Lassa fever medical therapy: Difference between revisions
Jump to navigation
Jump to search
Sergekorjian (talk | contribs) |
YazanDaaboul (talk | contribs) |
||
| Line 5: | Line 5: | ||
{{SK}} Lassa hemorrhagic fever; LHF | {{SK}} Lassa hemorrhagic fever; LHF | ||
==Overview== | ==Overview== | ||
[[Ribavirin]] | [[Ribavirin]] is an antiviral drug that is indicated for the treatment of Lassa fever. The efficacy of ribavirin is most strongly observed when it is administered intravenously early in the course of the disease. In addition to antiviral therapy, patients should typically receive supportive care to adequately maintain respiratory status and [[fluid]] and [[electrolyte]] balance. | ||
==Medical Therapy== | ==Medical Therapy== | ||
* All | * All hospitalized individuals with suspected Lassa fever should be isolated with proper disposal of [[body fluids]] and [[excretion|excreta]].<ref name="cdc" /> | ||
* | * Supportive care, including adequate f[[Fluid replacement|luid]] and electrolyte replacement and [[blood transfusions]], may also be required. | ||
* [[Ribavirin]] is an antiviral drug that is indicated for the treatment of Lassa fever. The efficacy of ribavirin is most strongly observed when it is administered intravenously early in the course of the disease.<ref name="who">Fact sheet N°179: Lassa Fever. World Health Organization. [http://www.who.int/mediacentre/factsheets/fs179/en/ Accessed on June 09, 2015.] </ref> Compared with oral ribavirin, intravenous (IV) ribavirin is almost twice as [[effective dose|effective]].<ref>{{cite journal |author=Fisher-Hoch SP, McCormick JB |title=Lassa fever vaccine |journal=Expert review of vaccines |volume=3 |issue=2 |pages=189-97 |year=2004 |pmid=15056044 |doi=10.1586/14760584.3.4.S189}}</ref> | |||
<center> | <center> | ||
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center | {| style="border: 0px; font-size: 90%; margin: 3px;" align="center" | ||
|- | |- | ||
|align="center" style="background:#4479BA; padding: 3px;"|{{fontcolor|#FFF|'''Optimal Treatment'''}} | | align="center" style="background:#4479BA; padding: 3px;" |{{fontcolor|#FFF|'''Optimal Treatment'''}} | ||
|- | |- | ||
|align="left" style="background:#efefef; padding: 10px;"|'''Ribavarin'''<ref name="pmid11988060">{{cite journal| author=Borio L, Inglesby T, Peters CJ, Schmaljohn AL, Hughes JM, Jahrling PB et al.| title=Hemorrhagic fever viruses as biological weapons: medical and public health management. | journal=JAMA | year= 2002 | volume= 287 | issue= 18 | pages= 2391-405 | pmid=11988060 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11988060 }} </ref> | | align="left" style="background:#efefef; padding: 10px;" |'''Ribavarin'''<ref name="pmid11988060">{{cite journal| author=Borio L, Inglesby T, Peters CJ, Schmaljohn AL, Hughes JM, Jahrling PB et al.| title=Hemorrhagic fever viruses as biological weapons: medical and public health management. | journal=JAMA | year= 2002 | volume= 287 | issue= 18 | pages= 2391-405 | pmid=11988060 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11988060 }} </ref> | ||
*{{fontcolor|#4479BA|''Loading dose:''}} 30 mg/kg (max. 2g) IV<br> | *{{fontcolor|#4479BA|''Loading dose:''}} 30 mg/kg (max. 2g) IV<br> | ||
*{{fontcolor|#4479BA|''Concentration dose:''}} 16 mg/kg (max. 1g) IV Q6H X 4 days, then 8 mg/kg (max. 500mg) IV Q8H X 6 days | *{{fontcolor|#4479BA|''Concentration dose:''}} 16 mg/kg (max. 1g) IV Q6H X 4 days, then 8 mg/kg (max. 500mg) IV Q8H X 6 days | ||
|- | |- | ||
|} | |} | ||
</center> | </center> | ||
== | ==Pregnancy== | ||
