, USA;
| | - Woutrina Smith
- One Health Institute, University of California, Davis, CA 95616, USA; (W.S.); (C.M.)
| | - Teresa Martinez Torres
- Global Health Surveillance and Diagnostics, MRIGlobal, Gaithersburg, MD 20878, USA; (T.M.T.); (J.L.); (R.W.)
| | - Julie Lucas
- Global Health Surveillance and Diagnostics, MRIGlobal, Gaithersburg, MD 20878, USA; (T.M.T.); (J.L.); (R.W.)
| | - Corina Monagin
- One Health Institute, University of California, Davis, CA 95616, USA; (W.S.); (C.M.)
| | - Richard Winegar
- Global Health Surveillance and Diagnostics, MRIGlobal, Gaithersburg, MD 20878, USA; (T.M.T.); (J.L.); (R.W.)
| | - Jacqueline Fletcher
- National Institute for Microbial Forensics & Food and Agricultural Biosecurity, Oklahoma State University, Stillwater, OK 74078, USA;
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18
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Boisen ML, Uyigue E, Aiyepada J, Siddle KJ, Oestereich L, Nelson DKS, Bush DJ, Rowland MM, Heinrich ML, Eromon P, Kayode AT, Odia I, Adomeh DI, Muoebonam EB, Akhilomen P, Okonofua G, Osiemi B, Omoregie O, Airende M, Agbukor J, Ehikhametalor S, Aire CO, Duraffour S, Pahlmann M, Böhm W, Barnes KG, Mehta S, Momoh M, Sandi JD, Goba A, Folarin OA, Ogbaini-Emovan E, Asogun DA, Tobin EA, Akpede GO, Okogbenin SA, Okokhere PO, Grant DS, Schieffelin JS, Sabeti PC, Günther S, Happi CT, Branco LM, Garry RF. Field evaluation of a Pan-Lassa rapid diagnostic test during the 2018 Nigerian Lassa fever outbreak. Sci Rep 2020; 10:8724. [PMID: 32457420 PMCID: PMC7250850 DOI: 10.1038/s41598-020-65736-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/08/2020] [Indexed: 01/07/2023] Open
Abstract
Lassa virus (LASV) is the causative agent of Lassa fever (LF), an often-fatal hemorrhagic disease. LF is endemic in Nigeria, Sierra Leone and other West African countries. Diagnosis of LASV infection is challenged by the genetic diversity of the virus, which is greatest in Nigeria. The ReLASV Pan-Lassa Antigen Rapid Test (Pan-Lassa RDT) is a point-of-care, in vitro diagnostic test that utilizes a mixture of polyclonal antibodies raised against recombinant nucleoproteins of representative strains from the three most prevalent LASV lineages (II, III and IV). We compared the performance of the Pan-LASV RDT to available quantitative PCR (qPCR) assays during the 2018 LF outbreak in Nigeria. For patients with acute LF (RDT positive, IgG/IgM negative) during initial screening, RDT performance was 83.3% sensitivity and 92.8% specificity when compared to composite results of two qPCR assays. 100% of samples that gave Ct values below 22 on both qPCR assays were positive on the Pan-Lassa RDT. There were significantly elevated case fatality rates and elevated liver transaminase levels in subjects whose samples were RDT positive compared to RDT negative.
