Lassa fever pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Pathophysiology
Infection in humans typically occurs via exposure to animal excrement through the respiratory or gastrointestinal tracts. Inhalation of tiny particles of infective material (aerosol) is believed to be the most significant means of exposure. It is possible to acquire the infection through broken skin or mucous membranes that are directly exposed to infective material. Transmission from person to person has also been established, presenting a disease risk for healthcare workers. Frequency of transmission via sexual contact has not been established.
In 80% of cases the disease is inapparent, but in the remaining 20% it takes a complicated course. It is estimated that the virus is responsible for about 5,000 deaths annually. The fever accounts for up to ⅓ of deaths in hospitals within the affected regions and 10 to 16% of total cases.
After an incubation period of six to twenty-one days, an acute illness with multiorgan involvement develops. Non-specific symptoms include fever, facial swelling, and muscle fatigue, as well as conjunctivitis and mucosal bleeding. The other symptoms arising from the affected organs are:
- Gastrointestinal tract
- nausea
- vomiting (bloody)
- diarrhea (bloody)
- stomach ache
- constipation
- dysphagia (difficulty swallowing)
- hepatitis
- Cardiovascular system
- pericarditis
- hypertension
- hypotension
- tachycardia (abnormally high heart rate)
- Respiratory tract
- cough
- chest pain
- dyspnoea
- pharyngitis
- pleuritis
- Nervous system
- encephalitis
- meningitis
- unilateral or bilateral hearing deficit
- seizures
Clinically, Lassa fever infections are difficult to distinguish from other viral hemorrhagic fevers such as Ebola and Marburg, and from more common febrile illnesses such as malaria.
The virus is excreted in urine for three to nine weeks and in semen for three months.