What if you could explore the world of One Health in Nigeria and learn from top scientists, like Dr. Nathan Shehu, Dr. Pam Luka, and Dr. Loya Inka Asala? In this fascinating episode, we dive into the West African Center for Emerging Infection Diseases program, and its goal to rebuild expertise on arboviruses, collect and identify mosquitoes, and assay them for potential virus-carrying. Join us as we discuss the power of cross-training and the importance of approaching global health with humility.
We also take a closer look at the passion and achievements of our guests' medical careers. Dr. Shehu shares his journey to his current research on Lassa fever, while Dr. Pam Luka talks about his childhood at his father's veterinary clinic at the MVRI campus and his journey as a sales rep. Discover how these experiences have shaped their paths and the importance of recognizing different levels of staff in healthcare and research. Don't miss our exploration of understanding and managing Lassa fever, the challenges of saving patients with Lassa fever, and the importance of early diagnosis and compassionate care.
Thanks for listening to the Infectious Science Podcast. Be sure to visit infectiousscience.org to join the conversation, access the show notes, and don’t forget to sign up for our newsletter to receive our free materials.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 2 (00:09):
Welcome to the Infectious Science podcast.
Speaker 3 (00:11):
This is not just another science podcast.
Speaker 2 (00:14):
Nope, Infectious Science is produced by a team
from the University of TexasMedical Branch and the Galveston
National Lab where we studysome of the most dangerous
viruses on the planet.
Our goal is to inspire futurescientists towards a career in
science, with a focus on onehealth.
Speaker 3 (00:28):
One health, one planet.
Speaker 2 (00:29):
That's right.
One health approaches publichealth threats by examining the
connections between people,plants, animals and the
environment we all share.
Speaker 3 (00:37):
This show will explore how one health is your
health, so sit back and learnsomething.
Speaker 2 (00:42):
Infectious Science.
Where enthusiasm for science?
Speaker 3 (00:45):
is contagious, scott.
Welcome to the InfectiousScience podcast man.
Thank you, matt.
So really appreciate you cominghere today and we've just been
really excited to have you comeand talk to us a little bit
about the type of work thatyou're doing.
You're one of the topscientists here at UTMB, and so
(01:08):
we really like to get togetherwith top scientists and pick
their brains about their work.
Part of this episode is thatwe're going to be hearing from
some of your collaborators inNigeria.
We know that these are someincredible scientists, some
incredible clinicians.
They're really been greatcollaborators.
Can you tell us a little bitabout what the relationship with
these partners, thesecollaborators, has meant to you
(01:29):
and what you hope the programbrings for the partnership in
these countries, because itsounds like these are very well
set up.
They have clinical facilities,they have labs.
They're actually doing somereally amazing work.
What's the relationship beenlike for you and what do you
hope is going to come out of itfor them?
Speaker 4 (01:45):
Well in Nigeria.
For example, I'd never been toNigeria until about a year ago.
We set up the centerapplication through Bobo
Pestler's relationships there.
One of the reasons I've beenreally excited about working in
Nigeria is that I focus on thearboviruses for the center.
Nigeria used to be a Britishcolony.
(02:05):
There was actually a lot ofvery important arbovirus
research done there until the1960s when Nigeria was
emancipated.
Ever since there's been verylittle arbovirus research done
there.
Like Senegal, the InstitutePasteur has had good support the
whole way since they were aFrench colony and maintain a lot
of research on arboviruses.
(02:25):
The same is not true forNigeria or Sierra Leone.
One of my goals is just to helprebuild their expertise on
arboviruses and a little bittheir capabilities and
facilities.
That's one of the overall goalsof the CREED network, but I
think that we do that in alittle bit more depth than a lot
of the other centers where theymostly focus on getting them
set up to do sequencing.
(02:47):
We try to do a whole lot morethan that.
We had to really start fromscratch with some of our field
sites teach them how to collectmosquitoes, how to identify them
, how to assay them to see ifthey're carrying viruses In
Nigeria.
It's been a lot of fun to workwith them to try to bring that
area of science back to Nigeria.
I think it's going to turn outthat there's a lot of important
(03:08):
things going on there that havejust been flying under the radar
for many years because nobody'sworking much on arboviruses
there.
We also Nathan Shea, who youtalked to.
You've probably seen more LASApatients than all but a handful
of physicians in Africa.
Even though he's a pretty youngguy, he sees a lot of cases and
knows a lot about LASA.
(03:28):
I don't know so much about LASA, so I'm learning a lot from
them.
The same is true for some ofthe livestock diseases where the
National Veterinary ResearchInstitution is very strong.
There I think you've talked toPam Luca.
They have a lot of expertisethat we don't have here at UTMB.
It's a great partnershipbetween human and veterinary
medicine, different fields ofvirology that are strong one
(03:51):
place and not in another.
The other thing that we'vereally done successfully is we
have, for example, senegaleseentomologists working to help
bring the expertise up in SierraLeone and Nigeria with mosquito
work.
They're really some of the bestin the world and they know the
populations in Africa muchbetter than I do or anyone else
in the US.
Really Having different Africangroups with different expertise
(04:14):
to do some cross training hasbeen pretty fulfilling too as
part of the center.
Speaker 3 (04:19):
That's amazing.
I think there's always thismodel in global health that
we're trying to get away from,which is jet setting from high
income countries to come and dostuff in low, low middle income
settings, And this idea ofreally setting up in country
networks, sharing expertise,learning from one another,
approaching that with humility.
I really think that's such agreat example of getting stuff
done.
Speaker 5 (04:42):
Welcome back to the Infectious Science Podcast.
I am Dr Dennis Bentham.
I am an associate professor inthe microbiology and immunology
department at the University ofTexas Medical Branch and the
Galveston National Lab.
Today we are recording aspecial episode.
We are on the road As part ofthe West African Center for
(05:03):
Emerging Infection Diseases.
We are in Nigeria And I'm heretoday with Dr Nathan Sheyew He's
an attending physician at theJoe's Teaching Hospital And Dr
Pam Luca he's a veterinarian andmolecular biologist at the
National Veterinary ResearchInstitute And Loya Inka Asala.
(05:26):
He's a veterinary researchofficer, also at the National
Veterinary Research InstituteAnd I'm very excited because we
will be talking about Nigeria,lhasa fever, african swine fever
and some other zoonoticdiseases in Nigeria And
hopefully we'll have time todive into one health in Nigeria
(05:46):
as well.
So welcome to the podcast, andI want to start with Dr Nathan
Sheyew And maybe you canintroduce yourself.
Tell us a little bit about yourcareer.
How did you end up becoming anattending physician at the Joe's
Teaching Hospital?
Speaker 6 (06:02):
Yeah, thank you, dennis.
My academic career startedEverything about my education is
in the northeastern part ofNigeria.
I was actually born in thenortheast.
I did my preliminary educationin the northeast, my
undergraduate in the northeast,but when I decided to come for
(06:23):
residency I came to NorthCentral Nigeria.
So growing up as a kid I hadthe desire to become a medical
doctor.
But when I went to college Istarted tossing around other
courses that probably might bebetter.
Growing up I started to do somehand skills of walking in
(06:46):
electrical workshop, repairingelectric fans, electric motors.
Then I started to say probablyI could develop something.
