Via allAfrica.com, a World Economic Forum blog post by Pardis Sabeti: How Africa Is Fighting Back Against Ebola. Excerpt from a fascinating report:
Through our experiences in Sierra Leone and Nigeria, my colleagues and I have come to believe that diseases like Ebola and Lassa - first discovered in the second half of the 20th century - may in fact have been circulating in villages for centuries.
In reality, these diseases may only be rare in their detection. Despite popular accounts, viral hemorrhagic fevers often have general symptoms, such as fever and headache, which can be mistaken for malaria or typhoid. Beyond misdiagnosis, many individuals with fever never come to the hospital at all despite having serious and sometimes fatal infections.
Indeed, these diseases may only be new to Western medicine. Lassa virus was discovered when two missionary nurses succumbed to the disease while working in Nigeria. Marburg virus was discovered in the town of the same name in Germany when workers at a primate centre began suffering from fevers, vomiting and bleeding. The Ebola virus was discovered during simultaneous outbreaks at a mission hospital in the Democratic Republic of the Congo and a cotton factory in Sudan.
Understanding these viruses is best done from the field, from places like the Irrua Specialist Teaching Hospital (ISTH) in Nigeria, where I came to work in 2008. My colleagues and I began our research on the genetics of Lassa fever, working with the outstanding local clinicians and scientists.
While there, my research partner Christian Happi told me a story of a young boy who was brought to the hospital by his father and successfully treated for Lassa fever. Weeks later Christian had travelled to the boy's village to investigate the origins of his disease. There he learned that the boy's mother had died of the same mysterious disease, as had his cousin and his neighbour.
All told, over 20 individuals had died, unnoticed by the outside world. Remarkably, none had come to the hospital, as the hospital had previously had no diagnostic tests for the disease, and limited ability to treat it. Their story made us consider the countless individuals who die silently each year from this disease.
Today, with diagnostic tests able to detect the Lassa virus genome in patient blood and therapeutics on site, the hospital has become a regional centre for treating Lassa fever. Surrounding communities - hearing of the many successful stories like the young boy's - know where to turn, and the site has become a referral centre for patients with undiagnosed febrile illness within hundreds of kilometres. The site is not just a specialist centre for Lassa fever care and research, but also a sentinel site for emerging infectious diseases of all kinds.
Technological advances in analysing the genomes of a wide variety of microbes have the potential to transform the clinical care, surveillance and understanding of devastating diseases like Lassa and Ebola.
But to truly fulfil that promise, the tools must be delivered to researchers on the ground - tools for global surveillance and tools for effective diagnosis and treatment of patients where they are.