* | * For 3rd-term pregnant women with Lassa fever, the risk of death is very high (odds ratio for death 5.57). Among these patients, emergent evacuation of the uterus (by induction or surgically) has been demonstrated to decrease the risk of death.<ref>{{cite journal |author=Price ME, Fisher-Hoch SP, Craven RB, McCormick JB |title=A prospective study of maternal and fetal outcome in acute Lassa fever infection during pregnancy |journal=BMJ |volume=297 |issue=6648 |pages=584–7 |year=1988 |pmid=3139220 |url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=3139220}}</ref> It is hypothesized that evacuating the uterus decreases the viral load significantly as the virus has high affinity for the [[placenta]] and other highly [[vascular]] tissues. Observational studies have demonstrated that the [[fetus]] has only a one in ten chance of survival irrespective of the therapies used or the interventions attempted. For that reason, the main focus is on reducing the risk of death in the mother. Following active obstetrical intervention, treatment with ribavirin should be initiated immediately. | ||
==References== | ==References== | ||
Revision as of 14:30, 10 June 2015
|
Lassa fever Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Lassa fever medical therapy On the Web |
|
American Roentgen Ray Society Images of Lassa fever medical therapy |
|
Risk calculators and risk factors for Lassa fever medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.Serge Korjian M.D.Ammu Susheela, M.D. [2]
Synonyms and keywords: Lassa hemorrhagic fever; LHF
Overview
Ribavirin is an antiviral drug that is indicated for the treatment of Lassa fever. The efficacy of ribavirin is most strongly observed when it is administered intravenously early in the course of the disease. In addition to antiviral therapy, patients should typically receive supportive care to adequately maintain respiratory status and fluid and electrolyte balance.
Medical Therapy
- All hospitalized individuals with suspected Lassa fever should be isolated with proper disposal of body fluids and excreta.[1]
- Supportive care, including adequate fluid and electrolyte replacement and blood transfusions, may also be required.
- Ribavirin is an antiviral drug that is indicated for the treatment of Lassa fever. The efficacy of ribavirin is most strongly observed when it is administered intravenously early in the course of the disease.[2] Compared with oral ribavirin, intravenous (IV) ribavirin is almost twice as effective.[3]
| Optimal Treatment |
Ribavarin[4]
|
Pregnancy
- For 3rd-term pregnant women with Lassa fever, the risk of death is very high (odds ratio for death 5.57). Among these patients, emergent evacuation of the uterus (by induction or surgically) has been demonstrated to decrease the risk of death.[5] It is hypothesized that evacuating the uterus decreases the viral load significantly as the virus has high affinity for the placenta and other highly vascular tissues. Observational studies have demonstrated that the fetus has only a one in ten chance of survival irrespective of the therapies used or the interventions attempted. For that reason, the main focus is on reducing the risk of death in the mother. Following active obstetrical intervention, treatment with ribavirin should be initiated immediately.
References
- ↑
- ↑ Fact sheet N°179: Lassa Fever. World Health Organization. Accessed on June 09, 2015.
- ↑ Fisher-Hoch SP, McCormick JB (2004). "Lassa fever vaccine". Expert review of vaccines. 3 (2): 189–97. doi:10.1586/14760584.3.4.S189. PMID 15056044.
- ↑ Borio L, Inglesby T, Peters CJ, Schmaljohn AL, Hughes JM, Jahrling PB; et al. (2002). "Hemorrhagic fever viruses as biological weapons: medical and public health management". JAMA. 287 (18): 2391–405. PMID 11988060.
- ↑ Price ME, Fisher-Hoch SP, Craven RB, McCormick JB (1988). "A prospective study of maternal and fetal outcome in acute Lassa fever infection during pregnancy". BMJ. 297 (6648): 584–7. PMID 3139220.