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Affiliation(s)
| | - Eghosa Uyigue
- The African Center of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Osun State, Nigeria
- Department of Biological Sciences, College of Natural Sciences, Redeemer's University, Ede, Osun State, Nigeria
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - John Aiyepada
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Katherine J Siddle
- The Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard University, Cambridge, MA, USA
- The Center for Systems Biology, Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA, USA
| | - Lisa Oestereich
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg, Germany
| | | | | | | | | | - Philomena Eromon
- The African Center of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Osun State, Nigeria
| | - Adeyemi T Kayode
- The African Center of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Osun State, Nigeria
- Department of Biological Sciences, College of Natural Sciences, Redeemer's University, Ede, Osun State, Nigeria
| | - Ikponmwosa Odia
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Donatus I Adomeh
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Ekene B Muoebonam
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Patience Akhilomen
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Grace Okonofua
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Blessing Osiemi
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Omigie Omoregie
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Michael Airende
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Jacqueline Agbukor
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Solomon Ehikhametalor
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Chris Okafi Aire
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Sophie Duraffour
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg, Germany
| | - Meike Pahlmann
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg, Germany
| | - Wiebke Böhm
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg, Germany
| | - Kayla G Barnes
- The Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard University, Cambridge, MA, USA
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Samar Mehta
- The Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard University, Cambridge, MA, USA
- Beth Israel Deaconess Medical Center, Division of Infectious Diseases, Boston, MA, USA
| | - Mambu Momoh
- Eastern Polytechnic Institute, Kenema, Sierra Leone
- Viral Hemorrhagic Fever Program, Kenema Government Hospital, Kenema, Sierra Leone
- Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - John Demby Sandi
- Viral Hemorrhagic Fever Program, Kenema Government Hospital, Kenema, Sierra Leone
- Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Augustine Goba
- Viral Hemorrhagic Fever Program, Kenema Government Hospital, Kenema, Sierra Leone
- Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Onikepe A Folarin
- The African Center of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Osun State, Nigeria
- Department of Biological Sciences, College of Natural Sciences, Redeemer's University, Ede, Osun State, Nigeria
| | - Ephraim Ogbaini-Emovan
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Danny A Asogun
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Ekaete A Tobin
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - George O Akpede
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Sylvanus A Okogbenin
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Peter O Okokhere
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
- The Department of Medicine, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
- The Department of Medicine, Faculty of Clinical Sciences, Ambrose Alli University, Ekpoma, Edo State, Nigeria
| | - Donald S Grant
- Viral Hemorrhagic Fever Program, Kenema Government Hospital, Kenema, Sierra Leone
- Ministry of Health and Sanitation, Freetown, Sierra Leone
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - John S Schieffelin
- Sections of Infectious Disease, Departments of Pediatrics and Internal Medicine, School of Medicine, Tulane University, New Orleans, LA, USA
| | - Pardis C Sabeti
- The Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard University, Cambridge, MA, USA
- The Center for Systems Biology, Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA, USA
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Harvard-MIT Health Sciences and Technology, MIT, Cambridge, MA, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Stephan Günther
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg, Germany
| | - Christian T Happi
- The African Center of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Osun State, Nigeria.
- Department of Biological Sciences, College of Natural Sciences, Redeemer's University, Ede, Osun State, Nigeria.
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
| | | | - Robert F Garry
- Zalgen Labs, LLC, Germantown, MD, USA.
- Tulane Health Sciences Center, Tulane University, New Orleans, LA, USA.
- Tulane University, School of Medicine, Department of Microbiology and Immunology, New Orleans, LA, USA.
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19
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Klitting R, Mehta SB, Oguzie JU, Oluniyi PE, Pauthner MG, Siddle KJ, Andersen KG, Happi CT, Sabeti PC. Lassa Virus Genetics. Curr Top Microbiol Immunol 2020. [PMID: 32418034 DOI: 10.1007/82_2020_212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In a pattern repeated across a range of ecological niches, arenaviruses have evolved a compact four-gene genome to orchestrate a complex life cycle in a narrow range of susceptible hosts. A number of mammalian arenaviruses cross-infect humans, often causing a life-threatening viral hemorrhagic fever. Among this group of geographically bound zoonoses, Lassa virus has evolved a unique niche that leads to significant and sustained human morbidity and mortality. As a biosafety level 4 pathogen, direct study of the pathogenesis of Lassa virus is limited by the sparse availability, high operating costs, and technical restrictions of the high-level biocontainment laboratories required for safe experimentation. In this chapter, we introduce the relationship between genome structure and the life cycle of Lassa virus and outline reverse genetic approaches used to probe and describe functional elements of the Lassa virus genome. We then review the tools used to obtain viral genomic sequences used for phylogeny and molecular diagnostics, before shifting to a population perspective to assess the contributions of phylogenetic analysis in understanding the evolution and ecology of Lassa virus in West Africa. We finally consider the future outlook and clinical applications for genetic study of Lassa virus.
