In October 2024, a middle-aged Iowa resident was admitted to the University of Iowa Health Care Medical Center in Iowa City with a rare case of Lassa fever, a deadly viral illness that causes brain swelling and excessive bleeding. The virus is endemic in some parts of Africa but not the U.S. and can spread between people through direct person-to-person contact.
To treat the patient, who likely contracted Lassa during a recent visit to west Africa, and prevent it from spreading, the University of Iowa’s healthcare workers turned to colleagues who work at the University of Nebraska Medical Center’s Global Center for Health Security.
The Nebraska center was established in 2017 to support health system preparedness and response to catastrophic public health emergencies and houses the only U.S. national quarantine unit for dangerous contagious diseases. Many of the Center’s experts have relied on the World Health Organization’s expertise and surveillance data to respond to possible rare infectious disease events in the U.S., including Lassa fever.
We spoke with University of Nebraska’s global health experts John Lowe, PhD, director of the Global Center for Health Security, and Jocelyn Herstein, PhD, MPH, a center scholar, about the Lassa fever case and how they interact and rely on the WHO.
Lowe’s and Herstein’s answers have been edited for clarity.
Tell us about how you helped your University of Iowa colleagues respond to the patient they were caring for with Lassa last October.
Lowe: The Lassa case was identified in a myriad of ways. One of the first things we did to help was pull together a meeting of our international colleagues experienced with Lassa, many of who we met through World Health Organization meetings and engagement. We are all in regular contact to share lessons learned and recommendations on responding to potential health emergencies. But we reached out to our colleagues in this specific case because we almost never see Lassa fever in the U.S. and because of that, we have limited experience managing it. We knew that our colleagues could help inform our response based on their experiences with Lassa fever.
What ultimately happened to this patient and did anyone else develop Lassa?
Lowe: This was an individual who had traveled back from West Africa and had been doing some construction-related activities that may have exposed him to rodents which can carry the Lassa virus. He fell ill after he returned to the U.S. and presented to the healthcare system. Lassa does not easily spread between people, but it can, and since we almost never see Lassa, there were just a lot of unknowns. Unfortunately, the person passed away, but because we were able to quickly share our expertise and connect with our networks of experts with experiences treating Lassa cases, our Iowa colleagues knew what precautions to take. No one else got sick after caring for the patient. This is why our relationships with the WHO are so important. They provide us with access to hands-on experience in outbreak response and treating patients for illnesses we don’t normally see locally.
In what other ways have you and your team interacted with and relied on the WHO?
Herstein: In the U.S., we are one of 13 dedicated isolation facilities for high-consequence infectious diseases. Back in 2014, we were one of the places that cared for U.S. responders who contracted Ebola while working in west Africa. As Director of International Partnerships and Programs for the U.S.’s National Emerging Special Pathogens Training and Education Center , I regularly work with and learn from WHO colleagues. The WHO recently created a WHO training academy to help all public health responders, including Americans, better prepare for health emergencies. The academy trains how to implement infectious disease prevention controls, safely manage patients with high-consequence infectious diseases, and how to protect oneself while doing so. We also get WHO updates on best practices, clinical guidelines and ongoing outbreaks. This is crucial information that we receive by being part of the WHO’s global health network that informs our readiness locally and nationally.
We get WHO updates on best practices, clinical guidelines and ongoing outbreaks. This is crucial information that we receive by being part of the WHO’s global health network.
And what about the U.S. response bird flu? How has the WHO been helpful?
Lowe: Over the last year, we’ve seen an unprecedented level of bird flu in animals, all over the world, but very much in our hemisphere, wiping out entire wild birds and sea mammals. We are beginning to see this trickle of human cases in the U.S. too, as well as a transition to infections at large agricultural operations, both poultry and dairy farms. To evaluate how alarming this is, we rely on international data about the different strains of bird flu virus around the world. That data is collected by the WHO and then shared with everyone, so we can understand how concerned we should be and how to be targeted we can be with our response. That is why remaining part of the WHO is so important.