Preparing For Ebola, But Stopping Lassa Fever

Last fall, with the Ebola epidemic raging, the small nation of Benin, a few countries away from the outbreak zone, experienced a cluster of unexplained deaths.

In mid-October, a 12-day-old baby was taken to a hospital in Tanguiéta, in northwest Benin, and died two days later. By early November, three employees of the hospital, St. Jean de Dieu, were dead too.

Ultimately, 16 people fell ill and nine died, including a prominent pediatrician. Ebola was suspected because of symptoms like vomiting and diarrhea. But in mid-November, lab tests were negative for the virus.

“There was a lot of panic,” Catherine Smallwood, a technical officer with the World Health Organization, said. “They didn’t know what it was.” W.H.O. described the incident recently in a report on its website.
Global Health

A column by Donald G. McNeil Jr. about global health news.

The day the Ebola tests came back negative, Dr. Smallwood and a W.H.O.-led team happened to arrive in Benin, part of an effort to help 14 vulnerable African countries prepare for a possible Ebola outbreak. The team suggested that the samples be tested for Lassa fever, a related virus that had never been seen in Benin.

The Lassa tests were positive.

At that point, Dr. Smallwood said, the W.H.O. team initiated “an Ebola response” — only against a different disease. Lassa, common in parts of West Africa and most likely transmitted through rat feces, can be treated with the drug ribavirin, but steps to keep infection from spreading are similar to those for Ebola.

“The entire staff of the hospital was in shock, so much in shock that they weren’t really able to react,” Dr. Smallwood said. “We had to insist that they take measures.” The staff created an isolation center, donned protective equipment and began monitoring roughly 200 people who had come in contact with Lassa patients.

Team members traveled about 250 miles to Ouogui, the baby’s home village. Her father, a traditional healer, had taken the infant to her grandfather in Tanguiéta after her mother and another of the healer’s three wives had become ill and died.

The healer “believed that some curse was being put upon him and his family,” Dr. Smallwood said. After learning that the culprit was a disease, he seemed relieved and “basically self-isolated his house and lit cinders around it, a traditional way of telling people to stay away.”

The international Ebola-preparedness effort helped Benin extinguish the Lassa outbreak. Since late November, no new cases have emerged."