Nigeria Hit by Unprecedented Lassa Fever Outbreak Leslie Roberts
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NEWS At Olorgesailie in Kenya, big hand axes (left) gave way INFECTIOUS DISEASE to smaller, more precise blades and points (right). more extreme. More than 80% of mammal Nigeria hit by unprecedented species had vanished and new kinds of el- ephants, pigs, foxes, and springboks gathered at tree-lined streams. MSA tools—relatively Lassa fever outbreak sophisticated blades and points that would have been hafted onto spears—were plentiful. As efforts to contain it mount, researchers are racing to find The site yielded no human fossils in this out what is driving this year’s surge in cases and deaths key time frame, so researchers can’t be sure who the new toolmakers were. But discover- ies elsewhere offer a strong hint. For years By Leslie Roberts Already, Nigeria’s fragile health care sys- archaeologists had thought the MSA tools tem is overwhelmed. The one dedicated were too old to have been made by our spe- y early January, it was clear some- Lassa fever ward in the country at Irrua cies. Then, last year, fossils resembling H. sa- thing “really, really extraordinary” Specialist Teaching Hospital in Edo state piens were found near MSA tools and dated was going on in Nigeria, says Lorenzo has just 24 beds. Without access to proper to nearly 300,000 years ago at Jebel Irhoud Pomarico of the Alliance for Interna- training and personal protective equip- in Morocco (Science, 9 June 2017, p. 993)— tional Medical Action (ALIMA). Cases ment, health care workers continue to timing that fits the Olorgesailie chronology. of Lassa fever, a rare viral hemor- become infected—by now 16 cases have Features of the MSA tools also suggest they Brhagic disease, were skyrocketing across the been reported, with one additional death. Downloaded from were the handiwork of sophisticated humans. country—more were recorded in the first As the government and its international The toolmakers were highly selective about 2 months of 2018 than in any previous year. partners scramble to set up isolation wards their raw materials, importing obsidian from Unprepared for a disease that has no vac- and deliver protective gear to health work- up to 90 kilometers away. Such far-flung con- cines or drugs and kills 20% to 30% of those ers, researchers on three continents are nections are a “hallmark of human social it sickens, eight health care workers were racing to figure out what is driving the un- organization, and an important buffer in for- infected early on and three died. “Some- precedented outbreak. Is it simply better http://science.sciencemag.org/ ager societies,” whose members may move to distant places in hard times, Brooks says. The tools also are smaller, more precise, and more uniform in shape than Acheulean tools. They represent a milestone in abstract thinking: A hand ax preserves the shape of the original lump of rock, but creating a blade from an already prepared core forces toolmakers to visualize its shape in advance, Brooks says. The team also found chunks of black rock on April 26, 2018 and pieces of red ochre that had been punc- tured by sharp stone chisels. They propose both were used as pigments to create marks of individual or group identity, suggesting a high degree of social organization. Expanded social networks are “a key unique feature of modern humans,” says archaeologist Curtis Marean of Arizona State University in Tempe, although he sus- pects there will be some debate about the evidence for long-distance networks, noting This year, the rats that carry Lassa fever may be more numerous, or more likely to harbor the virus. that most of the stone came from just 25 to 50 kilometers from the site. thing was going very wrong with the out- disease surveillance in the wake of Ebola, By combining artifacts with environmental break,” Pomarico says. the similar but more deadly disease that be- data, the papers help explain what drove the Since then, the situation has only gotten gan its rampage across West Africa in 2014? MSA, says archaeologist Shannon McPherron worse. The rodent-borne disease is endemic Has the virus changed in some way? Are of the Max Planck Institute for Evolutionary in Nigeria and several other West African there more of the rats that carry it, or are Anthropology in Leipzig, Germany. “They countries, fluctuating with the seasons and more of them infected? Or is another rodent were able to use the long time-sequence at usually causing “a trickle” of cases a year, capable of spreading the virus as well? Olorgesailie to demonstrate how changes in says Chikwe Ihekweazu, who heads the Nige- “There are lots of possible explanations,” the environment and the fauna correspond to ria Centre for Disease Control in Abuja. But says Stephan Günther, who heads the R E G N the shift to the MSA.” as of 11 March, 