Cases reported "lassa fever"

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1/12. lassa fever encephalopathy: lassa virus in cerebrospinal fluid but not in serum.

    The pathogenesis of neurologic complications of lassa fever is poorly understood. A Nigerian patient had fever, disorientation, seizures, and blood-brain barrier dysfunction, and lassa virus was found in cerebrospinal fluid (CSF) but not in serum. The concentration of lassa virus rna in CSF corresponded to 1 x 10(3) pfu/mL, as determined by a quantitative real-time polymerase chain reaction assay. To characterize the lassa virus in CSF, the 3.5-kb S rna was sequenced. In the S rna coding sequences, the CSF strain differed between 20% and 24.6% from all known prototype strains. These data suggest that lassa virus or specific lassa virus strains can persist in the central nervous system and thus contribute to neuropathogenesis. lassa virus infection should be considered in West African patients or in travelers returning from this area who present only with fever and neurologic signs. ( info)

2/12. Monitoring of clinical and laboratory data in two cases of imported lassa fever.

    During 2000, four cases of fatal lassa fever were imported from africa to europe. In two patients, consecutive serum samples were available for monitoring of virus load and cytokine levels in addition to standard laboratory data. Both patients had non-specific early clinical symptoms including high fever. Patient 1 developed multi-organ failure and died of hemorrhagic shock on day 15 of illness, while patient 2 died of respiratory failure due to aspiration without hemorrhage on day 16. ribavirin was administered to both patients beginning only on day 11. High serum aspartate aminotransferase and lactate dehydrogenase (LDH) levels were remarkable in both patients. Patient 1 had an initial virus load of 10(6) S rna copies/ml as measured by real-time RT-PCR. viremia increased steadily and reached a plateau of approximately 10(8)-10(9) copies/ml 4 days before death, while IFN-gamma and TNF-alpha rose to extremely high levels only shortly before death. In contrast, in patient 2 the virus load decreased from 10(7) to 10(6) copies/ml during the late stage of illness which was paralleled by a decrease in the IFN-gamma and TNF-alpha levels. The IL-10 level increased when specific IgM and IgG appeared. These data suggest that a high virus load and high levels of pro-inflammatory cytokines in the late stage of lassa fever play an important role in the pathogenesis of hemorrhage, multi-organ failure, and shock in lassa fever. ( info)

3/12. Imported lassa fever--new jersey, 2004.

    lassa fever is an acute viral illness caused by lassa virus, which is hosted by rodents in the Mastomys natalensis species complex and rarely imported to countries outside of those areas in africa where the disease is endemic. lassa fever is characterized by fever, muscle aches, sore throat, nausea, vomiting, and chest and abdominal pain. Approximately 15%-20% of patients hospitalized for lassa fever die from the illness; however, approximately 80% of human infections with lassa virus are mild or asymptomatic, and 1% of infections overall result in death. On August 28, 2004, a man aged 38 years residing in new jersey died from lassa fever after returning from travel to West africa. This report summarizes the clinical and epidemiologic investigations conducted by federal, state, and local public health agencies. The findings illustrate the need for clinicians and public health officials to remain alert to emerging infectious diseases and to institute appropriate measures to promptly identify and limit spread of unusual pathogens. ( info)

4/12. Historical lassa fever reports and 30-year clinical update.

    Five cases of lassa fever have been imported from West africa to the united states since 1969. We report symptoms of the patient with the second imported case and the symptoms and long-term follow-up on the patient with the third case. vertigo in this patient has persisted for 30 years. ( info)

5/12. Evaluation of infection control practices during an AE.

    The broadening global commitment of UK military personnel since the end of the Cold war has brought them into contact with a plethora of tropical diseases, some of which require isolation and air transfer to a UK medical facility. This presents a number of challenges to the safe repatriation of patients and attending medical and flight crews. During a recent repatriation of a patient with suspected lassa fever from West africa, the team's practices were evaluated and recommendations were made for improvements to future transfers by the deployable air isolator team. Valuable lessons were learned by the team, most notably the need to practice safe isolation procedures in a real working environment. In addition, the team should work on exercises together, thus aiding cohesion prior to deployment. ( info)

6/12. Exchange transfusion of a patient with fulminant lassa fever.

    We report a patient with fulminant lassa fever who responded dramatically to a 2.5-litre exchange transfusion of whole blood. On admission he was semicomatose with facial oedema and oral haemorrhage; his platelets showed markedly depressed aggregation to ADP; and his plasma inhibited the aggregation responses of normal platelets in vitro. Exchange transfusion resulted in rapid clinical improvement, recovery of platelet function, and disappearance of platelet-inhibitory activity in plasma. The patient died 2 weeks later from an acute encephalopathy. His initial response was sufficiently impressive to suggest that further evaluation of this therapeutic approach is justified in selected patients with overwhelming lassa virus infection. ( info)

7/12. Pediatric lassa fever: a review of 33 Liberian cases.

    Thirty-three cases of pediatric lassa fever were identified at Curran Lutheran Hospital and Phebe Hospital in liberia between January 1980 and March 1984. All 18 fetal cases died and the case-fatality rate for 15 childhood cases was 27%. We identified four clinical presentations according to age, including a case of congenital lassa fever, a condition not reported previously. Two cases of lassa fever were found serologically during a one-month survey of all pediatric admissions at Curran Lutheran Hospital, 2.4% of those children who had serum pairs collected. We also identified a "swollen baby syndrome" consisting of widespread edema, abdominal distention, and bleeding. This distinctive clinical presentation of lassa fever ended in death in three of four cases and was present in three of the four childhood deaths in this series. Its absence seems to be a good prognostic indicator in children. ( info)

8/12. A case of lassa fever: clinical and virological findings.

    Five days after arriving in london from Jos a young Nigerian women developed a severe and prolonged illness that proved to be lassa fever. Virus was not detected in urine during the first three weeks but then appeared and reached a peak during the sixth week, with continuing excretion for 67 days after the onset of illness. Laboratory investigations showed evidence of extensive tissue damage and disturbance of clotting, but there was no serious bleeding and she eventually made a complete recovery despite a high sustained viraemia and severe liver damage. Convalescent serum was used in treatment but it was difficult to assess its contribution to the favourable outcome. ( info)

9/12. A case of lassa fever: experience at St Thomas's Hospital.

    An 18-year-old Nigerian girl, normally resident in Jos, was admitted to hospital for five days before she was diagnosed as having lassa fever. There were several atypical features in the early stages of here illness, notably the absence of prostration, pharyngitis, or bradycardia and the development of appreciable leucocytosis. Consequent control and surveillance measures required checks for 21 days on 173 people who had had contact with as first line if they had handled her or specimens without taking precautions to avoid direct skin contact with her excretions, secretions, and blood; other contacts were categorised as second line. During her time in hospital she was managed in a single room on a general ward. She visited a number of investigative departments within the hospital, and her specimens were examined in five clinical laboratories. Despite this no secondary cases occurred among either first- or second-line contacts, and there was no serological evidence of subclinical infection among any of the contacts tested (159 people). ( info)

10/12. lassa fever--an autopsy report from the eastern part of nigeria.

    autopsy findings of a case of lassa fever from the Eastern part of nigeria are presented. The authors suggest that in lassa fever there is an involvement of the brain in the nature of encephalitis. ( info)
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