Some manually driven system canbe changed when I develop
electric motors.
So then, still in college, ithought of probably I will do
chemical engineering.
(07:07):
Then another thought I could dogeology, but somehow the
thought to read medicine andsurgery prevailed.
Then, of course, i readmedicine and surgery And it was
quite interesting.
And when I was studyingmedicine we are not studying to
pass, who are studying to gainknowledge.
(07:27):
We don't see reading, studyingas a burden, but we read with
excitement, we read beyond therequired syllables And what we
used to do those days is afterreading.
We have lots of groupdiscussions, so we'll be
challenging one another withwhat we've read and all of that,
and that's for us to keepreading and studying, and
(07:49):
studying.
After that, while then I startedmy housemanship at the
University of Maiduguri TeachingHospital.
So right when I was doing thehousemanship, which is
internship, then I also enrolledfor a graduate program,
master's in health planning andmanagement, and actually just
internship is a very hecticprocess.
(08:10):
So all of that actually createda milieu and opportunity for me
to work in difficultcircumstances, and I tell you
that some of the demandingsituation and circumstances that
I faced were just opportunitiesthat I had developed from those
experiences.
So outside that, I now decidedto go for residency.
(08:35):
Then I came to Josh UniversityTeaching Hospital And it was
quite challenging because oneneeded to get sponsorship and
the sponsorship was not tooforthcoming.
So I came to do residency witha little bit challenging
financial resources, but tomyself and to the family.
So it was really difficult.
There are times that one wouldeven attempt to track down to
(08:59):
the hospital.
So you could imagine that amedical doctor could attempt to
track down, because it was quitechallenging.
And as I kept on pursuing theresidency, then I started having
some resources.
Then, at a time many of mycolleagues had enough money to
be buying cars and I had somemoney So I had the option.
Then I got an opportunity toapply for an international
(09:20):
course in the US internationalcourse on applied epidemiology.
So the money that I had savedto buy a better car than the one
that I was using, which wasreally not too good I just used
that to invest in my education.
So that was when I attended theinternational course on applied
epidemiology organized by CDCand Emory University.
(09:43):
So that became a trigger and itcreated an interest in research
, collaboration, network and allof that.
So I came back and I completedmy residency and was employed as
a consultant physician with theJoss University, teaching also,
which is equivalent to like anattending physician.
So in a nutshell, that is it.
(10:03):
But I kept on having a desireto do another studies on
genomics and bioinformatics.
I just went for it again andalso gained knowledge.
So, in a nutshell, that's myeducational pathway.
Speaker 5 (10:17):
Thank you very much for sharing.
You mentioned your interest inelectronics and moving parts and
you mentioned the hand skillsand stuff like that.
So why didn't you end upbecoming a surgeon?
Speaker 6 (10:26):
Well why I didn't become a surgeon.
I checked my strengths and Irealized that clinicians are the
real, physicians are the real,because it needs.
When I was in my preclinicals Iwas very good in physiology
Well, even in most of thedisease.
But I love critical thinking,analytical thinking and all of
(10:48):
that And I just like internalmedicine.
And to my mind, when I wasdoing my national youth service
because in Nigeria, aftercompleting your undergraduate,
you will go for a mandatorynational youth service, so
during that time there'sopportunity that you practice
general medicine And at thattime I could do several
surgeries I repair herniarepairs, i do caesarean section,
(11:11):
i do lumpectomy, that is,removing of lumps.
So I felt that there was noneed to go beyond that.
That knowledge it is requiredif one is in any other place
where there is no specialist, soyou could draw from that.
So even to this day, if thereis opportunity to do surgery in
a rural place, of course I willdo it.
Speaker 5 (11:34):
So for the young audience, the medical students
or people interested in medicalschool, would you have any
advice for the career?
What was it for you?
Was it the mentors, or was itserendipity, or what shaped your
career?
Speaker 6 (11:48):
OK, first I realized that many people study a course
that they are not interested in,and so it becomes a burden.
On the other hand, there areseveral people that study a
course that was actuallybequeated to them, or they were
made to study a course that theynever liked it.
So you will see that the levelof commitment will never be the
(12:09):
same.
So what I tell people is thatwhen one has reached the point
of decision making regarding acourse of study, it's a very,
very important decision in lifethat must not be taken just at a
go, and many things need tocome.
Many people will just do ashort-term analysis, say
probably the duration of studyor how difficult it is or how
(12:32):
easy it is, but it's importantto know that once you choose a
career, it is something that youlive with for the rest of your
life.
So it's important to have theshort, medium and long-term
overview analysis and know yourstrengths, know your interests,
know where you're going.
Speaker 5 (12:49):
Then, before you now take a decision, Can you also
tell our audience how you endedup becoming part of the West
Africa Center for EmergingInfectious Diseases?
OK, for me first.
Speaker 6 (13:02):
I said that I don't want to be just an ordinary
clinician And I keep tellingpeople that if you just be a
clinician, they say that, ok,these are the symptoms of
pneumonia Someone will becoughing, someone will have
fever, someone will be weak.
That is the lowest level ofachievement, because anybody,
(13:24):
just you, just know that, yes,fever, cough, body weakness is
equals to pneumonia.
And of course, there are otherthings that, yes, it will lead
to investigation, but that isachieving, utilizing the
potentials that we have.
So it's important to go beyondthat, to go beyond just ordinary
(13:45):
thinking and asking relevantquestions, making discoveries.
And at some point I studied andlooked at those who made
discoveries Pluto, socrates, andsomeone that I respect so much
was asking us and challenging usall those who made discoveries,
do they have two brains?
(14:07):
Do they have two heads?
So if people passed all thesegreat scientists, philosophers,
they could sit down, they couldthink through.
Why couldn't I?
And so the first interest wasin LASA, in infectious disease,
because eventually Isubspecialized in infectious
disease And why I studiedinfectious disease?
(14:27):
Because I realized that mostthe challenge that I have, most
around me are infectiousdiseases, and then I realized
that diseases that have epidemicpotential, they are more
challenging And I have severalopportunities to see patients
with LASA fever where you willsee health workers.
once they say this is suspectedLASA fever, people will be
(14:49):
running away.
Then I will say that yes, thispatient needs to be cared for,
this patient needs to beattended to.
So I now started developinginterest in LASA fever And one
thing that is general withhealth care or research or
teamwork is lack of recognitionof other low-corder staff or
(15:10):
other people that are not inyour discipline.
Now it will surprise you thatat a point someone who everybody
will say this one is a juniorfaculty, a junior staff we are
seeing because he works with thestate minister of health.
He said that we are seeingpatients coming with LASA fever
in this hospital, a vangialhospital, which is the place
(15:30):
that the first case of LASAfever was ever managed in the
world.
And you are in the same city andyou are in the teaching
hospital.
You are a specialist.
Why is it that you have neverreported to us that you had LASA
fever?
So if it was yes, i'm a seniorfaculty I could have said what
are you saying?
But low and pure, i said, ok,let me start looking.
And immediately I start lookingand of course we started seeing
(15:52):
LASA fever.
So then we started to seepatients.
We started to writepublications, document our cases
.
Then I started to make somecollaboration and I realized
that there are several peoplewho needed some expertise, those
experts who are clinicians.