365 cases and 114 deaths had virology department at the Bernhard Nocht I TR S But these MSA toolmakers hadn’t devel- been confirmed across 19 states, with many Institute of Tropical Medicine in Hamburg, / S R oped the full package of sophisticated be- more suspected. Ihekweazu says the record- Germany, and whose team has long collabo- TE U E havior, Dunbar cautions. “It’s at the bottom setting figures are sure to be underestimates, rated with Nigerian researchers. Consider- R O: T of the scale of modern behavior,” he says. because the disease is maddeningly hard to ing how lethal Lassa fever is, shockingly O H j P “We’re not talking about Salvador Dalí.” diagnose, and many cases go unreported. little is known about it, he says. “We don’t SCIENCE sciencemag.org 16 MARCH 2018 • VOL 359 ISSUE 6381 1201 Published by AAAS DA_0316NewsInDepth.indd 1201 3/14/18 11:30 AM NEWS | IN DEPTH know why people die. We don’t know about unrecognized, outside of West Africa, QUANTUM PHYSICS the pathophysiology of the disease. We don’t where it could be responsible for un- know the point of no return.” diagnosed fevers. That could be beginning to change. In Initial symptoms are easily mistaken for Vibrations 2016, the World Health Organization added malaria or typhoid fever—body aches, sore Lassa fever to its new list of priority patho- throat, fever, nausea, diarrhea—before the gens of epidemic potential, calling for more disease progresses to organ failure, shock, used to talk research. And last week, the recently cre- and sometimes internal hemorrhaging. By ated Coalition for Epidemic Preparedness the time doctors suspect Lassa fever, it’s of- Innovations, known as CEPI, awarded its ten too late to save the patient. There is no to quantum first grant for development of a Lassa fever rapid test; accurately diagnosing the dis- vaccine to Themis Bioscience in Vienna. ease requires a real-time polymerase chain circuits Lassa fever was discovered in 1969, reaction technique, but just three labs in when two missionary nurses died of a Nigeria have that capability. Sound waves could supplant mysterious disease in the remote town of For now, the only treatment is a non- Lassa in Borno state in northeastern Ni- specific antiviral drug, ribavirin. If it’s ad- microwaves in controlling geria. When a third nurse fell ill, she was ministered during the first 6 days of the quantum computers evacuated to a hospital in New York City— illness, it seems to improve a patient’s prog- along with a thermos full of blood and nosis, but “no one arrives before day 7,” other samples from all three nurses, bound Augier says. Nor is everyone convinced that By Adrian Cho, in Los Angeles, California for Yale University’s then-new Arbovirus ribavirin works in Lassa fever, as the only Downloaded from Research Unit. There, a team led by Jordi data come from the 1980s, Augier says. or the moment, microwave photons are Casals-Ariet isolated a novel virus from the Several potential drugs are on the horizon, the keys to many quantum computers: samples. (He, too, almost died in the pro- in addition to the vaccine. Christian Happi Physicists use them to program, read cess, saved only by an infusion of antibody- at Redeemer’s University in Ede, Nigeria, out, and otherwise manipulate the ma- rich plasma from the third and the Irrua Specialist chines’ quantum bits. But microwave nurse, who recovered.) Teaching Hospital is de- technology is bulky, and its quantum http://science.sciencemag.org/ The cause is now known veloping a rapid diagnos- Fstates don’t last very long. Now, several to be an arenavirus, one “I used to scream tic test with colleagues at groups are exploring a new way to talk to of a class of rodent-borne Tulane University in New a quantum computer: with tiny vibrations, pathogens. Its natural res- and scream that Orleans, Louisiana; the normally carriers of pesky heat and noise. ervoir is a multimammate Lassa is important, Broad Institute in Cam- The budding discipline of quantum acous- rat, so-called for its rows bridge, Massachusetts; tics could shake up embryonic quantum of mammary glands, that but no one listened. and Zalgen, a company in computers by miniaturizing technologies is ubiquitous across West … Lassa fever is a Germantown, Maryland. and producing longer-lasting quantum mem- Africa. Cases peak in the disease of the poor.” Happi’s group and its ories. “We’re right on the cusp” of controlling dry season, when farmers partners are also sequenc- quantum vibrations, says Andrew Cleland, a on April 26, 2018 burn the bushes in prepa- Christian Happi, ing the virus “around the physicist at the University of Chicago in Il- ration for spring plant- Redeemer’s University clock,” he says, and trying linois, whose group presented its latest work ing and rats scurry into to figure out whether the last week here at the annual March meeting houses in search of food.