Irrua

Since Saturday evening, Eric, Christian and I have been in Irrua. We are staying at a nice hotel, though electricity is rare and hot water, as Eric put it, is never. They make good food though, and so far no one has been sick. Eric discovered his true Nigerian roots last night when he ordered bushmeat (grasscutter), and to my amazement thought it was delicious!

We have begun our work at the Irrua Specialist Teaching Hospital, where our Lassa ward and sample collection is located. Soon after we arrived on Saturday, we began to hear of the many headaches that had sprung up since Christian’s last visit here several months ago. The printer had disappeared from the office, some people were not doing their jobs, we needed a new freezer, none of the forms had been entered, and the list went on. Christian tackled each with his characteristic mix of exasperation and energy, and things began to get done.

Yesterday we made the frustrating discovery that none of the patient data had been entered, and the samples were not in the labeled kits we had sent. Eric and I spent the day entering hundreds of forms, while the lab technicians, admonished by Christian, relabeled the samples.

Even from just the sparse information on the records, personalities shined through. These brief glimpses into patients’ lives began to put a face to the horrible symptoms I had read about back in the US - fever, deafness, edema, conjunctival hemorrhage, spontaneous abortion.

We met with one of the directors of the hospital, and had a very interesting discussion about our project and his experience here in the field with Lassa. He said he was very interested and reassured to hear our preliminary estimates that the diagnostic was only 50% sensitive, because he sees many cases he is sure is Lassa which came up PCR-negative. He also told us about a very interesting case of a woman who had Lassa in pregnancy, refused treatment, and survived with her baby. Since current wisdom says fatality is 100% for fetuses during pregnancy, we were happy to hear this and excited to follow the case up.

We finally finished entering the forms in the evening, and headed back to the hotel for our late dinner. The unbelievably good pineapple and papaya we had for dessert nearly made up for the long day – I don’t think I’ll ever be able to eat American pineapple again. Today we plan to go through the hospital records for all of our suspected and confirmed cases.