Opposed to the belief the National Centre for Disease Control wants people to have in Nigeria, Ribavirin, the only drug that is being used currently to treat Lassa fever doesn’t subdue viral production, viral transmission, or improve immune response.

The drug only efficiently subdues the Lassa virus replication in vitro (in a test tube), and shows only moderate effectiveness in minimizing presence of viruses in the blood in a living thing.

That was the result of a research of six scientists led by Kirsten Alexandra Eberhardt of the Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany, and published in peer-reviewed International Journal of Infectious Diseases.

The researchers said,

The quality of evidence for the use of Ribavirin is very low, stemming largely from a single non-randomized clinical trial with historic controls and high risk of bias.

Based on the available data, current treatment guidelines may therefore put patients with mild Lassa fever at increased risk of death.

They warned,

The role of Ribavirin in the treatment of Lassa fever requires urgent reassessment.

The researchers said, while writing about the disease, that Lassa fever is clinically hard to differentiate from other endemic febrile illnesses in West Africa. They noted that its symptoms include cough, pharyngitis, fever and gastrointestinal complaints.

The researchers said,

In later stages, bleeding, facial oedema, convulsions, pericardial effusions and coma are commonly observed,

They noted that, unlike Ebola virus disease, there is no known advanced vaccine available on the market for the treatment of Lassa fever. They added that Lassa fever treatment is “largely supportive” and that

no antiviral drug has been approved by the United States Food and Drug Administration or the European Medicines Agency for its treatment.

The study said despite concerns in reference to lack of specificity and toxicity, Ribavirin, a guanosine analogue that is active against a wide range of RNA and DNA viruses has become an accepted off-label treatment for Lassa fever and is the recommended standard treatment for patients in international and national guidelines.

These recommendations are, however, based largely on a single clinical trial, performed in Sierra Leone in 1986, which suggests a beneficial effect of Ribavirin, especially when given within the first six days after onset of symptoms.

However, due to the non-specific nature of symptoms, treatment initiation is often late and associated with adverse treatment outcome,

the researchers regretted.

Recall that in September 2017, a study published in peer-reviewed Nature had stated that,

Ribavirin significantly improves Lassa fever outcome when administered in combination with sub-optimal doses of Favipiravir, a strong antiviral drug.

In China, scientists are currently studying Favipiravir for coronavirus experimental treatment.

However, the scientists noted that the

mechanisms explaining these conflicting findings have not yet been determined.

Consultant Virologist and former chairman of presidential task force on Lassa fever, Prof. Sunday Omilabu, while speaking on how authoritative the latest research was, told journalists that there were a couple of ongoing researches regarding Lassa fever treatment. However, he stated that the findings were not yet approved.

He explained that the only available and accepted drug for Lassa fever treatment is Ribavirin, noting, however, that efforts were still on the way to bring up other combinations.

He said Lassa fever treatment using a combination of Ribavirin and Favipiravir was still at clinical trial stages.

They are still at trial stages. Though most of them have promises, they are yet to be approved.

Ribavirin is the only drug of choice that we know, of which, if started very early, is very efficacious in the treatment of Lassa fever,

he said.

Speaking about the availability of Ribavirin in the local market, Omilabu said the Nigeria Centre for Disease Control (NCDC) usually “pre-position” the drug before any outbreak of the deadly disease.

It is readily made available by NCDC and positioned around endemic states.

Once a case is confirmed, I can assure you that in the next few hours, the drug will be supplied.

Everything about the treatment of Lassa fever is free — the diagnosis and treatment are taken care of by the Federal Government.

The minimum duration treatment with Ribavirin is 10 days, if it is administered intravenously.

Once viral load drops and the patient gets better, the treatment is then changed to tablets,

he said.

The Director of Research and Head, Microbiology Department, Nigeria Institute of Medical Research, Lagos, Dr. Rosemary Audu, also spoke on the issue and said that Ribavirin was not originally meant for Lassa fever treatment but remains the recommended medication.

She explained that although the drug has side effects, it remains the only available drug for treating the acute viral haemorrhagic illness.

Justin Nwosu

Justin Nwosu is the founder and publisher of Flavision. His core interest is in writing unbiased news about Nigeria in particular and Africa in general. He’s a strong adherent of investigative journalism, with a bent on exposing corruption, abuse of power and societal ills.