Ten years after Ebola, Sierra Leone battles another killer fever – 04/07/2024 at 05:14

Ten years after Ebola, Sierra Leone battles another killer fever – 04/07/2024 at 05:14
Ten years after Ebola, Sierra Leone battles another killer fever – 04/07/2024 at 05:14

Ecologist James Koninga holds a rat trap on June 12, 2024 in Kenema, eastern Sierra Leone (AFP / JOHN WESSELS)

Rummaging through the darkness of a small mud house in eastern Sierra Leone, ecologist James Koninga pulls a rat trap from under a sagging bed, a rudimentary but essential device against a deadly disease, Lassa fever.

James Koninga, 62, is part of a group of researchers studying Lassa fever, a viral hemorrhagic disease endemic to several West African countries and transmitted by rodents. He knows its effects: 30 years ago, the virus sent him, as a young scientist, to hospital with fever, diarrhea and headaches. Twenty days of ordeal.

“I saw myself leaving, I saw myself dying,” he said.

Ten years ago, another viral and hemorrhagic disease, Ebola, sowed death and fear in West Africa. Starting in Guinea, reaching Sierra Leone and Liberia, the epidemic, the most serious since the discovery of the virus in 1976, caused more than 11,000 deaths in two years.

Sierra Leone has been free of Ebola since 2016, thanks in part to vaccination.

The lessons from Ebola are now being used by scientists in their other fight against Lassa fever, starting in the Kenema region, the first in Sierra Leone where Ebola was reported a decade ago.

Samples from suspected cases of Lassa fever on June 13, 2024 at Kenema hospital in eastern Sierra Leone (AFP / JOHN WESSELS)

At 1%, the fatality rate of Lassa fever is far removed from Ebola (around 50% on average according to the World Health Organization). But it can reach 15% in patients with severe forms.

Researchers are on the lookout for any sign of progression of the disease. The number of cases is stagnating, but they are more widespread across the country. There is no recognized vaccine, treatments are limited and doctors are encountering, as with Ebola, obstacles that obstruct early treatment, the best guarantee of a cure.

Monitoring rodents is crucial in the Kenema region and remote villages like Mapuma, where Koninga now operates among homes under the cover of dense forest.

The virus is transmitted to humans mainly through contact with food or household items contaminated with rodent urine or droppings.

– Life with rats –

“Rats dig their burrows inside houses” and leave their droppings there, said James Koninga, wearing a mask and protective gloves.

“If people come back from the bush with sores and lie down on the bed, they risk getting infected.”

A lab technician works at Kenema Hospital in eastern Sierra Leone on June 13, 2024 (AFP / JOHN WESSELS)

Proximity to the bush, mud buildings, open storage of grain and water… Homes like those in Mapuma are “five-star hotels” for rats, says Lansana Kanneh, 58, a field supervisor at Kenema Government Hospital (KGH).

“Food is so scarce for people that they sometimes eat food that has been partially eaten by rodents,” he said.

Trappers can catch 20 rats per day.

They first make sure that the rodents are of the genus Mastomys, the reservoir of the virus. They take samples which will be analyzed. The rats are released after an injection which blocks the transmission of the virus.

The fever affects between 100,000 and 300,000 people a year in West Africa and kills about 5,000, according to the Africa Centers for Disease Control and Prevention. The numbers are likely lower than the actual figure.

Admissions to the specialist ward at Kenema Hospital, Sierra Leone’s only dedicated treatment centre, have been falling for the past 10 years. But the picture is deceptive.

Patients used to arrive in the dry season, between November and May, but now “we see cases year-round,” says Dr. Donald Grant, head of KGH’s Lassa fever program.

– “Act now” –

And mortality among hospitalized patients has increased alarmingly to over 50%.

“They sometimes spend 24 or 48 hours in hospital, and then they die,” Lansana Kanneh reports.

The team is seeing an increase in cases outside previously endemic districts. Dr Grant blames the expansion of human activity into the forest, which is bringing them closer to the rats.

A lab technician works at Kenema Hospital in eastern Sierra Leone on June 13, 2024 (AFP / JOHN WESSELS)

Detecting the disease early is vital. However, early symptoms such as fever can be confused with malaria, cholera or typhoid. The distance from doctors and several hours of bumpy roads discourage people from seeking care.

The memory of Ebola, which claimed the lives of around 4,000 Sierra Leoneans, remains strong.

“People thought it was health workers who were transmitting Ebola,” Lansana Kanneh recalls.

Dr. Grant hopes to have a licensed vaccine within the next few years. A vaccine is currently in an intermediate phase of clinical trials on several hundred people in Nigeria and Liberia.

In the meantime, the doctor calls for vigilance. Ebola “has taught us that we must not wait for the critical point where (the epidemic) will overwhelm us all,” he says. “The time to act is now.”

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