And that's how ProfessorSlobodan Pesla, who is
(16:13):
interested in LASA fever, whohas done the convenience studies
on LASA and has done somemodels of LASA fever hearing
loss in mouse models So hewanted to replicate, to have a
comprehensive study to see inhumans.
So that's how we wrote a grantNIH with him and we started to
(16:35):
work on LASA fever.
Speaker 5 (16:37):
Thank you, Dr Pam Luca.
What about you?
How did your career started out?
Tell us a little bit about yourstory, Yeah.
Speaker 1 (16:46):
I think my career started from the MVRI campus,
because that's where I was bornAnd my father worked there as an
attendant.
So when we were growing up weusually follow him to the vet
clinic And I think one thing Ilearned from him is that he's a
passionate person when it comesto taking care of animals,
(17:06):
because then at the veterinaryclinic animals could be admitted
, kept their money each before.
When they get better, then theowners come and take them, or if
someone is traveling, he canjust come to the clinic and keep
his animal and give money forfeeding, and then he does that
with a lot of commitment andpassion.
So sometimes we follow him andwe see And we also keep dogs
(17:29):
sometimes too.
In fact, here we don't reallyhave special food for animals,
but when you make food for mydad and he comes back and asks
as his animal eating, you saidno, he can take his food and
give to the animal.
So I think that's where Ipicked the passion.
And then, even when I finishedsecondary school and was going
for an undergraduate program, ithink I told myself I was going
(17:53):
to do veterinary medicine.
I went to a preparatory classand then I was given something
that would not give me a vetmedicine course.
I had to withdraw and then wentback prepared myself again and
went to the university Andeventually I did veterinary
medicine and came out.
And as soon as I came out, ithink I got a job as a sales rep
(18:14):
for a veterinary company.
So I was moving about sellingdrugs, selling animal feed and
other things.
So I think that too also helpedme to build some capacity when
it comes to human relationship,when it comes to personal drive,
because as a rep, nobody tellsyou what to do.
You're only given the targetfor the year.
You break it down into monthsand maybe into weeks, and then
(18:36):
you supervise yourself and youdo your work.
And it tells somewhere thatyou're doing your work.
If the sales are going, then itshows you're working.
If you're not making sales, itshows that you're not really
working.
So it's a system that helps youto be able to manage yourself
and be productive and have somepersonal drive, because it's
very necessary for whateverlevel of career you choose for
(18:58):
yourself, because if you'realways waiting for someone to
give you a push, you do notalways be there.
But like Nathan said, if it'salong the line of your interests
, it's along the line of yourstrength.
You can always jump out everyday and find yourself doing that
same thing that you love, butif someone is the one that is
asking you to do this, do that.
If the person is not theretomorrow, you will not be able
(19:20):
to continue.
So I think that I was able toget at the early stage of my
career.
So I did that work for a shortwhile and when I was going in
for that work I told myself Iwas going to do it for two years
.
Yes, i had the target.
I said I was going to do thisjob for two years and after two
years I'm off to do other things.
Because then I was alsointerested in business, i was
(19:41):
interested in financial issues,because then I also felt that if
I did not study veterinarymedicine, i would have studied
economics, genomics, economicsOh, economics.
Economics Because I wasinterested in business.
Speaker 5 (19:54):
Right Yeah.
Speaker 1 (19:55):
And then eventually, i think after I got employed
with the National VeterinaryResearch Institute, where I
started my career as a generalperson in the lab, doing
diagnostics, managing some otherscientists like technician, and
then growing to the rank thento my master's in molecular
biology and PhD, where I workedon ASF as the African Swine
(20:19):
Fever, and I did the master'sand the PhD in a resource
limited environment.
It's not like a high tech, butyou were exposed to doing things
, basic things, basic science,because you don't have the kit,
the extraction kit, to doextraction although you are
doing molecular biology.
So you could do theconventional extraction of maybe
(20:43):
chloroform isoamyl, you knowall those things.
And then, if it's a lysa, youcould just get your antigen and
you challenge some laboratoryanimals and generate polyclonal
antibodies and you play aroundwith it.
So eventually, when you havethe commercial one, it gives you
an idea of what is making thatto work.
So I think that's actually whathas been my journey into
(21:04):
veterinary medicine.
Like I said, it started with myfather.
It was what my dad was doingthat I picked interest in And as
I moved on, he finding things.
But interestingly, i think, iwent back to my yearbook, my
secondary school yearbook and Irealized that in that yearbook I
said I wanted to be avirologist.
So it's like a dream you hadand it's coming to reality,
(21:26):
although not as quick as youwanted it or not even as in the
places you want, although Iwasn't specific where I wanted
to be.
But I knew that this is what Iwant to be in life.
And you know, like they say, becareful, what you wish for, you
may get it.
So that was what I wished forand maybe that has been the
drive and it led me to where Iam.
Speaker 5 (21:46):
So there's no point in your early career or in your
secondary school, where youthought about becoming a human
doctor or physician, no, why not?
Speaker 1 (21:56):
Because I think it's the environment, because I grew
up in a veterinary researchinstitute compound where I see a
lot of veterinarians and someof them were like role model per
se.
I saw them and I said I want tobe like them.
So the environment had a rolein what I became anyway, because
I didn't grow up where thereare a lot of medical doctors.
(22:18):
Perhaps if I grew up where theyare I would have become a
medical doctor.
But, like I said, I grew up ina place where veterinary
medicine was practiced and mydad would also work there and
his passion and his commitment.
I said why not?
But I knew that whatever I'dchosen to do, I would do better
in it.
Speaker 5 (22:34):
What's your favorite animal, favorite animal to work
with?
Speaker 1 (22:37):
Dog.
I like dog because in my houseright now I have a dog, I have a
cat, my wife keeps poultry.
I love animals.
Speaker 5 (22:45):
Thank you for sharing .
It's a very interesting story.
Nathan, you mentioned that youspecialized in infectious
diseases and we touched brieflyon LASA virus, so for our
listeners, there might be somethat know about LASA virus, but
you also mentioned that LASAvirus was discovered here in
Nigeria.
Can you tell the audience a bitabout LASA virus?
How do humans become infectedAnd what does the disease look
(23:09):
like in humans And what can bedone to treat the disease?
Speaker 6 (23:12):
Okay, before I dive into the issue of the LASA fever
, because listening to Luka andAsala, they made reference to
some historical perspectives.
That has to do with eithertheir parents or these things,
and I realized that historicalperspective it's very, very
important in shaping one'scareer choice or many things in
(23:33):
life.
And my dad actually was alaboratory scientist and he is
now over 87 years old.
And do you know that he was thefirst person to have described
how a mycobacterium tuberculosisbaslite looks like?
Yes, the pathogen, the jam thatcauses tuberculosis.
(23:53):
So he would be describing to meand be telling me when I was
young what they were doing, howthey will use microscopes to
make diagnosis of this disease,of syphilis, of gonorrhea, and
he would even describe how theywere doing autopsies, how they
will cut skull and remove thebrain and they will later stitch
(24:18):
it back and nobody would know.
And for me I just compared whatthey were doing that time with
very short duration of trainingThey were able to do so many
things.
So even that time, justlistening to that, it kept on
gradually increasing my desireto read medicine And he believed
in me that this guy is verygood and he will never fail
(24:41):
anything.
