Promising Treatments for Lassa Fever in a Neglected Part of the World

By: Austin Weynand, MHS

Dr. Robert Cross in Kenema, Sierra Leone where he works with an international team of virologists, ecologists, epidemiologists, clinicians, and public health professionals to respond to emerging global public health threats like Lassa Fever, Ebola Virus, Crimean-Congo Hemorrhagic Fever, and Nipah Virus

While still maintaining close connections with his African coworkers, Dr. Cross progressed to UTMB for his postdoctoral work, which consisted of vaccine and therapeutics development against the aforementioned viruses. Lassa fever in particular has a great number of survivors living in West Africa, from which Dr. Cross and his collaborators derived a substantial library of samples. These samples were used to develop human monoclonal antibodies that can treat people who already have the disease. Their antibodies, designed to work for lineage II and III Lassa virus isolates that dominate Nigeria, have thus far proven effective in both guinea pigs and macaques.1

It’s important to understand that there are currently no approved treatments for Lassa fever. There are several distinct genetic lineages of the virus which adds difficulty to designing effective treatments. The disease it causes is often fatal, and it results in thousands of hospitalizations and deaths annually in West Africa. Moreover, there is a One Health obstacle built into its transmission – the virus finds reservoir in rats.2 Where infected rodent excretion intersects with human food and living spaces, infection can occur. Consequently, Dr. Cross employs One Health strategies to confront outbreaks from multiple angles.

Dr. Cross does not spend all his time in Galveston’s high-containment laboratory; he still travels to West Africa for public health intervention. He always tries to couple any of the work in these endemic areas with opportunities for capacity building, with aims to improve diagnostic abilities and support hands-on training in biocontainment. Moreover, pronounced anti-Lassa campaigns exist in these countries to educate the population on Lassa fever. The stigma against the disease is gradually being eroded and replaced with empowering knowledge. Today major efforts are being made to improve the self-sufficiency of local physicians and public health practitioners. Dr. Cross describes one example of community outreach to me, which takes the form of "town halls.” During these meetings, residents of a village congregate to share information about an outbreak or preventative measures to avoid one. Such hands-on approaches are extremely important to Dr. Cross.

Dr. Cross and Dr. Scott Weaver were recently awarded funding through the NIH/NIAID to establish the West African Center for Emerging Infectious Diseases (WAC-EID), which will advance disease surveillance in Senegal, Sierra Leone, and Nigeria.3 Surveillance will encompass viruses of many different vectors and reservoirs – including those of rodents.

References:

  1. Cross, R. W., Heinrich, M. L., Fenton, K. A., Borisevich, V., Agans, K. N., Prasad, A. N., Woolsey, C., Deer, D. J., Dobias, N. S., Rowland, M. M., Lathigra, R., Borrega, R., Geisbert, J. B., Garry, R. F., Branco, L. M., & Geisbert, T. W. (2023). A human monoclonal antibody combination rescues nonhuman primates from advanced disease caused by the major lineages of Lassa virus. Proceedings of the National Academy of Sciences, 120(34), e2304876120. https://doi.org/10.1073/pnas.2304876120
  2. Lassa fever. (31 July 2017). The World Health Organization. https://www.who.int/news-room/fact-sheets/detail/lassa-fever
  3. West African Center for Emerging Infectious Diseases (WAC-EID). (n.d.) CREID. https://creid-network.org/research-centers/wac-eid


WHO infographic on Lassa Fever; photo taken from the WHO website


Dr. Robert Cross in Kenema, Sierra Leone at the Kenema Government Hospital during the 2013-2016 West African Ebola Epidemic during the peak of the outbreak. Here he is training local Sierra Leonean scientists on molecular diagnostic techniques for Ebola virus.

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