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{{Lassa fever}}
{{Lassa fever}}
{{CMG}}; {{AE}} {{Ammu}}
{{CMG}}; {{AE}} {{Ammu}}
==Overview==
==Overview==
[[Lassa fever]] caused by [[Arenaviridae]] is an acute viral illness that has been reported at first in West Africa. Although there has been sero-epidemeological evidence of [[Lassa fever]] in 1930's-1950's, the first case was reported in 1969 from Nigeria.
The first case of documented Lassa fever was reported in 1969 following the death of 2 nurses in Lassa, Nigeria.  
==Historical Perspective==
==Historical Perspective==
* [[Lassa fever]] is an acute viral illness that occurs in west Africa. The illness was discovered in 1969 when two missionary nurses died in Nigeria. The [[virus]] is named after the town in Nigeria where the first cases occurred. The [[virus]], a member of the [[virus]] family [[Arenaviridae]], is a single-stranded [[RNA]] [[virus]] and is [[zoonotic]], or [[animal-borne]].
* In 1955-1956, epidemics with clinical and epidemiological resemblance to Lassa fever were reported in Eastern Province and Sierra Leone.
* The illness was discovered in 1969 when two missionary [[nurse]]s died in Nigeria, West Africa. The cause of the [[illness]] was found to be [[Lassa virus]], named after the town in Nigeria where the first cases originated. Early and aggressive treatment using [[Ribavirin]] was pioneered by [[Joseph B. McCormick|Joe McCormick]] in 1979.
* The first case of documented Lassa fever was reported in 1969 following the death of 2 nurses in Lassa, Nigeria.<ref name="pmid782738">{{cite journal| author=Monath TP| title=Lassa fever: review of epidemiology and epizootiology. | journal=Bull World Health Organ | year= 1975 | volume= 52 | issue= 4-6 | pages= 577-92 | pmid=782738 | doi= | pmc=PMC2366662 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=782738  }} </ref> Prior to that, similar cases in West Africa were reported and thought to be caused by Lassa fever given the clinical and epidemiological resemblance of the presentation to Lassa fever.
* [[Lassa fever]] is endemic in parts of west Africa including Sierra Leone, Liberia, Guinea and Nigeria; however, other neighboring countries are also at risk, as the [[animal]] vector for [[Lassa virus]], the "multimammate rat" ([[Mastomys natalensis]]) is distributed throughout the region. In 2009, the first case from Mali was reported in a traveler living in southern Mali; Ghana reported its first cases in late 2011. Isolated cases have also been reported in Côte d’Ivoire and Burkina Faso and there is serologic evidence of [[Lassa virus]] [[infection]] in Togo and Benin.
 
* The number of [[Lassa virus]] [[infections]] per year in west Africa is estimated at 100,000 to 300,000, with approximately 5,000 deaths. Unfortunately, such estimates are crude, because surveillance for cases of the [[disease]] is not uniformly performed. In some areas of Sierra Leone and Liberia, it is known that 10%-16% of people admitted to hospitals every year have [[Lassa fever]], which indicates the serious impact of the [[disease]] on the population of this region. <ref name=CDC>{{cite web | title = The Centers for Disease Control and Prevention | url =http://www.cdc.gov/vhf/lassa/transmission/index.html }}</ref>
* Administration of ribavirin for the treatment of Lassa fever was first introduced by [[Joseph B. McCormick|Joe McCormick]] in 1979.
* Based on the sero-epidemiological studies, it is estimated that [[Lassa fever]] might have occurred without clinical recognition years before the first case reported in 1969. Few such cases are mentioned below<ref name="pmid782738">{{cite journal| author=Monath TP| title=Lassa fever: review of epidemiology and epizootiology. | journal=Bull World Health Organ | year= 1975 | volume= 52 | issue= 4-6 | pages= 577-92 | pmid=782738 | doi= | pmc=PMC2366662 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=782738  }} </ref>.
* Lassa fever is uncommon outside West Africa. Only 6 patients with Lassa fever have historically been hospitalized in USA (all 6 patients had recently traveled to West Africa). The most recent case of Lassa fever in USA was reported in May 2015.<br>
:* 14 day history of [[fever]], [[rash]], [[headache]], [[bradycardia]], [[puffy face]] was reported on a Nigerian Missionary from Makurdi in 1935.
 