So to live to that expectation,i have to force myself to read
extra hard so that failure willnot be an option.
So now talking about LASA fever.
Lasa fever is an infectiousdisease, and an infectious
disease that is caused by avirus.
And why it is called LASA fever?
(25:02):
Because the first disease thatwas eventually diagnosed in the
United States first occurred ina white missionary who was
working in a town innortheastern Nigeria called LASA
So the actual name of the townis LASA And eventually the white
missionary was lifted andbrought to Plato State, nigeria,
(25:23):
at the Evangel Hospital whereshe was initially managed, and
after that several people camedown with the disease.
So if a patient has LASA fevers, there are some symptoms that
the person will present.
The first most common symptomsit will start with fever, then
with sore throat and generalbody weakness, then, as time
(25:45):
progress, then the patient willbegin to bleed from the nose, at
times from the gums, at timesthe person will be urinating
blood, at times.
Then the urine will begin toreduce until the kidney may shut
down And the disease istransmitted through rodents.
When someone either in theprocess of preparing because
(26:06):
there are some areas thatactually prepare rodents as
delicacy So in the process ofprocessing it to eat.
Then there are some areas inNigeria that spread dry foods
outside and rodents could go andurinate or defecate on it.
So if it is consumed it canalso lead to LASA fever.
But the most challenging thingabout LASA fever is that it can
(26:29):
be transmitted from human tohuman, and that's what pose a
big challenge, both locallywhere it is and also the
potential that it can betransported outside the country,
because if someone is sick, orprobably someone, may begin to
have fever and eventually willtravel to other parts of the
country and eventually will nowdevelop LASA fever and it will
(26:53):
keep spreading.
So essentially, this is thegeneral picture of LASA fever.
Speaker 5 (26:58):
So please correct me if I'm wrong, When I've never
seen a LASA patient.
When I read textbooks aboutLASA fever, some people say
because it's classified withother hemorrhagic fever such as
Ebola virus or Crimean Congo orother hemorrhagic fever virus.
Some people say the hemorrhagicpresentation is not as
prominent as is with, like maybesome of the other hemorrhagic
(27:20):
fever viruses.
Do you agree or do you disagree?
Speaker 6 (27:24):
Well, from what we have seen, there are several
unanswered questions, becausethere are times I have seen many
patients coming down withsevere hemorrhagic disease.
They will come with LASA feverwithin three, four days.
They are hemorrhaging, bleedingeverywhere and they are gone.
And then there are patientsthat will come with mild
(27:48):
symptoms and of course you knowthat over 80% of LASA fever may
be asymptomatic, but even the20% symptomatic, the severity
varies And even within the samefamily who are exposed to the
same environmental condition,who had human-to-human contact
with LASA fever, you will seethe husband may have LASA fever
(28:09):
with hemorrhage and probably thewife will just have LASA fever
with mild symptoms, and some maybe asymptomatic.
And you could see that in onepart of the country you may have
severe symptoms and in someother part there may be mild
symptoms.
So if one will just give ablanket answer that it doesn't
have comparative hemorrhagicsymptoms like other, then it is
(28:31):
not the entire story.
Speaker 5 (28:33):
Okay, what can be done to save the patient?
Speaker 6 (28:36):
Well, the challenge with saving patients with LASA
fever has to do with earlydiagnosis, early presentation to
the hospital and the requisitetraining to the personnel, first
on infection prevention andcontrol and also on the
management And, aside from that,the issue of compassionate care
(28:58):
.
I tell you I have seen lots ofpatients with LASA fever who
have died because they presenteda late and you would see the
anguish that the family and thefear because it comes with
double stigma.
You will see that family, theyhave lost a relation because of
LASA fever and they arestigmatized.
(29:20):
They are also afraid that theymay eventually come down with
LASA fever.
So there's so much psychosocialchallenges.
So they need a compassionatecare of a physician And on the
other side you have severalhealthcare workers who are
afraid to take care of patientswho have LASA fever.
So now here you are.
(29:41):
You have a relation who isdying of LASA fever and you have
healthcare workers who aretimes.
For realistic purpose, theyneed to wear appropriate gear
before they could see.
So even if someone is wearingthe appropriate gear, the first
marks, n95 marks and the gownthe relation would expect the
(30:01):
healthcare worker should justrush without the appropriate
gear in order to attend to thepatient.
Then, on the other hand, thereare several others who wouldn't
want to have anything to do withLASA fever.
I just give you one case.
We were trying to give atraining on one of the
hemorrhagic fevers, so someonewas in the ER a health worker
who was saying come for training.
(30:22):
I said no, no, no, no.
I don't want to have anythingwith LASA fever or anything, but
the person is still in thehospital.
So I realized that there isalways a gap regarding
compassionate care, regardinghuman capacity development and
regarding interest.
Speaker 5 (30:37):
Nathan, you mentioned that there are healthcare
workers that don't want to gointo those rooms, that don't
want to work with these patients.
What about you?
Are you not afraid?
Speaker 6 (30:48):
Yes, you see, i wrote a paper and I published it
locally and I said thathealthcare environment is a war
zone And there are severalpeople who enroll into army and
they go to wars.
And if anybody that elists as amilitary person, it means that,
yes, he knows that he willprepare for war.
So and you say you are aclinician.
That's one thing.
(31:08):
I'm a clinician Then.
The second thing is that I havethe compassionate care based on
my faith and belief in God that, yes, i need to help those who
are suffering, i need to carefor those who are weak.
So anytime someone hassuspected or confirmed LASA
fever, there's a trigger and forme it's so gratifying The
(31:29):
number of patients that I'vetreated with LASA fever if they
see me, the gratitude you cannever, ever compare it.
The sense of satisfaction, thegratitude when orders, even
their family relations, arerunning away from them, but I
come to help them, care for themYou can never compare that.
Speaker 5 (31:50):
What about your family?
What about your wife and yourchildren?
What do they think about whenyou go into those wards?
Speaker 6 (31:57):
Yes, unfortunately there was one incident that
another hell worker, who iswalking, even in my hospital,
went and was telling my wife andmy family you see a husband,
he's going to be seen patientwith LASA fever when others are
running away.
He's not wise.
He's not wise, he's a fool.
But the good thing is that Ihave a very strong family, very
supportive wife.
(32:18):
I remember if it is because,yes, she knows that, yes, i'm
reading medicine And even in theearly part of marriage, when
I'm on call, we will drive tothe hospital together.
She will be in the car, i willgo and see patients and go back
And I carried her through allthat.
I'm doing And anytime, forinstance, even before I
(32:39):
subspecialize, if I go to help apatient, i will come and report
and say see what I have done,see how I have saved this.
So she's a partner.
Actually She's a partner, andthere are several times that I
will be needed to go to attendto a patient.
It may be even through thenight.
There was a time that patientwas really ill And I saw that
before the hospital ambulancewould come and pick me and I
(33:01):
because it will take time.
So I just drove through thenight And that wouldn't have
been possible if my wife said no.
If she said no, i wouldn't havegone because I have a
justifiable reason.
So it's a good support.
And I tell you there is nocareer, there is nothing that
one will be successful without agood, supportive family.
Speaker 2 (33:21):
Thanks for listening to the Infectious Science
podcast.
