Low and middle income countries in Africa are confronted with the challenge to timely and accurately diagnose dangerous diseases that can spread from animals to humans and to prevent their further spread. The IAEA, in partnership with the Food and Agriculture Organization of the United Nations (FAO) and in collaboration with the World Health Organization (WHO), is providing assistance to African Member States on the use of nuclear-derived techniques in identifying and characterizing quickly and effectively zoonotic diseases such as Ebola, Highly Pathogenic Avian Influenza, Crimean-Congo haemorrhagic fever and Rift Valley fever quickly and effectively.
In cases where a single pathogen needs be identified from among a million similar micro-organisms, nuclear technologies are the only platform to provide the high sensitivity and specificity necessary. Catching these pathogens in livestock and wildlife helps in anticipating possible risks of transfer to humans.
Before scientists, veterinarians and field workers can undertake zoonotic diagnostic tests on animals, they need to learn how to protect themselves and prevent further spread of the diseases to animals or humans. An IAEA training held in Cameroon earlier this autumn taught them exactly that.
“Training courses such as this one help to bridge the knowledge gap and ensure personnel safety,” said Victor Matt-Lebby, senior health specialist and Director of Hospital and Laboratory Services in Sierra Leone. During the 2014-2015 Ebola outbreak, which claimed over 4000 lives in his country, several of Matt-Lebby’s field workers and scientists succumbed to the disease. “We have experienced how important it is to protect our personnel when handling contaminated samples.”
Other countries, luckily, do not have first-hand experience in dealing with outbreaks as virulent as the Ebola outbreak in Sierra Leone and its neighbours, but the danger of zoonotic diseases is a real threat to the entire continent, as demonstrated by the current Highly Pathogenic Avian Influenza (HPAI-H5N1) epidemic in several West-African countries. “We need to empower our local field teams and staff to collect field samples in a safe and secure way and our laboratories to safely analyse these samples using nuclear-derived technologies,” said Stella Acaye Atim, a veterinarian from Uganda, one of 17 participants in the one-week course.
These nuclear-derived technologies play a critical role in the early and rapid detection of these diseases, using applications such as the polymerase chain reaction (PCR), reverse transcription polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA), explained Michel Warnau, Section Head in the Technical Cooperation Division for Africa at the IAEA. “These cutting-edge technologies are recognized as fast and efficient, as within a few hours they can detect specific zoonotic viruses,” he said. “But a prerequisite to this work is to learn about protective gear sample collection, handling and transportation – all in a safe and secure way.”
The barrier between the skin and the virus: wearing protective gear
“Double gloves, boots and overshoes, face masks, goggles, full head cover make up the uncomfortable but essential equipment that veterinarians and field workers need to wear,” said Trevor R. Shoemaker, an epidemiologist from the U.S. Centers for Disease Control and Prevention, based in Uganda. “To top it all, literally, another layer of plastic is wrapped around the body for extra safety”.
During the practical demonstration of irradiated personal protection equipment, many participants noted the criticality of full body cover, making sure that no skin was exposed. After double checking that there was no risk of exposure, the safety outfit needs to be scrupulously checked by another person.
“For me, this training has been an eye-opener as I have understood how I need to kit myself for any investigation using the protective gear,” said Amina Garba S. Abu, a laboratory scientist from Nigeria. “We also need to be mindful of when discarding material, to ensure that it’s been thoroughly sprayed with a disinfectant.”
Wearing the personal protection equipment is no easy feat, particularly as the almost hermetically sealed environment inside is extremely warm. “Working in this gear for more than 40 to 50 minutes is quite a challenge,” said Hermann Unger of the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture.
From collection to transportation: Monitor and track samples
While collecting and transporting samples, it is vital that the samples are properly sealed, placed in air tight containers, correctly labelled and shipped with utmost care. This was another aspect of the course, where participants also received information on how to handle extremely dangerous infectious agents and biomaterials and how to use specific containment equipment.
While collecting samples, care needs to be taken to prevent any possible drips or leaks, said Thomas Strecker, a lecturer at the Institute of Virology of Marburg University, Germany. “You need to be alert to prevent unknowingly transmitting the viruses.”
This course, prepared in response to Member State needs, supports African countries in strengthening preparedness against possible animal and zoonotic disease outbreaks, so that they are better prepared and can implement the appropriate preventive and control measures as early as possible. In the case of Sierra Leone, for instance, laboratory equipment received from the IAEA last year has been crucial to the diagnosis of Ebola in parts of the country, Matt-Lebby said.
Participants from Benin, Burkina Faso, Cameroon, Côte d'Ivoire, Ghana, Mali, Nigeria, Sierra Leone, Togo and Uganda attended the training in Cameroon, and many of them will participate in the follow-up training in Uganda in December, where they will be using nuclear-derived techniques whilst wearing protective gear and applying safe and secure analyses, said Ivancho Naletoski of the Joint FAO/IAEA Division.
We have experienced how important it is to protect our personnel when handling contaminated samples