The deuce-ace of Lassa Fever, Ebola virus disease and COVID-19 simultaneous infections and epidemics in West Africa: clinical and public health implications

Abstract

Globally, the prevailing COVID-19 pandemic has caused unprecedented clinical and public health concerns with increasing morbidity and mortality. Unfortunately, the burden of COVID-19 in Africa has been further exacerbated by the simultaneous epidemics of Ebola virus disease (EVD) and Lassa Fever (LF) which has created a huge burden on African healthcare systems. As Africa struggles to contain the spread of the second (and third) waves of the COVID-19 pandemic, the number of reported cases of LF is also increasing, and recently, new outbreaks of EVD. Before the pandemic, many of Africa’s frail healthcare systems were already overburdened due to resource limitations in staffing and infrastructure, and also, multiple endemic tropical diseases. However, the shared epidemiological and pathophysiological features of COVID-19, EVD and LF as well their simultaneous occurrence in Africa may result in misdiagnosis at the onset of infection, an increased possibility of co-infection, and rapid and silent community spread of the virus(es). Other challenges include high population mobility across porous borders, risk of human-to-animal transmission and reverse zoonotic spread, and other public health concerns. This review highlights some major clinical and public health challenges toward responses to the COVID-19 pandemic amidst the deuce-ace of recurrent LF and EVD epidemics in Africa. Applying the One Health approach in infectious disease surveillance and preparedness is essential in mitigating emerging and re-emerging (co-)epidemics in Africa and beyond.

Travel-Related Monkeypox Outbreaks in the Era of COVID-19 Pandemic: Are We Prepared?

“…Amid the monkeypox outbreak, the first COVID-19 case in Nigeria was reported in March 2020 [29,30]. The onset of COVID-19 limited international travel and movement, which may account for the few cases of MPVX reported in 2020 and no record of travelrelated or exported cases [30].…”

“…Amid the monkeypox outbreak, the first COVID-19 case in Nigeria was reported in March 2020 [29,30]. The onset of COVID-19 limited international travel and movement, which may account for the few cases of MPVX reported in 2020 and no record of travelrelated or exported cases [30]. The focus on COVID-19 may have been a disadvantage in the fight against monkeypox and other endemic diseases as most Nigerian states laid emphasis on the surveillance and monitoring of the pandemic [30].…”

“…The onset of COVID-19 limited international travel and movement, which may account for the few cases of MPVX reported in 2020 and no record of travelrelated or exported cases [30]. The focus on COVID-19 may have been a disadvantage in the fight against monkeypox and other endemic diseases as most Nigerian states laid emphasis on the surveillance and monitoring of the pandemic [30]. In addition, the fear associated with COVID-19 may have led to people not seeking care in health facilities, resulting in missed cases [30].…”

“…The focus on COVID-19 may have been a disadvantage in the fight against monkeypox and other endemic diseases as most Nigerian states laid emphasis on the surveillance and monitoring of the pandemic [30]. In addition, the fear associated with COVID-19 may have led to people not seeking care in health facilities, resulting in missed cases [30]. Current estimates show that there are currently 21 cases of MPVX and one death in Nigeria [5], which calls for concern, given that countries are lifting restrictions on COVID-19.…”

Designing a novel multi‑epitope vaccine against Ebola virus using reverse vaccinology approach

“…EBOV is transmitted from wild animals to humans and spreads through human-to-human transmission 7 . Human-to-human transmission of EBOV occurs through direct contact with infected people's skin, contact with blood and body fluids, and sexual intercourse, handling, secretions, organs, or other bodily fluids of infected people 8 .…”