Be sure to hit subscribe andvisit infectiousscienceorg to
join the conversation, accessthe show notes and to sign up
for our newsletter and receiveour free materials.
Speaker 3 (33:32):
If you enjoyed this new episode of Infectious
Science, please leave us areview on Apple Podcasts at
Spotify and go ahead and sharethis episode with some of your
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Speaker 2 (33:41):
Also, don't hesitate to ask questions and tell us
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To get in touch, drop a line inthe comments section or send us
a message on social media.
Speaker 3 (33:50):
So we'll see you next time for a new episode, and in
the meantime, stay happy stayhealthy, stay interested.
Welcome to the Infectious Science podcast.
Speaker 3 (00:11):
This is not just another science podcast.
Speaker 2 (00:14):
Nope, Infectious Science is produced by a team
from the University of TexasMedical Branch and the Galveston
National Lab where we studysome of the most dangerous
viruses on the planet.
Our goal is to inspire futurescientists towards a career in
science, with a focus on onehealth.
Speaker 3 (00:28):
One health, one planet.
Speaker 2 (00:29):
That's right.
One health approaches publichealth threats by examining the
connections between people,plants, animals and the
environment we all share.
Speaker 3 (00:37):
This show will explore how one health is your
health, so sit back and learnsomething.
Speaker 2 (00:42):
Infectious Science.
Where enthusiasm for science?
Speaker 3 (00:45):
is contagious, scott.
Welcome to the InfectiousScience podcast man.
Thank you, matt.
So really appreciate you cominghere today and we've just been
really excited to have you comeand talk to us a little bit
about the type of work thatyou're doing.
You're one of the topscientists here at UTMB, and so
(01:08):
we really like to get togetherwith top scientists and pick
their brains about their work.
Part of this episode is thatwe're going to be hearing from
some of your collaborators inNigeria.
We know that these are someincredible scientists, some
incredible clinicians.
They're really been greatcollaborators.
Can you tell us a little bitabout what the relationship with
these partners, thesecollaborators, has meant to you
(01:29):
and what you hope the programbrings for the partnership in
these countries, because itsounds like these are very well
set up.
They have clinical facilities,they have labs.
They're actually doing somereally amazing work.
What's the relationship beenlike for you and what do you
hope is going to come out of itfor them?
Speaker 4 (01:45):
Well in Nigeria.
For example, I'd never been toNigeria until about a year ago.
We set up the centerapplication through Bobo
Pestler's relationships there.
One of the reasons I've beenreally excited about working in
Nigeria is that I focus on thearboviruses for the center.
Nigeria used to be a Britishcolony.
(02:05):
There was actually a lot ofvery important arbovirus
research done there until the1960s when Nigeria was
emancipated.
Ever since there's been verylittle arbovirus research done
there.
Like Senegal, the InstitutePasteur has had good support the
whole way since they were aFrench colony and maintain a lot
of research on arboviruses.
(02:25):
The same is not true forNigeria or Sierra Leone.
One of my goals is just to helprebuild their expertise on
arboviruses and a little bittheir capabilities and
facilities.
That's one of the overall goalsof the CREED network, but I
think that we do that in alittle bit more depth than a lot
of the other centers where theymostly focus on getting them
set up to do sequencing.
(02:47):
We try to do a whole lot morethan that.
We had to really start fromscratch with some of our field
sites teach them how to collectmosquitoes, how to identify them
, how to assay them to see ifthey're carrying viruses In
Nigeria.
It's been a lot of fun to workwith them to try to bring that
area of science back to Nigeria.
I think it's going to turn outthat there's a lot of important
(03:08):
things going on there that havejust been flying under the radar
for many years because nobody'sworking much on arboviruses
there.
We also Nathan Shea, who youtalked to.
You've probably seen more LASApatients than all but a handful
of physicians in Africa.
Even though he's a pretty youngguy, he sees a lot of cases and
knows a lot about LASA.
(03:28):
I don't know so much about LASA, so I'm learning a lot from
them.
The same is true for some ofthe livestock diseases where the
National Veterinary ResearchInstitution is very strong.
There I think you've talked toPam Luca.
They have a lot of expertisethat we don't have here at UTMB.
It's a great partnershipbetween human and veterinary
medicine, different fields ofvirology that are strong one
(03:51):
place and not in another.
The other thing that we'vereally done successfully is we
have, for example, senegaleseentomologists working to help
bring the expertise up in SierraLeone and Nigeria with mosquito
work.
They're really some of the bestin the world and they know the
populations in Africa muchbetter than I do or anyone else
in the US.
Really Having different Africangroups with different expertise
(04:14):
to do some cross training hasbeen pretty fulfilling too as
part of the center.
Speaker 3 (04:19):
That's amazing.
I think there's always thismodel in global health that
we're trying to get away from,which is jet setting from high
income countries to come and dostuff in low, low middle income
settings, And this idea ofreally setting up in country
networks, sharing expertise,learning from one another,
approaching that with humility.
I really think that's such agreat example of getting stuff
done.
Speaker 5 (04:42):
Welcome back to the Infectious Science Podcast.
I am Dr Dennis Bentham.
I am an associate professor inthe microbiology and immunology
department at the University ofTexas Medical Branch and the
Galveston National Lab.
Today we are recording aspecial episode.
We are on the road As part ofthe West African Center for
(05:03):
Emerging Infection Diseases.
We are in Nigeria And I'm heretoday with Dr Nathan Sheyew He's
an attending physician at theJoe's Teaching Hospital And Dr
Pam Luca he's a veterinarian andmolecular biologist at the
National Veterinary ResearchInstitute And Loya Inka Asala.
(05:26):
He's a veterinary researchofficer, also at the National
Veterinary Research InstituteAnd I'm very excited because we
will be talking about Nigeria,lhasa fever, african swine fever
and some other zoonoticdiseases in Nigeria And
hopefully we'll have time todive into one health in Nigeria
(05:46):
as well.
So welcome to the podcast, andI want to start with Dr Nathan
Sheyew And maybe you canintroduce yourself.
Tell us a little bit about yourcareer.
How did you end up becoming anattending physician at the Joe's
Teaching Hospital?
Speaker 6 (06:02):
Yeah, thank you, dennis.
My academic career startedEverything about my education is
in the northeastern part ofNigeria.
I was actually born in thenortheast.
I did my preliminary educationin the northeast, my
undergraduate in the northeast,but when I decided to come for
(06:23):
residency I came to NorthCentral Nigeria.
So growing up as a kid I hadthe desire to become a medical
doctor.
But when I went to college Istarted tossing around other
courses that probably might bebetter.
Growing up I started to do somehand skills of walking in
(06:46):
electrical workshop, repairingelectric fans, electric motors.
Then I started to say probablyI could develop something.
Some manually driven system canbe changed when I develop
electric motors.
So then, still in college, ithought of probably I will do
chemical engineering.
(07:07):
Then another thought I could dogeology, but somehow the
thought to read medicine andsurgery prevailed.
Then, of course, i readmedicine and surgery And it was
quite interesting.
And when I was studyingmedicine we are not studying to
pass, who are studying to gainknowledge.
(07:27):
We don't see reading, studyingas a burden, but we read with
excitement, we read beyond therequired syllables And what we
used to do those days is afterreading.
We have lots of groupdiscussions, so we'll be
challenging one another withwhat we've read and all of that,
and that's for us to keepreading and studying, and
(07:49):
studying.
