Ebola, make way for Lassa.

Erika Check Hayden had a nice piece in Nature a couple of weeks ago in which she did a very good job of placing us in a clinic in Sierra Leone without actually visiting the place herself. We see and hear the tin roof on the Ebola ward collapse, and we see the crush of patients as the Ebola epidemic takes off.

But as I was working through a stack of Natures this weekend, I noticed something on the last page of the piece that I thought was stunning.

The hospital ward she wrote about, in Kenema, Sierra Leone, was set up not to fight Ebola–but to fight Lassa, another life-threatening illness that can sometimes cause hemorrhagic fever. Sheik Humarr Khan, of Kenema, and Robert Garry, a virologist at Tulane University in New Orleans, had been working on a Lassa treatment and research program, including a dedicated ward and a diagnostic laboratory, for nearly a decade. Before it could be completed, the hospital was overwhelmed by Ebola.

And here’s the passage that I found especially disturbing:

But with all the attention now on Ebola, physicians who work in Kenema are concerned about Lassa. The peak Lassa season, November to April (J. G. Shaffer et al. PLoS Negl. Trop. Dis. 8, e2748; 2014), is approaching, and of the hospital’s original 36 specialized Lassa staff, 11 have now been infected and 6 have died. Surveillance staff, doctors, nurses, drivers, cleaners and lab technicians have all lost their lives to Ebola.

Even if the doctors get control of the Ebola outbreak, they will still face the seasonal increase in Lassa infections. So far, however, the hospital is seeing fewer Lassa patients than it would have expected at this point in the season. Why? “We think the patients are reluctant to come in,” Garry told Hayden. “That’s not good.” And if they do come in, the hospital might not be able to care for them, with its staff so terribly decimated.

Lassa has been mentioned elsewhere, in the coverage, but it does not seem to be receiving the attention that it should. What will happen when Sierra Leone and perhaps its neighbors are faced with Lassa on top of Ebola? Could the situation there get any worse?

-Paul Raeburn