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  • Ward rounds at the Lassa fever isolation ward

Overview

The Lassa fever virus is an Old World Mammarenavirus that causes a viral hemorrhagic fever disease and is classified as biosafety-level 4 pathogen. It occurs in several countries in West Africa like Guinea, Sierra Leone, Liberia and Nigeria. Due to the lack in medical infrastructure in some of the regions where the virus occurs, no clear epidemiological data are available. However scientists estimate up to 300.000 infections occurring annually. Recent estimates report a case fatality rate of 30% in hospitalised patients. The virus is transmitted via rodents but also from human-to-human. Seroprevalence studies suggest that many people come in contact with the virus but only some fall seriously ill. Those who do suffer from an acute febrile illness, often with pharyngitis that can quickly turn into multi-organ failure. In such severely ill patients particularly neurological symptoms, like lethargy, agitation and seizures are observed – case reports of the Lassa fever virus being detected in the cerebrospinal fluid lead to the question if such symptoms are caused by the virus directly infection the hosts’ central nervous system. Furthermore, acute renal failure occurs in several patients and disturbance of the coagulation cascade can lead to hemorrhage (diffuse bleeding) that, in the worst case scenario results in cardiovascular shock. What exactly leads to these organ manifestations of Lassa fever and if they simply occur in the framework of a serious acute illness (such as in severe pneumonia or sepsis) or if they are direct effects mediated by the presence of the virus in the described end-organs is not known.

This research group has been set up with the goal to research these most interesting questions. Knowledge about the mechanisms of organ pathology in Lassa fever will aid greatly in clinical management, diagnosis and further research on drug targets and vaccines.

To this end, we combine clinical research projects in Nigeria at our collaborative site, the Irrua Specialist Teaching Hospital, with further hypothesis testing in in-vivo and in-vitro models of Lassa fever at our laboratory at BNITM.

Translational Research

In order to test which specific cell subpopulations the Lassa virus infects and which effect follows its presence, we are currently conducting infection experiments with human renal and CNS cell lines, including kidney and brain organoid models in addition to analysis of organs from our established mouse (IFNAR-/-) model. 

Clinical Research

Current clinical research has identified renal failure and neurological complications, notably seizures as main predictors for fatal outcome in Lassa fever. However it is known how Lassa virus causes those complications and followingly, how to treat and prevent them. Whether direct virus effects, inflammation or bleeding cause pathology remains enigmatic. In our clinical research projects we are working to describe and decipher renal failure and CNS pathology in Lassa fever. For instance, we recently established electroencephalography (EEG) diagnosis for patients with seizures at the isolation ward in Irrua.

Installation of EEG equipment in the Lassa fever isolation ward.

MIND Lassa

Infection with a highly-contagious, deadly pathogen and treatment on an isolation ward is a very stressful event for patients. Frequent psychiatric consultations are required to assist patients with confusion and anxiety. Furthermore, there are an increasing number of reports of stigmatization and post-treatment depression of Lassa fever patients. In order to bridge the important gap between clinical medicine and health psychology and public health, the MIND Lassa program employs an interdisciplinary team of clinicians, psychiatrists, psychologist and health-anthropologists to study psychiatric and psycho-social aspects of Lassa fever using quantitative and qualitative methods with the ultimate aim to improve patient care and public health intervention.

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Contact

Till Omansen, MD, PhD

Phone: +49 40 42818-267
Fax: +49 40 42818-281
E-Mail: till.omansen@bnitm.de