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Affiliation(s)
- Raphaëlle Klitting
- Department of Immunology and Microbiology, The Scripps Research Institute , La Jolla, CA, USA
| | - Samar B Mehta
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Judith U Oguzie
- African Center of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer's University, Ede, Osun State, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemers University, Ede, Osun State, Nigeria
| | - Paul E Oluniyi
- African Center of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer's University, Ede, Osun State, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemers University, Ede, Osun State, Nigeria
| | - Matthias G Pauthner
- Department of Immunology and Microbiology, The Scripps Research Institute , La Jolla, CA, USA
| | | | - Kristian G Andersen
- Department of Immunology and Microbiology, The Scripps Research Institute , La Jolla, CA, USA.
| | - Christian T Happi
- African Center of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer's University, Ede, Osun State, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemers University, Ede, Osun State, Nigeria
| | - Pardis C Sabeti
- Broad Institute of MIT and Harvard, Cambridge, MA, USA.
- Center for Systems Biology, Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA, USA.
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA, USA.
- Howard Hughes Medical Institute, Chevy Chase, MD, USA.
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20
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Usifoh SF, Odigie AE, Ighedosa SU, Uwagie-Ero EA, Aighewi IT. Lassa Fever-associated Stigmatization among Staff and Students of the University of Benin, Nigeria. J Epidemiol Glob Health 2020; 9:107-115. [PMID: 31241868 PMCID: PMC7310750 DOI: 10.2991/jegh.k.190514.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/21/2019] [Indexed: 11/10/2022] Open
Abstract
Lassa Fever (LF) remains a health burden in several endemic areas of Nigeria, and its toll remains unabated over several decades. Although most studies have focused on virological and clinical considerations, few studies have attempted to address the perceived psychosocial component of LF disease in Nigeria. Evaluation of stigmatization and discrimination faced by LF survivors is an important step in improving individual health and protecting public health. This study aimed to assess LF-associated stigmatization associated among staff and students of the University of Benin. Descriptive analyses of 600 consenting respondents (300 staff and 300 students) sampled using pretested questionnaires was conducted, and the Chi-square test was used to test for significant association between perceived LF stigmatization and predefined variables. LF was a potential cause of stigmatization in a higher proportion of student (n = 162, 57.9%) than staff (n = 112, 39.9%). LF-associated stigmatization among students was significantly associated with sex (p = 0.012) and poor knowledge (p = 0.013) of LF transmission and prevention. A greater tendency for stigmatization was observed among females than males. A comprehensive emergency response plan incorporating accurate knowledge dissemination about the disease may be a first step toward tackling perceived LF stigmatization.
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Affiliation(s)
- Stella Folajole Usifoh
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Benin, Benin City, Nigeria
| | - Amienwanlen Eugene Odigie
- Department of Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Benin, Benin City, Nigeria
| | | | | | - Isoken Tito Aighewi
- Department of Environmental Management and Toxicology, Faculty of Life Sciences, University of Benin, Benin City, Nigeria
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21
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Prevalence and outcome of Lassa fever among hospitalized patients in Ebonyi State, Nigeria, 2018-2019. Virus Res 2020; 285:198000. [PMID: 32380207 DOI: 10.1016/j.virusres.2020.198000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/28/2020] [Accepted: 04/28/2020] [Indexed: 01/26/2023]
Abstract
Lassa fever (LF) is a viral hemorrhagic illness endemic in West Africa. Annually, about 300,000-500,000 people are being infected, with about 5000 deaths. Symptoms of LF include high grade fever, headache, malaise, abdominal pain, vomiting, diarrhea, or sore throat. Terminal features may include bleeding from all orifices (mouth, nose, ear, anus and vagina), facial and neck oedema or pleural effusion. People of all ages, gender, and occupations were included in this study. A total of 440 patients' samples and Bio data were used for this study. The samples were analyzed for Lassa fever virus RNA using Real Time Reverse Transcriptase Polymerase Chain Reaction. The data obtained were analyzed using SPSS 20.0 and version 7 of Epi-Info statistical software. Analysis of these samples showed LASV prevalence of 25.7%. Chi-square analysis (p ≤ 0.05) showed that LASV infection does not depend on age, gender, or occupation. Our research re-emphasized the fact that LASV is a serious cause of fatality in humans. Our data showed that among 327 negative patients, 19 died. On the contrary, 113 LASV confirmed positive cases had 42 deaths. This result is highly significant. More so, Lassa fever disease outcome was compared across gender. There was no significant difference between the two genders. Death or recovery from LF infection does not depend on sex. However, recovery from LF significantly depends on age of the patient. Fatal outcome is significantly higher among adults/elderly. We aim to raise awareness to the recurrence of LASV in Ebonyi State and urgent need for other medical interventions, including other therapeutic measures, and possible vaccine production, considering the impact of this virus.
