A traveller returning to the United States from West Africa brought home more than photographs and memories…They came back infected with Lassa fever, a virus that can be deadly if untreated. It is similar, but unrelated to Ebola.
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Lassa Fever Case in Minnesota Shows How Easily Deadly Viruses Can Travel the Globe
A traveller returning to the United States from West Africa brought home more than photographs and memories…They came back infected with Lassa fever, a virus that can be deadly if untreated. It is similar, but unrelated to Ebola.
CDC Director Tom Frieden said in a statement released yesterday:
“This imported case is a reminder that we are all connected by international travel. A disease anywhere can appear anywhere else in the world within hours,”
Lassa fever is a haemorrhagic fever but can be treated with the anti-viral drug Ribavirin. Ebola has no treatment or cure.
The man flew into New york from West Africa before flying on to Minneapolis and officials are working with airlines to identify and contact passengers and others who may have had close contact with him.
There have only been seven cases of Lassa ever recorded in the United states, all of them in travellers returning from business or vacations. The disease is common in Africa where about 5000 cases a year out of the 100,000 plus cases reported prove fatal.
The World Heath organization states:
Lassa fever is an acute viral haemorrhagic illness caused by Lassa virus, a member of the arenavirus family of viruses. It is transmitted to humans from contacts with food or household items contaminated with rodent excreta. The disease is endemic in the rodent population in parts of West Africa. Person-to-person infections and laboratory transmission can also occur, particularly in the hospital environment in the absence of adequate infection control measures. Diagnosis and prompt treatment are essential.
The CDC gives the following information on the disease:
Transmission of Lassa virus to humans occurs most commonly through ingestion or inhalation. Mastomys rodents shed the virus in urine and droppings and direct contact with these materials, through touching soiled objects, eating contaminated food, or exposure to open cuts or sores, can lead to infection.
Because Mastomys rodents often live in and around homes and scavenge on leftover human food items or poorly stored food, direct contact transmission is common. Mastomys rodents are sometimes consumed as a food source and infection may occur when rodents are caught and prepared. Contact with the virus may also occur when a person inhales tiny particles in the air contaminated with infected rodent excretions. This aerosol or airborne transmission may occur during cleaning activities, such as sweeping.
Direct contact with infected rodents is not the only way in which people are infected; person-to-person transmission may occur after exposure to the virus in the blood, tissue, secretions, or excretions of a Lassa virus-infected individual. Casual contact (including skin-to-skin contact without exchange of body fluids) does not spread Lassa virus. Person-to-person transmission is common in health care settings (called nosocomial transmission) where proper personal protective equipment (PPE) is not available or not used. Lassa virus may be spread in contaminated medical equipment, such as reused needles.
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Signs and symptoms of Lassa fever typically occur 1-3 weeks after the patient comes into contact with the virus. For the majority of Lassa fever virus infections (approximately 80%), symptoms are mild and are undiagnosed. Mild symptoms include slight fever, general malaise and weakness, and headache. In 20% of infected individuals, however, disease may progress to more serious symptoms including hemorrhaging (in gums, eyes, or nose, as examples), respiratory distress, repeated vomiting, facial swelling, pain in the chest, back, and abdomen, and shock. Neurological problems have also been described, including hearing loss, tremors, and encephalitis. Death may occur within two weeks after symptom onset due to multi-organ failure.
The most common complication of Lassa fever is deafness. Various degrees of deafness occur in approximately one-third of infections, and in many cases hearing loss is permanent. As far as is known, severity of the disease does not affect this complication: deafness may develop in mild as well as in severe cases.
Approximately 15%-20% of patients hospitalized for Lassa fever die from the illness. However, only 1% of all Lassa virus infections result in death. The death rates for women in the third trimester of pregnancy are particularly high. Spontaneous abortion is a serious complication of infection with an estimated 95% mortality in fetuses of infected pregnant mothers.
Because the symptoms of Lassa fever are so varied and nonspecific, clinical diagnosis is often difficult. Lassa fever is also associated with occasional epidemics, during which the case-fatality rate can reach 50% in hospitalized patients.
Take care
Liz
Sources:
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Contributed by Lizzie Bennett of Underground Medic.
Lizzie Bennett retired from her job as a senior operating department practitioner in the UK earlier this year. Her field was trauma and accident and emergency and she has served on major catastrophe teams around the UK. Lizzie publishes Underground Medic on the topic of preparedness.
