Our Global Voices Posts

Tracking Lassa Fever Across Three Countries

Posted on by By Lesley Chace, MPH CDC FETP Lead - Francophone West Africa

Tracking Lassa Fever Across Three Countries

 

Lesley Chase, MPH , CDC FETP Lead-Francophone West Africa

When a Beninese migrant worker fell ill in Nigeria in December 2017, he decided to return to his parents’ home in Togo for care. His condition deteriorated during his trip through Benin. On his trip he stopped at Tandou Health Center in Tchaourou, Benin, was attended to by two healthcare workers, and continued his trip. He arrived home in Nadoba, Togo but his condition worsened and he went to several traditional healers near his home in Togo, as well as another health center in Boukombé, Benin, which referred him to the nearest hospital, Saint Jean de Dieu Zone Hospital in Tanguiéta, Benin. Here the attending doctor immediately suspected a hemorrhagic fever.

The patient was placed in isolation and a blood sample was sent to the national laboratory of Cotonou or diagnostic testing. He died the following day and laboratory tests confirmed he had Lassa fever. Public health workers in Benin immediately notified their colleagues across the border in Togo, and worked together to identify and follow fifty-five contacts, 23 in Togo and 32 in Benin.

This tragic story of a very sick man traveling across three countries caught the attention of Lesley Chace, CDC’s support lead for Francophone West Africa Field Epidemiology Training Programs (FETP). She wondered if the man had infected others on his journey and if Nigeria and Benin were communicating with each other about this epidemic-prone viral hemorrhagic fever.

Nigeria had an ongoing Lassa fever outbreak that had peaked in October 2017. About 10 days after the man died, Benin declared a Lassa fever outbreak with 21 cases, including four deaths. Lassa fever is endemic in many West African countries and shares some characteristics with Ebola. The last Lassa fever outbreak in Benin occurred in February 2017 and involved someone traveling from Nigeria. The frequent movement of people across the Benin-Nigeria and Benin-Togo borders makes it imperative for the countries to foster both formal and informal communication and information sharing.

 

Connecting Across Borders

Lassa Team Review
Lassa Team Review

When the outbreak started, both Benin and Nigeria had established successful FETPs that, with support from CDC, allowed for information sharing and collaboration, an opportunity Chace wanted to capitalize on. For nearly 40 years, CDC has worked with ministries of health worldwide to develop country- and region-specific FETPs, building a cadre of more than 14,000 skilled disease detectives in over 70 countries. These FETPs, modeled after the CDC Epidemic Intelligence Service program, provide “boots on the ground” to respond to natural disasters and disease outbreaks, as well as to conduct hundreds of investigations, including surveillance evaluations and planned studies.

“With FETPs, we are building professional networks of similarly trained epidemiologists who can learn from each other and call on each other for epidemiology support,” said Chace. “This situation where a person with Lassa fever traveled across borders presented an excellent opportunity to strengthen communication and collaboration in the face of a possible outbreak affecting several countries.”

CDC FETP Africa Region team lead Ken Johnson moved swiftly to link the leadership of Benin FETP to Nigeria FETP to share information. “Collaborations like these are made easier when there are FETPs in each country. A disease recognizes no borders, but joint efforts between two or more FETPs can facilitate a stronger response and save lives,” said Johnson. CDC’s efforts helped the two country programs to share information and situational updates that informed each country’s outbreak response and prevention efforts.

In West Africa, all three tiers of FETPs—Frontline, Intermediate, and Advanced—continue to lay the foundation for cross-country and regional collaborations to respond to disease threats and outbreaks. By sharing knowledge, skills, and experiences, FETPs and their trainees can potentially accomplish more than if they worked alone. Working collaboratively creates opportunities for countries to share best practices and lessons learned from epidemiology work. Through these exchanges, they gain a more harmonized approach and increased capacities to improve the health security of the population.