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22
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Wiley MR, Fakoli L, Letizia AG, Welch SR, Ladner JT, Prieto K, Reyes D, Espy N, Chitty JA, Pratt CB, Di Paola N, Taweh F, Williams D, Saindon J, Davis WG, Patel K, Holland M, Negrón D, Ströher U, Nichol ST, Sozhamannan S, Rollin PE, Dogba J, Nyenswah T, Bolay F, Albariño CG, Fallah M, Palacios G. Lassa virus circulating in Liberia: a retrospective genomic characterisation. THE LANCET. INFECTIOUS DISEASES 2019; 19:1371-1378. [PMID: 31588039 DOI: 10.1016/s1473-3099(19)30486-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/28/2019] [Accepted: 07/18/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND An alarming rise in reported Lassa fever cases continues in west Africa. Liberia has the largest reported per capita incidence of Lassa fever cases in the region, but genomic information on the circulating strains is scarce. The aim of this study was to substantially increase the available pool of data to help foster the generation of targeted diagnostics and therapeutics. METHODS Clinical serum samples collected from 17 positive Lassa fever cases originating from Liberia (16 cases) and Guinea (one case) within the past decade were processed at the Liberian Institute for Biomedical Research using a targeted-enrichment sequencing approach, producing 17 near-complete genomes. An additional 17 Lassa virus sequences (two from Guinea, seven from Liberia, four from Nigeria, and four from Sierra Leone) were generated from viral stocks at the US Centers for Disease Control and Prevention (Atlanta, GA) from samples originating from the Mano River Union (Guinea, Liberia, and Sierra Leone) region and Nigeria. Sequences were compared with existing Lassa virus genomes and published Lassa virus assays. FINDINGS The 23 new Liberian Lassa virus genomes grouped within two clades (IV.A and IV.B) and were genetically divergent from those circulating elsewhere in west Africa. A time-calibrated phylogeographic analysis incorporating the new genomes suggests Liberia was the entry point of Lassa virus into the Mano River Union region and estimates the introduction to have occurred between 300-350 years ago. A high level of diversity exists between the Liberian Lassa virus genomes. Nucleotide percent difference between Liberian Lassa virus genomes ranged up to 27% in the L segment and 18% in the S segment. The commonly used Lassa Josiah-MGB assay was up to 25% divergent across the target sites when aligned to the Liberian Lassa virus genomes. INTERPRETATION The large amount of novel genomic diversity of Lassa virus observed in the Liberian cases emphasises the need to match deployed diagnostic capabilities with locally circulating strains and underscores the importance of evaluating cross-lineage protection in the development of vaccines and therapeutics. FUNDING Defense Biological Product Assurance Office of the US Department of Defense and the Armed Forces Health Surveillance Branch and its Global Emerging Infections Surveillance and Response Section.
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Affiliation(s)
- Michael R Wiley
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA; Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Lawrence Fakoli
- National Public Health Institute of Liberia, Monrovia, Liberia
| | - Andrew G Letizia
- Naval Medical Research Unit Three Ghana Detachment, Accra, Ghana
| | - Stephen R Welch
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jason T Ladner
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA; Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Karla Prieto
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA; Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Daniel Reyes
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA; Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Nicole Espy
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Joseph A Chitty
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Catherine B Pratt
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA; Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Nicholas Di Paola
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Fahn Taweh
- National Public Health Institute of Liberia, Monrovia, Liberia
| | - Desmond Williams
- US Centers for Disease Control and Prevention, Atlanta, GA, USA; US Centers for Disease Control and Prevention, Monrovia, Liberia
| | - Jon Saindon
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - William G Davis
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ketan Patel
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Ute Ströher
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stuart T Nichol
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shanmuga Sozhamannan
- Defense Biological Product Assurance Office, Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense (CBRND)-Joint Project Lead, CBRND Enabling Biotechnologies, Frederick, MD, USA; Logistics Management Institute, Tysons, VA, USA
| | - Pierre E Rollin
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John Dogba
- National Public Health Institute of Liberia, Monrovia, Liberia
| | | | - Fatorma Bolay
- National Public Health Institute of Liberia, Monrovia, Liberia
| | | | - Mosoka Fallah
- National Public Health Institute of Liberia, Monrovia, Liberia
| | - Gustavo Palacios
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA.
