Samples: From Patient to Laboratory 4000 miles away
VHFC researchers take a diverse approach to investigating the Lassa virus, as well as the human immune response to the virus. They study the structure of the virus, develop rapid diagnostics assays and try to understand how the virus evolves over time. Acquiring samples to enable research and diagnostics development to take place is a challenging process, consisting of a multitude of logistical and technical hurdles.
Lassa fever is endemic in rural West Africa, in areas with limited infrastructure for research and transportation. Once a patient arrives at a hospital where a blood sample can be obtained and analyzed, the highly contagious nature of the virus makes handling the sample risky for both medical staff and laboratory technicians. In order to minimize the risk of transmission, hospital staff adhere to strict usage of personal protective equipment. This includes wearing masks, gloves, gowns, face shields, and protective footwear whenever drawing blood samples from Lassa patients or handling the samples in the laboratory.
For the purposes of scientific research, different components of the blood sample need to be extracted, deactivated, stored and shipped to laboratories in the United States. Maintaining the quality of the samples throughout this process is notoriously difficult. Quality control in turn is important in order to ensure that results are reliable. As anyone conducting research that relies on samples from remote locations, contamination and quality degradation are something to be constantly mindful of. It is with this challenge in mind that Stephen Gire, a research scientist with the Sabeti Lab at Harvard University, recently traveled to Sierra Leone. Stephen and his colleagues rely on samples from the Kenema Government Hospital for their analysis of the Lassa virus genome as well as the genomes of the infected patients. Their challenge was to employ a sample storage solution that would be easily incorporated into the existing work flow of the laboratory technicians working at the hospital. Whilst technicians conduct valuable work for Western researchers, they are also tasked with processing the day to day laboratory testing requirements of the hospital. By understanding the processes already at play in the laboratory, Stephen and his colleagues could ensure that any new technologies or operating procedures that were introduced would not disrupt the daily work of the technicians.
Introducing new technologies and training local staff in implementation is crucial to the progress researchers are making in understanding the dynamics of Lassa fever. During his time in Kenema, Stephen worked closely with the Director of the Lassa Laboratory, Augustine Goba. Mr. Goba is responsible for the development and execution of research programs at the Kenema Government Hospital and manages a team of laboratory technicians. Any new technologies or techniques related to sample processing go through him and he in turn trains the rest of his team.
Initial results from samples processed using a new method from the company Biomatrica implemented by Stephen and his collaborators in Sierra Leone, look very promising. However, maintenance and continuous monitoring are crucial in order to ensure best possible outcomes. Stephen’s colleague, Kristian Andersen will be traveling to Kenema soon to see how the new technologies are faring, and to implement changes if necessary. Good quality samples are very much a result of a group effort. By maintaining not only the operating procedures, but also the relationships with individuals at every stage of the collections, researchers are able to acquire the materials they need to take steps towards understanding the mechanisms behind the Lassa virus.