After that, while then I startedmy housemanship at the
University of Maiduguri TeachingHospital.
So right when I was doing thehousemanship, which is
internship, then I also enrolledfor a graduate program,
master's in health planning andmanagement, and actually just
internship is a very hecticprocess.
(08:10):
So all of that actually createda milieu and opportunity for me
to work in difficultcircumstances, and I tell you
that some of the demandingsituation and circumstances that
I faced were just opportunitiesthat I had developed from those
experiences.
So outside that, I now decidedto go for residency.
(08:35):
Then I came to Josh UniversityTeaching Hospital And it was
quite challenging because oneneeded to get sponsorship and
the sponsorship was not tooforthcoming.
So I came to do residency witha little bit challenging
financial resources, but tomyself and to the family.
So it was really difficult.
There are times that one wouldeven attempt to track down to
(08:59):
the hospital.
So you could imagine that amedical doctor could attempt to
track down, because it was quitechallenging.
And as I kept on pursuing theresidency, then I started having
some resources.
Then, at a time many of mycolleagues had enough money to
be buying cars and I had somemoney So I had the option.
Then I got an opportunity toapply for an international
(09:20):
course in the US internationalcourse on applied epidemiology.
So the money that I had savedto buy a better car than the one
that I was using, which wasreally not too good I just used
that to invest in my education.
So that was when I attended theinternational course on applied
epidemiology organized by CDCand Emory University.
(09:43):
So that became a trigger and itcreated an interest in research
, collaboration, network and allof that.
So I came back and I completedmy residency and was employed as
a consultant physician with theJoss University, teaching also,
which is equivalent to like anattending physician.
So in a nutshell, that is it.
(10:03):
But I kept on having a desireto do another studies on
genomics and bioinformatics.
I just went for it again andalso gained knowledge.
So, in a nutshell, that's myeducational pathway.
Speaker 5 (10:17):
Thank you very much for sharing.
You mentioned your interest inelectronics and moving parts and
you mentioned the hand skillsand stuff like that.
So why didn't you end upbecoming a surgeon?
Speaker 6 (10:26):
Well why I didn't become a surgeon.
I checked my strengths and Irealized that clinicians are the
real, physicians are the real,because it needs.
When I was in my preclinicals Iwas very good in physiology
Well, even in most of thedisease.
But I love critical thinking,analytical thinking and all of
(10:48):
that And I just like internalmedicine.
And to my mind, when I wasdoing my national youth service
because in Nigeria, aftercompleting your undergraduate,
you will go for a mandatorynational youth service, so
during that time there'sopportunity that you practice
general medicine And at thattime I could do several
surgeries I repair herniarepairs, i do caesarean section,
(11:11):
i do lumpectomy, that is,removing of lumps.
So I felt that there was noneed to go beyond that.
That knowledge it is requiredif one is in any other place
where there is no specialist, soyou could draw from that.
So even to this day, if thereis opportunity to do surgery in
a rural place, of course I willdo it.
Speaker 5 (11:34):
So for the young audience, the medical students
or people interested in medicalschool, would you have any
advice for the career?
What was it for you?
Was it the mentors, or was itserendipity, or what shaped your
career?
Speaker 6 (11:48):
OK, first I realized that many people study a course
that they are not interested in,and so it becomes a burden.
On the other hand, there areseveral people that study a
course that was actuallybequeated to them, or they were
made to study a course that theynever liked it.
So you will see that the levelof commitment will never be the
(12:09):
same.
So what I tell people is thatwhen one has reached the point
of decision making regarding acourse of study, it's a very,
very important decision in lifethat must not be taken just at a
go, and many things need tocome.
Many people will just do ashort-term analysis, say
probably the duration of studyor how difficult it is or how
(12:32):
easy it is, but it's importantto know that once you choose a
career, it is something that youlive with for the rest of your
life.
So it's important to have theshort, medium and long-term
overview analysis and know yourstrengths, know your interests,
know where you're going.
Speaker 5 (12:49):
Then, before you now take a decision, Can you also
tell our audience how you endedup becoming part of the West
Africa Center for EmergingInfectious Diseases?
OK, for me first.
Speaker 6 (13:02):
I said that I don't want to be just an ordinary
clinician And I keep tellingpeople that if you just be a
clinician, they say that, ok,these are the symptoms of
pneumonia Someone will becoughing, someone will have
fever, someone will be weak.
That is the lowest level ofachievement, because anybody,
(13:24):
just you, just know that, yes,fever, cough, body weakness is
equals to pneumonia.
And of course, there are otherthings that, yes, it will lead
to investigation, but that isachieving, utilizing the
potentials that we have.
So it's important to go beyondthat, to go beyond just ordinary
(13:45):
thinking and asking relevantquestions, making discoveries.
And at some point I studied andlooked at those who made
discoveries Pluto, socrates, andsomeone that I respect so much
was asking us and challenging usall those who made discoveries,
do they have two brains?
(14:07):
Do they have two heads?
So if people passed all thesegreat scientists, philosophers,
they could sit down, they couldthink through.
Why couldn't I?
And so the first interest wasin LASA, in infectious disease,
because eventually Isubspecialized in infectious
disease And why I studiedinfectious disease?
(14:27):
Because I realized that mostthe challenge that I have, most
around me are infectiousdiseases, and then I realized
that diseases that have epidemicpotential, they are more
challenging And I have severalopportunities to see patients
with LASA fever where you willsee health workers.
once they say this is suspectedLASA fever, people will be
(14:49):
running away.
Then I will say that yes, thispatient needs to be cared for,
this patient needs to beattended to.
So I now started developinginterest in LASA fever And one
thing that is general withhealth care or research or
teamwork is lack of recognitionof other low-corder staff or
(15:10):
other people that are not inyour discipline.
Now it will surprise you thatat a point someone who everybody
will say this one is a juniorfaculty, a junior staff we are
seeing because he works with thestate minister of health.
He said that we are seeingpatients coming with LASA fever
in this hospital, a vangialhospital, which is the place
(15:30):
that the first case of LASAfever was ever managed in the
world.
And you are in the same city andyou are in the teaching
hospital.
You are a specialist.
Why is it that you have neverreported to us that you had LASA
fever?
So if it was yes, i'm a seniorfaculty I could have said what
are you saying?
But low and pure, i said, ok,let me start looking.
And immediately I start lookingand of course we started seeing
(15:52):
LASA fever.
So then we started to seepatients.
We started to writepublications, document our cases
.
Then I started to make somecollaboration and I realized
that there are several peoplewho needed some expertise, those
experts who are clinicians.
And that's how ProfessorSlobodan Pesla, who is
(16:13):
interested in LASA fever, whohas done the convenience studies
on LASA and has done somemodels of LASA fever hearing
loss in mouse models So hewanted to replicate, to have a
comprehensive study to see inhumans.
So that's how we wrote a grantNIH with him and we started to
(16:35):
work on LASA fever.
Speaker 5 (16:37):
Thank you, Dr Pam Luca.
What about you?
How did your career started out?
Tell us a little bit about yourstory, Yeah.
Speaker 1 (16:46):
I think my career started from the MVRI campus,
because that's where I was bornAnd my father worked there as an
attendant.
