# Prevalence, Pathogenesis, and Persistence of Lassa Fever in West Africa

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $724,693

## Abstract

PROJECT SUMMARY
Lassa virus (LASV), the causative agent of Lassa fever, is a persistent global public health threat that
has infected and killed more people than all Ebola outbreaks combined. Unlike Ebola and other viral
hemorrhagic fevers (VHF), Lassa fever is perennial and endemic in West Africa resulting in
approximately 300,000 infections and 5,000 deaths each year, principally in Liberia, Sierra Leone, and
Guinea. The World Health Organization (WHO) reports that the incidence of Lassa fever is increasing,
perhaps as a consequence of climate change, as is the severity and case fatality rate of the disease.
As LASV has been imported into non-endemic countries – with more than 32 cases reported, one third
of which were fatal – the significance of enhanced detection and management of Lassa fever extends
beyond West Africa. Many of these deaths could be prevented with better diagnostics, supportive
clinical care, and therapeutics. Yet despite being a major cause of death in West Africa, Lassa fever
remains under-diagnosed, understudied, and largely ignored. For these reasons, in 2016, the WHO
released a research and development blueprint call-to-action, which identified LASV as a “top priority
emerging pathogen” that is likely to cause a severe outbreak in the near future and urgently needs to
be studied. Civil unrest coupled with inadequate healthcare and research infrastructure in West Africa
have prevented clinical research on this high-priority pathogen, thereby limiting our understanding of
the true burden of Lassa fever, the pathogenic mechanisms, and the infectivity of survivors. The
primary goal of this proposal is to leverage clinical infrastructure established during the Ebola epidemic
to fill critical gaps in our understanding of Lassa fever. Specifically:
  In AIM I we will establish molecular diagnostics at Phebe Hospital in Bong county, Liberia – a
 hyper-endemic area for Lassa fever to determine the prevalence of acute Lassa fever among
 admitted febrile patients as well as the seroprevalance of prior LASV exposure.
  In AIM II we will probe putative pathogenic mechanisms of acute and convalescent Lassa fever
 including immune activation, endothelial dysfunction, and persistence of viral antigens in genital
compartments.
  In AIM III we will characterize the compartmental dynamics of LASV in blood, semen and
 cervical-vaginal fluid to determine the duration of viral shedding and assess the infectivity of
 PCR-positive samples.
We will conduct this work in the context of close and strong working relationships with healthcare
leaders in West Africa and a well-developed infrastructure for clinical research we have established in
Liberia where we have recruited, enrolled, and longitudinally followed and sampled over 300 Ebola
survivors. Establishment of these cohorts allowed our team to determine the feasibility of our approach
and develop, pilot, and refine the procedures needed to sustain high-quality data collection during the
st...

## Key facts

- **NIH application ID:** 9851335
- **Project number:** 5R01AI135105-03
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** William Fischer
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $724,693
- **Award type:** 5
- **Project period:** 2018-02-07 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9851335

## Citation

> US National Institutes of Health, RePORTER application 9851335, Prevalence, Pathogenesis, and Persistence of Lassa Fever in West Africa (5R01AI135105-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9851335. Licensed CC0.

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