:* Lassa neutralizing [[antibody]] was obtained from a [[patient]] who was a missionary in Nigeria by Henderson et al. in 1971 and he had a history of [[Lassa]] like illness in 1952.
{| style="border: 0px; margin: 5px;" width=800px
:* In Eastern Province and Sierra Leone, epidemics which has clinical and epidemiological resemblance to [[Lassa fever]] has been reported in 1955-1956.
| align="center" style="background:#4479BA; padding: 5px 5px;"|{{fontcolor|#FFF|'''Year of import'''}}
[[File:Lassa fever history.jpg|thumb|center|800 px|Doctor in a West African hospital is examining a Lassa fever patient in 1977 Adapted from Centers for Disease Control and Prevention Lassa fever history<SMALL><SMALL>''[http://phil.cdc.gov/phil/details.asp]''<ref name="CDC PHIL Lassa History">{{Cite web | title = Public Health Image Library (PHIL), Centers for Disease Control and Prevention- Lassa fever history | url = http://phil.cdc.gov/phil/details.asp}}</ref></SMALL></SMALL>]]
| align="center" style="background:#4479BA; padding: 5px 5px;"|{{fontcolor|#FFF|'''Clinical features'''}}
| align="center" style="background:#4479BA; padding: 5px 5px;"|{{fontcolor|#FFF|'''From'''}}
| align="center" style="background:#4479BA; padding: 5px 5px;"|{{fontcolor|#FFF|'''To'''}}
|-
| style="padding: 5px 5px; background: #EBEBEB;"| 1969||style="padding: 5px 5px; background: #EBEBEB;"|[[Fever]], [[malaise]], [[headache]], [[nausea]], [[sore throat]], [[epigastric]]/right upper quadrant tenderness, [[pleural effusion]], facial/[[cervical edema]], [[dysphagia]], [[elevated transaminases]], [[cough]], [[dyspnea]], [[pulmonary infiltrates]], [[epiglottal edema]], [[lethargy]], [[nystagmus]], [[lightheadedness]], [[dizziness]] without [[vertigo]], [[ataxia]], [[alopecia]]||style="padding: 5px 5px; background: #F2F2F2;"|Nigeria||style="padding: 5px 5px; background: #F2F2F2;"|New York
|-
| style="padding: 5px 5px; background: #EBEBEB;"| 1975||style="padding: 5px 5px; background: #EBEBEB;"|[[Abdominal pain]], [[diarrhea]], [[fever]], [[headache]], [[myalgia]], [[arthralgia]], [[conjunctival injection]], [[lymphadenopathy]], weight loss, [[pleuritic chest pain]], [[pleural effusion]], unilateral [[deafness]]||style="padding: 5px 5px; background: #F2F2F2;"|Sierra Leone||style="padding: 5px 5px; background: #F2F2F2;"|Washington, DC
|-
| style="padding: 5px 5px; background: #EBEBEB;"| 1976||style="padding: 5px 5px; background: #EBEBEB;"|[[Abdominal cramps]], [[nausea]], [[vomiting]], [[diarrhea]], [[fatigue]], [[headache]], [[retroorbital pain]], [[neck]]/[[back pain]], [[paresthesias]], right [[ear pain]], [[fever]], [[vertigo]], [[syncope]], [[dysmorphopsias]], [[alopecia]], [[weight loss]], [[ecchymoses]], [[insomnia]], [[depression]], [[hypotension]], left-sided facial weakness, right-sided [[Babinski reflex]], [[Weber test]] lateralized to the left||style="padding: 5px 5px; background: #F2F2F2;"|Sierra Leone||style="padding: 5px 5px; background: #F2F2F2;"|Washington, DC
|-
| style="padding: 5px 5px; background: #EBEBEB;"| 1989||style="padding: 5px 5px; background: #EBEBEB;"|Shaking chills, [[fever]], [[sore throat]], [[myalgia]], [[headache]], [[dysphagia]], bloody [[diarrhea]], elevated [[transaminases]], [[hypotension]], [[adult respiratory distress syndrome]], [[death]]||style="padding: 5px 5px; background: #F2F2F2;"|Nigeria||style="padding: 5px 5px; background: #F2F2F2;"|Chicago, IL
|-
| style="padding: 5px 5px; background: #EBEBEB;"| 2004||style="padding: 5px 5px; background: #EBEBEB;"|[[Chills]], [[fever]], [[sore throat]], [[diarrhea]], [[back pain]], [[adult respiratory distress syndrome]], [[death]]||style="padding: 5px 5px; background: #F2F2F2;"|Sierra Leone and Liberia||style="padding: 5px 5px; background: #F2F2F2;"|Trenton, New Jersy
|-
| style="padding: 5px 5px; background: #EBEBEB;"| 2015||style="padding: 5px 5px; background: #EBEBEB;"|[[Fever]], [[sore throat]], [[tiredness]], [[death]]||style="padding: 5px 5px; background: #F2F2F2;"|Liberia||style="padding: 5px 5px; background: #F2F2F2;"|New Jersy
|}
<SMALL>Data from the Center of Disease Control and Prevention, as of May 2015</SMALL>
<br>
[[Image:Lassa fever history.jpg|600 px]]<br>
<sup>A physician examining a patient with Lassa fever patient in West Africa in 1977. Image retrieved from the Centers for Disease Control and Prevention (CDC) - Lassa Fever History</sup><ref name="CDC PHIL Lassa History">{{Cite web | title = Public Health Image Library (PHIL), Centers for Disease Control and Prevention- Lassa fever history | url = http://phil.cdc.gov/phil/details.asp}}</ref>