So when we were growing up weusually follow him to the vet
clinic And I think one thing Ilearned from him is that he's a
passionate person when it comesto taking care of animals,
(17:06):
because then at the veterinaryclinic animals could be admitted
, kept their money each before.
When they get better, then theowners come and take them, or if
someone is traveling, he canjust come to the clinic and keep
his animal and give money forfeeding, and then he does that
with a lot of commitment andpassion.
So sometimes we follow him andwe see And we also keep dogs
(17:29):
sometimes too.
In fact, here we don't reallyhave special food for animals,
but when you make food for mydad and he comes back and asks
as his animal eating, you saidno, he can take his food and
give to the animal.
So I think that's where Ipicked the passion.
And then, even when I finishedsecondary school and was going
for an undergraduate program, ithink I told myself I was going
(17:53):
to do veterinary medicine.
I went to a preparatory classand then I was given something
that would not give me a vetmedicine course.
I had to withdraw and then wentback prepared myself again and
went to the university Andeventually I did veterinary
medicine and came out.
And as soon as I came out, ithink I got a job as a sales rep
(18:14):
for a veterinary company.
So I was moving about sellingdrugs, selling animal feed and
other things.
So I think that too also helpedme to build some capacity when
it comes to human relationship,when it comes to personal drive,
because as a rep, nobody tellsyou what to do.
You're only given the targetfor the year.
You break it down into monthsand maybe into weeks, and then
(18:36):
you supervise yourself and youdo your work.
And it tells somewhere thatyou're doing your work.
If the sales are going, then itshows you're working.
If you're not making sales, itshows that you're not really
working.
So it's a system that helps youto be able to manage yourself
and be productive and have somepersonal drive, because it's
very necessary for whateverlevel of career you choose for
(18:58):
yourself, because if you'realways waiting for someone to
give you a push, you do notalways be there.
But like Nathan said, if it'salong the line of your interests
, it's along the line of yourstrength.
You can always jump out everyday and find yourself doing that
same thing that you love, butif someone is the one that is
asking you to do this, do that.
If the person is not theretomorrow, you will not be able
(19:20):
to continue.
So I think that I was able toget at the early stage of my
career.
So I did that work for a shortwhile and when I was going in
for that work I told myself Iwas going to do it for two years
.
Yes, i had the target.
I said I was going to do thisjob for two years and after two
years I'm off to do other things.
Because then I was alsointerested in business, i was
(19:41):
interested in financial issues,because then I also felt that if
I did not study veterinarymedicine, i would have studied
economics, genomics, economicsOh, economics.
Economics Because I wasinterested in business.
Speaker 5 (19:54):
Right Yeah.
Speaker 1 (19:55):
And then eventually, i think after I got employed
with the National VeterinaryResearch Institute, where I
started my career as a generalperson in the lab, doing
diagnostics, managing some otherscientists like technician, and
then growing to the rank thento my master's in molecular
biology and PhD, where I workedon ASF as the African Swine
(20:19):
Fever, and I did the master'sand the PhD in a resource
limited environment.
It's not like a high tech, butyou were exposed to doing things
, basic things, basic science,because you don't have the kit,
the extraction kit, to doextraction although you are
doing molecular biology.
So you could do theconventional extraction of maybe
(20:43):
chloroform isoamyl, you knowall those things.
And then, if it's a lysa, youcould just get your antigen and
you challenge some laboratoryanimals and generate polyclonal
antibodies and you play aroundwith it.
So eventually, when you havethe commercial one, it gives you
an idea of what is making thatto work.
So I think that's actually whathas been my journey into
(21:04):
veterinary medicine.
Like I said, it started with myfather.
It was what my dad was doingthat I picked interest in And as
I moved on, he finding things.
But interestingly, i think, iwent back to my yearbook, my
secondary school yearbook and Irealized that in that yearbook I
said I wanted to be avirologist.
So it's like a dream you hadand it's coming to reality,
(21:26):
although not as quick as youwanted it or not even as in the
places you want, although Iwasn't specific where I wanted
to be.
But I knew that this is what Iwant to be in life.
And you know, like they say, becareful, what you wish for, you
may get it.
So that was what I wished forand maybe that has been the
drive and it led me to where Iam.
Speaker 5 (21:46):
So there's no point in your early career or in your
secondary school, where youthought about becoming a human
doctor or physician, no, why not?
Speaker 1 (21:56):
Because I think it's the environment, because I grew
up in a veterinary researchinstitute compound where I see a
lot of veterinarians and someof them were like role model per
se.
I saw them and I said I want tobe like them.
So the environment had a rolein what I became anyway, because
I didn't grow up where thereare a lot of medical doctors.
(22:18):
Perhaps if I grew up where theyare I would have become a
medical doctor.
But, like I said, I grew up ina place where veterinary
medicine was practiced and mydad would also work there and
his passion and his commitment.
I said why not?
But I knew that whatever I'dchosen to do, I would do better
in it.
Speaker 5 (22:34):
What's your favorite animal, favorite animal to work
with?
Speaker 1 (22:37):
Dog.
I like dog because in my houseright now I have a dog, I have a
cat, my wife keeps poultry.
I love animals.
Speaker 5 (22:45):
Thank you for sharing .
It's a very interesting story.
Nathan, you mentioned that youspecialized in infectious
diseases and we touched brieflyon LASA virus, so for our
listeners, there might be somethat know about LASA virus, but
you also mentioned that LASAvirus was discovered here in
Nigeria.
Can you tell the audience a bitabout LASA virus?
How do humans become infectedAnd what does the disease look
(23:09):
like in humans And what can bedone to treat the disease?
Speaker 6 (23:12):
Okay, before I dive into the issue of the LASA fever
, because listening to Luka andAsala, they made reference to
some historical perspectives.
That has to do with eithertheir parents or these things,
and I realized that historicalperspective it's very, very
important in shaping one'scareer choice or many things in
(23:33):
life.
And my dad actually was alaboratory scientist and he is
now over 87 years old.
And do you know that he was thefirst person to have described
how a mycobacterium tuberculosisbaslite looks like?
Yes, the pathogen, the jam thatcauses tuberculosis.
(23:53):
So he would be describing to meand be telling me when I was
young what they were doing, howthey will use microscopes to
make diagnosis of this disease,of syphilis, of gonorrhea, and
he would even describe how theywere doing autopsies, how they
will cut skull and remove thebrain and they will later stitch
(24:18):
it back and nobody would know.
And for me I just compared whatthey were doing that time with
very short duration of trainingThey were able to do so many
things.
So even that time, justlistening to that, it kept on
gradually increasing my desireto read medicine And he believed
in me that this guy is verygood and he will never fail
(24:41):
anything.
So to live to that expectation,i have to force myself to read
extra hard so that failure willnot be an option.
So now talking about LASA fever.
Lasa fever is an infectiousdisease, and an infectious
disease that is caused by avirus.
And why it is called LASA fever?
(25:02):
Because the first disease thatwas eventually diagnosed in the
United States first occurred ina white missionary who was
working in a town innortheastern Nigeria called LASA
So the actual name of the townis LASA And eventually the white
missionary was lifted andbrought to Plato State, nigeria,
(25:23):
at the Evangel Hospital whereshe was initially managed, and
after that several people camedown with the disease.