Posted on by By Lesley Chace, MPH CDC FETP Lead - Francophone West AfricaTags , , , , , ,

From Mangoes to Meningitis: A Tale of One Laboratory Scientist in Burkina Faso

Rasmata Ouédraogo Traoré

Rasmata Ouédraogo-Traoré PhD is the Chief of the Medical Analysis Laboratory of the Charles De Gaulle Pediatric Hospital, which houses the National Reference Laboratory for meningitis in Burkina Faso, and a professor of bacteriology-virology, medical sciences and pharmacy at the University of Ouagadougou. A concerned mother in Burkina Faso says to me, “I think that Read More >

Posted on by Professor Rasmata Ouédraogo-Traoré, PhDTags , , ,

Overcoming Refusals to Polio Vaccination in Uttar Pradesh, India

In 2014, WHO South-East Asia Region (SEAR) became the fourth region, among WHO’s six regions, to be certified as having interrupted all wild polio virus (WPV) circulation. India was the last country to eliminate polio in SEAR, proving that polio could be eradicated in the most challenging settings. Multiple international partners collaborated with Government of Read More >

Posted on by Alford (A.J.) Williams, Public Health Advisor, Global Immunization Division

I have seen Ebola. Now you have a vaccine.

Debut of preventive use of Ebola Virus Disease (EVD) vaccine for health care and frontline workers in Uganda before an outbreak For the first time, an unlicensed Ebola vaccine tested in clinical trials during the West African outbreak was offered to health care workers (HCWs) and other front line workers (FLWs) working in facilities bordering Read More >

Posted on by Rosalind Carter-Epidemiologist, Global Immunization Division

Readying the World for Maternal RSV Vaccine

Updated from the original posting on Vaccines Work on February 18, 2019 By getting vaccinated in pregnancy, mothers can safeguard themselves and their infants in the first few vulnerable months of life against certain diseases. This strategy is a powerful approach for reaching two stages of life often underserved by current immunization programs—pregnancy and early Read More >

Posted on by By Dr. Bruce Innis, Global Head, Respiratory Infections & Maternal Immunization, PATH Center for Vaccine Access and Immunization, and AMI Strategic Leadership and Dr. Sadaf Khan, PATH Senior Program Officer and AMI Maternal & Newborn Health Technical AdvisorTags , , ,

Promoting access to and use of clean and safe water to stop hepatitis E

GoersWindhoek

My name is Dr. Matthew Goers, an Epidemic Intelligence Service (or EIS) officer with CDC’s Division of Global Health Protection. Our division works with other countries and international organizations to respond to international disasters, disease outbreaks, and humanitarian crises. In September of 2017, Namibia began reporting sporadic cases of acute jaundice, abdominal pain, and fatigue. Read More >

Posted on by Dr. Matthew GoersTags , , ,

Thirty years of a Unique Partnership to End Polio-GPEI

chad-polio-vaccination-innovation-outbreak

In 1988, CDC joined three other partners (World Health Organization (WHO), United Nation International Children Fund (UNICF) and Rotary International to launch the ambitious Global Polio Eradication Initiative (GPEI). The world was a dangerous place with respect to polio. A case of polio occurred every 90 seconds, meaning 350,000 children had paralytic polio every year. Read More >

Posted on by Dr. John F. Vertefeuille - Incident Manager for the CDC Polio Response and Branch Chief of the Polio Eradication Branch, Global Immunization Division, Center for Global Health, Centers for Disease Control and PreventionTags , , ,

Getting to the Heart of the Matter in Latin America and the Caribbean

A blood pressure screening in Barbados raises awareness of hypertension and cardiovascular disease.

“I don’t get migraines, I don’t get dizzy spells any longer,” explains Ms. Williams, a patient at a polyclinic on the Caribbean island nation of Barbados. “It is working for me where I have no problems now with high blood pressure. Yes, I’m hypertensive, but I’m controlled.” Ms. Williams was enrolled as a patient in Read More >

Posted on by Bethany Hall, Scientific Health Communications FellowTags

Rapid Detection Accelerates India’s Response to Nipah Outbreak

CDC is working internationally to build laboratory capacity so that disease can be identified at their source. Photo: CDC India

  On May 17, 2018, almost two weeks after his brother died of febrile illness, a male patient in his mid-twenties visited a hospital in Kerala, India, with a fever. A day later, he was dead — but not before his doctors noticed his symptoms were consistent with encephalitis.Recognizing the potential danger, they immediately sent Read More >

Posted on by Dr. Kayla Laserson, CDC India Country Director

Zambia: A regional leader in NPHI development and emergency management

Dr. Victor Mukonka, Director of the Zambia National Public Health Institute

The Zambia National Public Health Institute (ZNPHI) is young but is already emerging as a leader for public health in Southern Africa. We are proud of our growth over the past four years and the increasing role we have assumed in the region. As ZNPHI  Southern Africa’s first regional workshop on public health emergency management Read More >

Posted on by Dr. Victor Mukonka, Director of the Zambia National Public Health Institute