• Researchers from multiple countries are gathering in the Nigerian capital Abuja to discuss the progress of Enable, the largest ever Lassa fever study.
• Set up and funded by CEPI, Enable aims to provide a more detailed description of the epidemiology of Lassa fever in West Africa.
• The Nigeria Centre for Disease Control & Prevention (NCDC) leads the Nigerian component of the study while the project is also being conducted in Benin, Guinea, Liberia, and Sierra Leone.
• Lassa fever is typically spread to humans by infected rodents, with severe cases potentially resulting in a haemorrhagic fever associated with a high risk of death. It is recognised by the WHO as a disease with epidemic potential.
• There are no vaccines for Lassa Fever currently approved for human use.
Saturday 22 October, ABUJA, Nigeria – The Coalition for Epidemic Preparedness Innovations (CEPI) and the Nigeria Centre for Disease Control and Prevention (NCDC) have teamed up to host a workshop in Abuja, Nigeria, for scientists from across the West Africa sub-region to discuss and review progress of their ongoing Lassa fever research.
Taking place from today, Saturday 22 October, and through to Monday 24 October, the three-day event brings together experts from Nigeria, Benin, Guinea, Liberia and Sierra Leone – all countries affected by Lassa fever – to share progress, challenges and insights from their work on the largest ever Lassa fever study, known as the Enable Lassa Research Programme.
Launched in late 2020, Enable aims to provide a better understanding of the true Lassa disease burden across West Africa—where there are regular outbreaks—and to guide the development of vaccines against this epidemic threat. The Enable programme has been set up and funded by CEPI, which is established as one of the largest global funders of Lassa fever research.
First identified over fifty years ago, Lassa fever is typically spread when a person comes into contact with the body fluids of the infected rodent species Mastomys natalensis - otherwise known as the Natal multimammate mouse or rat – or food and other materials contaminated by its urine, faeces and saliva. Human-to-human transmission is possible but rare. While the majority of cases are asymptomatic, severe cases can result in bleeding, fever, body ache, and result in death in approximately one percent of those infected. In recognition of its epidemic potential and disease burden in the West African region, the World Health Organization (WHO) R&D Blueprint listed Lassa Fever as one of nine emerging infectious diseases in urgent need of research and development activities. The disease is endemic in parts of West Africa, but recent modelling data suggests that climate change could cause Lassa fever to spread to other regions across the African continent.
Current knowledge about the annual burden of clinical Lassa fever is hindered by a lack of formal and standard clinical diagnoses for the illness and variability in symptoms. To address this knowledge gap, Enable partners are carrying out assessments, including follow-up of study participants by in person visits by health workers or via phone calls, to obtain a more accurate estimate of the population-level incidence of Lassa fever. NCDC is leading on the Nigerian component of Enable alongside other key partners*. All Enable partners are using a core protocol and methods to allow for standardised assessments and comparable datasets across the countries.
Supported by up to US $29 million of CEPI funding, a total of around 23,000 participants across the five countries participating in Enable are being followed up for two years to better understand the incidence and associated predictors of the disease – including gender and age – as well as the spread of the virus across the region.
There are currently no licensed vaccines to protect against Lassa fever, although some vaccines are currently under development. Data collected from the Enable programme will help to inform how and where future Lassa vaccine clinical trials can be carried out. CEPI has to date supported the development of six Lassa vaccines, with four candidate vaccines having progressed to Phase I clinical trials - some of the first in the world – in Liberia, Ghana, the US, and Belgium. CEPI’s ultimate goal, as part of its plan to reduce epidemic and pandemic threats, is to support the development a licensed Lassa vaccine for routine use in affected areas.
In addition to reviewing the progress of the study so far, today’s workshop will bring the Enable partners together to network and identify research and technical priorities to focus on going forward. Attendees are also set to discuss priorities on preparing for future Lassa vaccine trials.
Workshop attendees include representatives working for health and science organisations from West Africa and beyond. In addition to NCDC experts, this includes representatives from Irrua Specialist Teaching Hospital, Redeemer's University, and the Federal Medical Centre, Owo, Ondo State in Nigeria, as well as the Enable teams in Benin, Guinea, Liberia, and Sierra Leone, and disease experts from Belgium, France, Germany and the US.
Dr. N’Faly Magassouba, Programme Steering Committee (PSC) Chair of the Enable Lassa Research Programme and Principal Investigator of the Enable site, Guinea, said:
“The Enable Lassa Research Programme has brought together north-to-south and south-to-south research collaborations under a single umbrella, like never before, to work collectively to provide valuable insights to support Lassa fever research and vaccine development in West Africa. These collaborations will also lead to strengthened existing clinical research and public health capacities at each study sites.”
Dr Ifedayo Adetifa, Director General, NCDC said:
“Lassa fever is one of the recurrent and concurrent disease outbreaks Nigeria contends with. It is responsible for significant morbidity and mortality and has significant impact on healthcare delivery in affected regions given the deaths caused in healthcare workers. The country has made progress over the years in the management of Lassa fever; however, many gaps still exist for example limited options for therapeutics and vaccines, and the absence of evidence-informed interventions for vector control. We are happy with our mutually beneficial collaboration with CEPI especially through the Enable programme and look forward as a nation to the availability of effective vaccines and therapeutics against Lassa fever”.
