Tonye Princewill

February 10, 2012

Lassa fever…and the ‘joker’ was death (2)

Lassa fever…and the ‘joker’ was death (2)

Doctor and patient

By Tonye Princewill
SO Laura Wine died. So too did Shaw, after an 11-day illness. This was early 1969. But the scenario was just starting to unfurl. These were merely the opening sequences in a medical drama, whose spiralling plot spun a web of desperation – a web that would soon span the Atlantic and ensnare both the Nigerian and U.S. governments. This is what my research revealed:

With Penny Pinneo, the American Head Nurse, assisting, Jeanette Troup took blood and tissue samples from Shaw’s remains, for study and analysis. A week later, Pinneo too developed early Lassa symptoms – which, by then, were recognized as a growing malaria-like fever and malaise, vomiting, stomach pains, unproductive coughing, muscle pain and extreme prostration (physical weakness).

In his power point account, on which I now rely, Dr. Johsua Sule reports that when Pinneo’s condition worsened, she was flown from Jos to New York, U.S.A. Attending physicians there sent a specimen from her to the Arbovirus Research Laboratory at Yale University, in the neighboring state of Connecticut.

At Yale, a team of scientists isolated the pathogen, identifying it as a highly infectious hemorrhagic virus: An arenavirus, which causes infected persons to bleed profusely from all body-openings. Scientists named the illness “Lassa” fever, after the village in Borno State where Laura Wine may have been infected.The isolation of the Lassa virus was hardly a cause for celebration. Two of the investigators took sick. One, Dr. Juan Roman, died. Jordi Casals-Ariet, the other infected team member, famously received an anti serum from Penny Pinneo and both of them survived.

The New York Times reports that when news broke that Juan Roman’s accident was fatal, Dr. Wilbur Downs, Director of Yale’s Arbovirus Research Unit, was reading a copy of The Andromeda Strain – a science fiction novel about a lethal virus which invaded Earth on a fallen U.S. satellite.

He suddenly stopped reading the novel, Dr. Charles H. Calisher, a professor at Colorado State University, recalls, “fearing that Lassa fever might wipe out New Haven [where Yale is located] and the Eastern Seaboard”.

Sharing those concerns, the U.S. government immediately halted research on the virus at Yale. It was given a Bio-Safety Level 4 (BSL-4) classification. This places Lassa in the league with Ebola and Marburg – two highly infectious hemorrhagic agents capable of aerosol transmission.

There is no vaccine or cure. By 1970, the Lassa virus was ravaging Jos. At least 28 individuals were stricken, 13 fatally. Among the victims was a young woman, Tamalama Sale from Bassa, just outside Jos. According to Sule, her mother and daughter were also infected.

Sule recovered after 10 days of illness. But Sule says nothing about the fate of her mother and daughter. He reports that 12 Nigerians were infected, including four staff of Evengel Hospital – two of which died. With the exception of Sale, the infected Nigerians are faceless – presented as figures, rather than people. Sule, presumably, is a Nigerian. Yet his account, like the other sources I’ve seen, personifies and humanises foreigners to the exclusion of any detail about the afflicted indigenes of the area.

Sule records that Jeanette Troup was performing an autopsy on one of the expired Nigerians, when she accidentally cut her finger. “Dr. Troup,” he reports, “became ill and died after 10 days.” Both the Federal Ministry of Health and the Virology Research Laboratory at the University of Ibadan, UI, were involved in the Jos epidemic. Drawing on the experience of Jordi Casals, the Yale investigator who received antibodies from Pinneo, the Nigerian team obtained antiserum via plasmapheresis.

Infected patients were then infused with fever-resistant antibodies from former Lassa victims. This technique is based on the fact that a person who is infected with the virus, and survives, tends to build up resistance to it. Formerly infected individuals can, therefore, attend to Lassa fever patients, without fear of re-infection. Indeed, Jordi Casals actually came to Nigeria and set up a research programme at Evangel Hospital in Jos.

A photograph in Sule’s power-point account shows Casals and Pinneo (she returned to Evangel) standing with Raphael Adeyemi – then a young medical worker – who also survived an attack of the virus. They contributed plasma and the UI Lab has been collecting and freezing antiserum from other victims.

If there’s any “upside” to a health hazard of this magnitude, it is that Lassa fever kills 15 per cent to 20 per cent of its victims, compared with up to 90 per cent for the Congo Ebola virus – although 29 percent of Lassa survivors suffer partial or complete deafness. But this fatality rate is an average. According to the U.S. Centre for Disease Control, CDC, the death rate is much higher for women in the third trimester of their pregnancy, while 95 percent of all infected foetus perish.

•To be continued.