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23
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Computer-designed orthogonal RNA aptamers programmed to recognize Ebola virus glycoproteins. BIOSAFETY AND HEALTH 2019. [DOI: 10.1016/j.bsheal.2019.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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24
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Mattiuzzo G, Bentley EM, Page M. The Role of Reference Materials in the Research and Development of Diagnostic Tools and Treatments for Haemorrhagic Fever Viruses. Viruses 2019; 11:E781. [PMID: 31450611 PMCID: PMC6783900 DOI: 10.3390/v11090781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/15/2019] [Accepted: 08/21/2019] [Indexed: 11/16/2022] Open
Abstract
Following the Ebola outbreak in Western Africa in 2013-16, a global effort has taken place for preparedness for future outbreaks. As part of this response, the development of vaccines, treatments and diagnostic tools has been accelerated, especially towards pathogens listed as likely to cause an epidemic and for which there are no current treatments. Several of the priority pathogens identified by the World Health Organisation are haemorrhagic fever viruses. This review provides information on the role of reference materials as an enabling tool for the development and evaluation of assays, and ultimately vaccines and treatments. The types of standards available are described, along with how they can be applied for assay harmonisation through calibration as a relative potency to a common arbitrary unitage system (WHO International Unit). This assures that assay metrology is accurate and robust. We describe reference materials that have been or are being developed for haemorrhagic fever viruses and consider the issues surrounding their production, particularly that of biosafety where the viruses require specialised containment facilities. Finally, we advocate the use of reference materials at early stages, including research and development, as this helps produce reliable assays and can smooth the path to regulatory approval.
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MESH Headings
- Africa, Western/epidemiology
- Animals
- Antigens, Viral/blood
- Dengue Virus/immunology
- Dengue Virus/isolation & purification
- Dengue Virus/pathogenicity
- Diagnostic Techniques and Procedures
- Disease Outbreaks/prevention & control
- Ebolavirus/immunology
- Ebolavirus/isolation & purification
- Ebolavirus/pathogenicity
- Epidemics/prevention & control
- Hemorrhagic Fever Virus, Crimean-Congo/immunology
- Hemorrhagic Fever Virus, Crimean-Congo/isolation & purification
- Hemorrhagic Fever Virus, Crimean-Congo/pathogenicity
- Hemorrhagic Fever, Crimean/diagnosis
- Hemorrhagic Fever, Crimean/immunology
- Hemorrhagic Fever, Crimean/prevention & control
- Hemorrhagic Fever, Ebola/diagnosis
- Hemorrhagic Fever, Ebola/immunology
- Hemorrhagic Fever, Ebola/prevention & control
- Humans
- Information Services
- Lassa Fever/diagnosis
- Lassa Fever/immunology
- Lassa Fever/prevention & control
- Lassa virus/immunology
- Lassa virus/isolation & purification
- Lassa virus/pathogenicity
- Marburg Virus Disease/diagnosis
- Marburg Virus Disease/immunology
- Marburg Virus Disease/prevention & control
- Marburgvirus/immunology
- Marburgvirus/isolation & purification
- Marburgvirus/pathogenicity
- RNA Virus Infections/diagnosis
- RNA Virus Infections/immunology
- RNA Virus Infections/prevention & control
- RNA Viruses/immunology
- RNA Viruses/isolation & purification
- RNA Viruses/pathogenicity
- RNA, Viral/isolation & purification
- Rift Valley Fever/diagnosis
- Rift Valley Fever/immunology
- Rift Valley Fever/prevention & control
- Rift Valley fever virus/immunology
- Rift Valley fever virus/isolation & purification
- Rift Valley fever virus/pathogenicity
- Severe Dengue/diagnosis
- Severe Dengue/immunology
- Severe Dengue/prevention & control
- Vaccines/standards
- World Health Organization
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Affiliation(s)
- Giada Mattiuzzo
- Division of Virology, National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Hertfordshire EN6 3QG, UK.
| | - Emma M Bentley
- Division of Virology, National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Hertfordshire EN6 3QG, UK.
| | - Mark Page
- Division of Virology, National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Hertfordshire EN6 3QG, UK.