Gabrielle Breugelmans, Director of Epidemiology at CEPI, said:
“The devastating COVID-19 pandemic has again reiterated the power of scientific collaboration. The connections and learnings made by researchers at this important meeting will help Enable to progress its work and provide valuable insights into the extent of Lassa fever disease burden across West Africa which, in turn, can guide future vaccine trials.”
The workshop builds on discussions held at the first ever global Lassa fever conference, co-hosted by the NCDC and CEPI in January 2019, which emphasised the need for additional research on Lassa’s disease burden.
Notes to Editors
About Lassa fever
Lassa fever is spread through contact with the infected rodent host Mastomys natalensis, or from person-to-person contact via bodily fluids. It is a zoonotic viral infection found predominantly in West Africa. While the majority of patients will be asymptomatic, one in five will experience severe symptoms which can include swelling, aches, and haemorrhaging. On average, 1% of cases are fatal, with the disease especially risky for pregnant women in their third trimesters. In those that recover, hearing loss is commonly reported post-infection. Further information on Lassa fever can be found in the ‘Lassa fever Disease Factfile’ on our website.
There are no licenced vaccines or treatments specifically for Lassa. CEPI has supported the development of six Lassa vaccine candidates. Phase I trials to assess the safety of the vaccine candidate have been launched with Emergent Biosolutions, Inovio Pharmaceuticals, IAVI, and Themis Bioscience.
Further information on Enable
*The Enable Lassa research programme study site partners are:
BENIN Fondation pour la Recherche Scientifique (FORS)
LIBERIA Co-led by University of North Carolina at Chapel Hill (UNC) and Phebe Hospital in partnership with the National Public Health Institute of Liberia (NPHIL)
GUINEA Université Gamal Nasser de Conakry (UGANC) in partnership with Robert Koch Institut (RKI)
NIGERIA Nigeria Centre for Disease Control and Prevention (NCDC), Irrua Specialist Teaching Hospital (ISTH), Federal Medical Centre (FMC) Owo, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Redeemer’s University Nigeria (RUN) and the African Field Epidemiology Network (AFENET). Together, the Nigerian partners make up the NiLE project of Enable.
SIERRA LEONE Co-led by Kenema Government Hospital (KGH) and Tulane University
Coordinating institutions supporting the overall Enable programme implementation include P-95, Margan Clinical Research Organization (MMARCRO), Epicentre, and the Bernard Nocht Institute for Tropical Medicine (BNITM).
Enable partners were first selected following Calls for Proposals, published by CEPI in 2018 and 2019, which sought groups with extensive Lassa research and field research experience across West Africa.
Enable was launched because, at present, the majority of patients who become infected with Lassa fever are thought to be asymptomatic and fail to seek diagnosis. Cases may also occur in remote regions where there are difficulties in accessing health care services for testing. As a result, the true case count is unknown and likely to be much higher than current estimates of 100,000 to 300,000 cases per year.
More information about Enable, including its aims, set-up, and implementation is available here.
CEPI is an innovative partnership between public, private, philanthropic, and civil organisations, launched at Davos in 2017, to develop vaccines against future epidemics. Prior to COVID-19, CEPI’s work focused on developing vaccines against Ebola virus, Lassa virus, Middle East Respiratory Syndrome coronavirus, Nipah virus, Rift Valley Fever virus and Chikungunya virus – it has over 20 vaccine candidates against these pathogens in development. CEPI has also invested in new platform technologies for rapid vaccine development against unknown pathogens (Disease X).
During the current pandemic, CEPI initiated multiple programmes to develop vaccines against SARS-CoV-2 and its variants with a focus on speed, scale and access. These programmes leverage the rapid response platforms developed by CEPI’s partners prior to the emergence of COVID-19 as well as new collaborations. The aim is to advance clinical development of a diverse portfolio of safe and effective COVID-19 candidates and to enable fair allocation to these vaccines worldwide through COVAX.
CEPI’s 5-year plan lays out a $3.5 billion roadmap to compress vaccine development timelines to 100 days, develop a universal vaccine against COVID-19 and other Betacoronaviruses, and create a “library” of vaccine candidates for use against known and unknown pathogens. The plan is available at endpandemics.cepi.net.
About Nigeria Centre for Disease Control and Prevention
The Nigeria Centre for Disease Control and Prevention (NCDC) is the country’s national public health institute, with the mandate to lead the preparedness, detection, and response to public health emergencies. The Bill for an Act to establish NCDC was signed into law in November 2018, by President Muhammadu Buhari. The mission of the NCDC is ‘To protect the health of Nigerians through evidence-based prevention, integrated disease surveillance and response, using a One Health approach, guided by research, and led by a skilled workforce.
Email: [email protected]
Phone: +44 7387 055214
Nigeria Centre for Disease Control and Prevention
Email: [email protected]