So if a patient has LASA fevers, there are some symptoms that
the person will present.
The first most common symptomsit will start with fever, then
with sore throat and generalbody weakness, then, as time
(25:45):
progress, then the patient willbegin to bleed from the nose, at
times from the gums, at timesthe person will be urinating
blood, at times.
Then the urine will begin toreduce until the kidney may shut
down And the disease istransmitted through rodents.
When someone either in theprocess of preparing because
(26:06):
there are some areas thatactually prepare rodents as
delicacy So in the process ofprocessing it to eat.
Then there are some areas inNigeria that spread dry foods
outside and rodents could go andurinate or defecate on it.
So if it is consumed it canalso lead to LASA fever.
But the most challenging thingabout LASA fever is that it can
(26:29):
be transmitted from human tohuman, and that's what pose a
big challenge, both locallywhere it is and also the
potential that it can betransported outside the country,
because if someone is sick, orprobably someone, may begin to
have fever and eventually willtravel to other parts of the
country and eventually will nowdevelop LASA fever and it will
(26:53):
keep spreading.
So essentially, this is thegeneral picture of LASA fever.
Speaker 5 (26:58):
So please correct me if I'm wrong, When I've never
seen a LASA patient.
When I read textbooks aboutLASA fever, some people say
because it's classified withother hemorrhagic fever such as
Ebola virus or Crimean Congo orother hemorrhagic fever virus.
Some people say the hemorrhagicpresentation is not as
prominent as is with, like maybesome of the other hemorrhagic
(27:20):
fever viruses.
Do you agree or do you disagree?
Speaker 6 (27:24):
Well, from what we have seen, there are several
unanswered questions, becausethere are times I have seen many
patients coming down withsevere hemorrhagic disease.
They will come with LASA feverwithin three, four days.
They are hemorrhaging, bleedingeverywhere and they are gone.
And then there are patientsthat will come with mild
(27:48):
symptoms and of course you knowthat over 80% of LASA fever may
be asymptomatic, but even the20% symptomatic, the severity
varies And even within the samefamily who are exposed to the
same environmental condition,who had human-to-human contact
with LASA fever, you will seethe husband may have LASA fever
(28:09):
with hemorrhage and probably thewife will just have LASA fever
with mild symptoms, and some maybe asymptomatic.
And you could see that in onepart of the country you may have
severe symptoms and in someother part there may be mild
symptoms.
So if one will just give ablanket answer that it doesn't
have comparative hemorrhagicsymptoms like other, then it is
(28:31):
not the entire story.
Speaker 5 (28:33):
Okay, what can be done to save the patient?
Speaker 6 (28:36):
Well, the challenge with saving patients with LASA
fever has to do with earlydiagnosis, early presentation to
the hospital and the requisitetraining to the personnel, first
on infection prevention andcontrol and also on the
management And, aside from that,the issue of compassionate care
(28:58):
.
I tell you I have seen lots ofpatients with LASA fever who
have died because they presenteda late and you would see the
anguish that the family and thefear because it comes with
double stigma.
You will see that family, theyhave lost a relation because of
LASA fever and they arestigmatized.
(29:20):
They are also afraid that theymay eventually come down with
LASA fever.
So there's so much psychosocialchallenges.
So they need a compassionatecare of a physician And on the
other side you have severalhealthcare workers who are
afraid to take care of patientswho have LASA fever.
So now here you are.
(29:41):
You have a relation who isdying of LASA fever and you have
healthcare workers who aretimes.
For realistic purpose, theyneed to wear appropriate gear
before they could see.
So even if someone is wearingthe appropriate gear, the first
marks, n95 marks and the gownthe relation would expect the
(30:01):
healthcare worker should justrush without the appropriate
gear in order to attend to thepatient.
Then, on the other hand, thereare several others who wouldn't
want to have anything to do withLASA fever.
I just give you one case.
We were trying to give atraining on one of the
hemorrhagic fevers, so someonewas in the ER a health worker
who was saying come for training.
(30:22):
I said no, no, no, no.
I don't want to have anythingwith LASA fever or anything, but
the person is still in thehospital.
So I realized that there isalways a gap regarding
compassionate care, regardinghuman capacity development and
regarding interest.
Speaker 5 (30:37):
Nathan, you mentioned that there are healthcare
workers that don't want to gointo those rooms, that don't
want to work with these patients.
What about you?
Are you not afraid?
Speaker 6 (30:48):
Yes, you see, i wrote a paper and I published it
locally and I said thathealthcare environment is a war
zone And there are severalpeople who enroll into army and
they go to wars.
And if anybody that elists as amilitary person, it means that,
yes, he knows that he willprepare for war.
So and you say you are aclinician.
That's one thing.
(31:08):
I'm a clinician Then.
The second thing is that I havethe compassionate care based on
my faith and belief in God that, yes, i need to help those who
are suffering, i need to carefor those who are weak.
So anytime someone hassuspected or confirmed LASA
fever, there's a trigger and forme it's so gratifying The
(31:29):
number of patients that I'vetreated with LASA fever if they
see me, the gratitude you cannever, ever compare it.
The sense of satisfaction, thegratitude when orders, even
their family relations, arerunning away from them, but I
come to help them, care for themYou can never compare that.
Speaker 5 (31:50):
What about your family?
What about your wife and yourchildren?
What do they think about whenyou go into those wards?
Speaker 6 (31:57):
Yes, unfortunately there was one incident that
another hell worker, who iswalking, even in my hospital,
went and was telling my wife andmy family you see a husband,
he's going to be seen patientwith LASA fever when others are
running away.
He's not wise.
He's not wise, he's a fool.
But the good thing is that Ihave a very strong family, very
supportive wife.
(32:18):
I remember if it is because,yes, she knows that, yes, i'm
reading medicine And even in theearly part of marriage, when
I'm on call, we will drive tothe hospital together.
She will be in the car, i willgo and see patients and go back
And I carried her through allthat.
I'm doing And anytime, forinstance, even before I
(32:39):
subspecialize, if I go to help apatient, i will come and report
and say see what I have done,see how I have saved this.
So she's a partner.
Actually She's a partner, andthere are several times that I
will be needed to go to attendto a patient.
It may be even through thenight.
There was a time that patientwas really ill And I saw that
before the hospital ambulancewould come and pick me and I
(33:01):
because it will take time.
So I just drove through thenight And that wouldn't have
been possible if my wife said no.
If she said no, i wouldn't havegone because I have a
justifiable reason.
So it's a good support.
And I tell you there is nocareer, there is nothing that
one will be successful without agood, supportive family.
Speaker 2 (33:21):
Thanks for listening to the Infectious Science
podcast.
Be sure to hit subscribe andvisit infectiousscienceorg to
join the conversation, accessthe show notes and to sign up
for our newsletter and receiveour free materials.
Speaker 3 (33:32):
If you enjoyed this new episode of Infectious
Science, please leave us areview on Apple Podcasts at
Spotify and go ahead and sharethis episode with some of your
friends.
Speaker 2 (33:41):
Also, don't hesitate to ask questions and tell us
what topics you'd like us tocover for future episodes.
To get in touch, drop a line inthe comments section or send us
a message on social media.
Speaker 3 (33:50):
So we'll see you next time for a new episode, and in
the meantime, stay happy stayhealthy, stay interested.
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