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Emperador DM, Yimer SA, Mazzola LT, Norheim G, Kelly-Cirino C. Diagnostic applications for Lassa fever in limited-resource settings. BMJ Glob Health 2019; 4:e001119. [PMID: 30899576 PMCID: PMC6407552 DOI: 10.1136/bmjgh-2018-001119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 11/03/2022] Open
Abstract
Lassa fever, caused by arenavirus Lassa virus (LASV), is an acute viral haemorrhagic disease that affects up to an estimated 300 000 individuals and causes up to 5000 deaths per year in West Africa. Currently available LASV diagnostic methods are difficult to operationalise in low-resource health centres and may be less sensitive to detecting all known or emerging LASV strains. To prioritise diagnostic development for LASV, we assessed the diagnostic applications for case detection, clinical management, surveillance, outbreak response, and therapeutic and vaccine development at various healthcare levels. Diagnostic development should prioritise point-of-care and near-patient diagnostics, especially those with the ability to detect all lineages of LASV, as they would allow for rapid detection in resource-limited health facilities closer to the patient.
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Affiliation(s)
- Devy M Emperador
- Foundation for Innovative New Diagnostics (FIND), Emerging Threats Programme, Geneva, Switzerland
| | - Solomon A Yimer
- Department of Vaccine Science, Coalition for Epidemic Preparedness Innovation (CEPI), Oslo, Norway
| | - Laura T Mazzola
- Foundation for Innovative New Diagnostics (FIND), Emerging Threats Programme, Geneva, Switzerland
| | - Gunnstein Norheim
- Department of Vaccine Science, Coalition for Epidemic Preparedness Innovation (CEPI), Oslo, Norway
| | - Cassandra Kelly-Cirino
- Foundation for Innovative New Diagnostics (FIND), Emerging Threats Programme, Geneva, Switzerland
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Kelly-Cirino CD, Nkengasong J, Kettler H, Tongio I, Gay-Andrieu F, Escadafal C, Piot P, Peeling RW, Gadde R, Boehme C. Importance of diagnostics in epidemic and pandemic preparedness. BMJ Glob Health 2019; 4:e001179. [PMID: 30815287 PMCID: PMC6362765 DOI: 10.1136/bmjgh-2018-001179] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/02/2018] [Accepted: 11/06/2018] [Indexed: 11/26/2022] Open
Abstract
Diagnostics are fundamental for successful outbreak containment. In this supplement, ‘Diagnostic preparedness for WHO Blueprint pathogens’, we describe specific diagnostic challenges presented by selected priority pathogens most likely to cause future epidemics. Some challenges to diagnostic preparedness are common to all outbreak situations, as highlighted by recent outbreaks of Ebola, Zika and yellow fever. In this article, we review these overarching challenges and explore potential solutions. Challenges include fragmented and unreliable funding pathways, limited access to specimens and reagents, inadequate diagnostic testing capacity at both national and community levels of healthcare and lack of incentives for companies to develop and manufacture diagnostics for priority pathogens during non-outbreak periods. Addressing these challenges in an efficient and effective way will require multiple stakeholders—public and private—coordinated in implementing a holistic approach to diagnostics preparedness. All require strengthening of healthcare system diagnostic capacity (including surveillance and education of healthcare workers), establishment of sustainable financing and market strategies and integration of diagnostics with existing mechanisms. Identifying overlaps in diagnostic development needs across different priority pathogens would allow more timely and cost-effective use of resources than a pathogen by pathogen approach; target product profiles for diagnostics should be refined accordingly. We recommend the establishment of a global forum to bring together representatives from all key stakeholders required for the response to develop a coordinated implementation plan. In addition, we should explore if and how existing mechanisms to address challenges to the vaccines sector, such as Coalition for Epidemic Preparedness Innovations and Gavi, could be expanded to cover diagnostics.
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Affiliation(s)
| | - John Nkengasong
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Hannah Kettler
- Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | | | | | | | - Peter Piot
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Renuka Gadde
- Becton Dickinson (BD), Franklin Lakes, New Jersey, USA
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