==References==
==References==
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[[Category:Tropical disease]]
[[Category:Tropical disease]]
[[Category:Biological weapons]]
[[Category:Biological weapons]]
[[Category:Infectious disease]]

Latest revision as of 18:08, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Overview

The first case of documented Lassa fever was reported in 1969 following the death of 2 nurses in Lassa, Nigeria.

Historical Perspective

  • In 1955-1956, epidemics with clinical and epidemiological resemblance to Lassa fever were reported in Eastern Province and Sierra Leone.
  • The first case of documented Lassa fever was reported in 1969 following the death of 2 nurses in Lassa, Nigeria.[1] Prior to that, similar cases in West Africa were reported and thought to be caused by Lassa fever given the clinical and epidemiological resemblance of the presentation to Lassa fever.
  • Administration of ribavirin for the treatment of Lassa fever was first introduced by Joe McCormick in 1979.
  • Lassa fever is uncommon outside West Africa. Only 6 patients with Lassa fever have historically been hospitalized in USA (all 6 patients had recently traveled to West Africa). The most recent case of Lassa fever in USA was reported in May 2015.
Year of import Clinical features From To
1969 Fever, malaise, headache, nausea, sore throat, epigastric/right upper quadrant tenderness, pleural effusion, facial/cervical edema, dysphagia, elevated transaminases, cough, dyspnea, pulmonary infiltrates, epiglottal edema, lethargy, nystagmus, lightheadedness, dizziness without vertigo, ataxia, alopecia Nigeria New York
1975 Abdominal pain, diarrhea, fever, headache, myalgia, arthralgia, conjunctival injection, lymphadenopathy, weight loss, pleuritic chest pain, pleural effusion, unilateral deafness Sierra Leone Washington, DC
1976 Abdominal cramps, nausea, vomiting, diarrhea, fatigue, headache, retroorbital pain, neck/back pain, paresthesias, right ear pain, fever, vertigo, syncope, dysmorphopsias, alopecia, weight loss, ecchymoses, insomnia, depression, hypotension, left-sided facial weakness, right-sided Babinski reflex, Weber test lateralized to the left Sierra Leone Washington, DC
1989 Shaking chills, fever, sore throat, myalgia, headache, dysphagia, bloody diarrhea, elevated transaminases, hypotension, adult respiratory distress syndrome, death Nigeria Chicago, IL
2004 Chills, fever, sore throat, diarrhea, back pain, adult respiratory distress syndrome, death Sierra Leone and Liberia Trenton, New Jersy
2015 Fever, sore throat, tiredness, death Liberia New Jersy

Data from the Center of Disease Control and Prevention, as of May 2015

A physician examining a patient with Lassa fever patient in West Africa in 1977. Image retrieved from the Centers for Disease Control and Prevention (CDC) - Lassa Fever History[2]

References

  1. ↑ Monath TP (1975). "Lassa fever: review of epidemiology and epizootiology". Bull World Health Organ. 52 (4–6): 577–92. PMC 2366662. PMID 782738.
  2. ↑ "Public Health Image Library (PHIL), Centers for Disease Control and Prevention- Lassa fever history".
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