Lassa fever natural history, complications and prognosis: Difference between revisions
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The most common [[complication]] of Lassa fever is [[deafness]]. Various degrees of deafness occur in approximately one-third of cases, and in many cases [[hearing loss]] is permanent. [[Spontaneous abortion]] is another serious complication. Approximately 15%-20% of patients hospitalized for Lassa fever die from the illness. However, overall only about 1% of [[infection]]s with Lassa virus result in death. The death rates are particularly high for women (greater than 80%) in the [[third trimester]] of [[pregnancy]], and for [[fetus]]es, about 95% of which die in the uterus of infected pregnant mothers. | The most common [[complication]] of Lassa fever is [[deafness]]. Various degrees of deafness occur in approximately one-third of cases, and in many cases [[hearing loss]] is permanent. [[Spontaneous abortion]] is another serious complication. Approximately 15%-20% of patients hospitalized for Lassa fever die from the illness. However, overall only about 1% of [[infection]]s with Lassa virus result in death. The death rates are particularly high for women (greater than 80%) in the [[third trimester]] of [[pregnancy]], and for [[fetus]]es, about 95% of which die in the uterus of infected pregnant mothers. | ||
==Natural History== | ==Natural History== | ||
* 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<ref name=CDC>{{cite web | title = The Centers for Disease Control and Prevention | url =http://www.cdc.gov/vhf/virus-families/arenaviridae.html }}</ref>. | * 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<ref name=CDC>{{cite web | title = The Centers for Disease Control and Prevention | url =http://www.cdc.gov/vhf/virus-families/arenaviridae.html }}</ref>. | ||
* 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. | * 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.[[File:Signs and symptoms.png|thumb|center|800 px|Outbreak Distribution Map Lassa Fever CDC.png<SMALL><SMALL>''[http://www.cdc.gov/NCIDOD/dvrd/spb/mnpages/lassaslides.htm]''<ref name="CDC">{{Cite web | title = Center for Disease Control and Prevention (CDC) | url = http://www.cdc.gov/NCIDOD/dvrd/spb/mnpages/lassaslides.htm}}</ref></SMALL></SMALL>]] | * 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]].[[File:Signs and symptoms.png|thumb|center|800 px|Outbreak Distribution Map Lassa Fever CDC.png<SMALL><SMALL>''[http://www.cdc.gov/NCIDOD/dvrd/spb/mnpages/lassaslides.htm]''<ref name="CDC">{{Cite web | title = Center for Disease Control and Prevention (CDC) | url = http://www.cdc.gov/NCIDOD/dvrd/spb/mnpages/lassaslides.htm}}</ref></SMALL></SMALL>]] | ||
==Complications== | ==Complications== | ||
* 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. Other complications include the following. | * 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. Other complications include the following. | ||
===Sensorineural Deafness=== | ===Sensorineural Deafness=== | ||
* The most common complication of Lassa fever is [[deafness]]. | * The most common complication of Lassa fever is [[deafness]]. | ||
* Occurs in 1/3rd of the cases. | * Occurs in 1/3rd of the cases. | ||
* Various degrees of deafness occur in approximately one-third of [[infections]], and in many cases hearing loss is permanent. | * 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. | * 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. | ||
* It could be unilateral or bilateral. | * It could be unilateral or bilateral. | ||
| Line 20: | Line 20: | ||
* Increased mortality in 3rd trimester of more than 30% to the mother. | * Increased mortality in 3rd trimester of more than 30% to the mother. | ||
* Increased [[viremia]] in [[pregnant]] woman. | * Increased [[viremia]] in [[pregnant]] woman. | ||
* Evacuation of the uterus improves mother's chance of survival. | * Evacuation of the [[uterus]] improves mother's chance of survival. | ||
* Placental infection of the fetus. | * Placental infection of the [[fetus]]. | ||
* [[Spontaneous abortion]] is a serious complication of infection with an estimated 95% mortality in fetuses of infected pregnant mothers. | * [[Spontaneous abortion]] is a serious complication of infection with an estimated 95% mortality in fetuses of infected pregnant mothers. | ||
* Increased fetal and neonatal mortality of more than 85%. | * Increased fetal and neonatal mortality of more than 85%. | ||
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==Prognosis== | ==Prognosis== | ||
* Prognosis of lassa fever is poor if its associated with following features<ref name=CDC>{{cite web | title = The Centers for Disease Control and Prevention | url =http://www.cdc.gov/NCIDOD/dvrd/spb/mnpages/lassaslides.htm }}</ref>. | * Prognosis of lassa fever is poor if its associated with following features<ref name=CDC>{{cite web | title = The Centers for Disease Control and Prevention | url =http://www.cdc.gov/NCIDOD/dvrd/spb/mnpages/lassaslides.htm }}</ref>. | ||
:* Increased viremia. | :* Increased [[viremia]]. | ||
:* Serum AST level > 150 IU/L | :* Serum [[AST]] level > 150 IU/L | ||
:* Bleeding | :* [[Bleeding]]. | ||
:* Encephalitis. | :* [[Encephalitis]]. | ||
:* Edema | :* [[Edema]] | ||
:* Third trimester of pregnancy. | :* [[Third trimester of pregnancy]]. | ||
==References== | ==References== | ||
Revision as of 06:42, 1 June 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [3]
Overview
The most common complication of Lassa fever is deafness. Various degrees of deafness occur in approximately one-third of cases, and in many cases hearing loss is permanent. Spontaneous abortion is another serious complication. Approximately 15%-20% of patients hospitalized for Lassa fever die from the illness. However, overall only about 1% of infections with Lassa virus result in death. The death rates are particularly high for women (greater than 80%) in the third trimester of pregnancy, and for fetuses, about 95% of which die in the uterus of infected pregnant mothers.
Natural History
- 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[1].
- 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.
Outbreak Distribution Map Lassa Fever CDC.png[1][1]
Complications
- 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. Other complications include the following.
Sensorineural Deafness
- The most common complication of Lassa fever is deafness.
- Occurs in 1/3rd of the cases.
- 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.
- It could be unilateral or bilateral.
Lassa Fever in Pregnancy
- Increased mortality in 3rd trimester of more than 30% to the mother.
- Increased viremia in pregnant woman.
- Evacuation of the uterus improves mother's chance of survival.
- Placental infection of the fetus.
- Spontaneous abortion is a serious complication of infection with an estimated 95% mortality in fetuses of infected pregnant mothers.
- Increased fetal and neonatal mortality of more than 85%.
Lassa Fever in Children
Swollen Baby Syndrome
- Edema.
- Abdominal distention.
- Bleeding.
- Poor prognosis.
Prognosis
- Prognosis of lassa fever is poor if its associated with following features[1].
- Increased viremia.
- Serum AST level > 150 IU/L
- Bleeding.
- Encephalitis.
- Edema
- Third trimester of pregnancy.