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Lassa Fever Spreads Across the Globe

APR 11, 2016 | SARAH ANWAR

Additional Lassa Cases Outside of Africa

In mid-March 2016, WHO was notified by the National IHR Focal Point for Germany of two linked lassa fever cases, the first of which is believed to be an imported case from Togo.

An infected health care worker was stationed in the West African nation before he was evacuated to Cologne. The patient was suffering from complicated falciparum malaria and died from multi-organ failure on February 26, one day after arrival in Germany. The deceased was diagnosed with lassa fever in Hamburg on March 9th after an autopsy revealed hemorrhaging fever.

Prior to the first patient’s lassa diagnosis, a funeral home employee was also infected with the virus after handling the corpse, although the individual was reported to have worn gloves and to not have been exposed to any bodily fluids. The second patient had already exhibited symptoms of an upper respiratory infection before coming in contact with the corpse. The individual had not travelled in the 21 days before falling ill, thus WHO believes the source of infection to be the primary case. This would be the first report of secondary transmission of an imported lassa fever case in Germany. The patient is currently in special quarantine in Frankfurt, along with four family members who volunteered to accompany him in isolation.

Fifty-two contacts of the first patient have been identified, most of whom are health-care workers or funeral home personnel, and are being monitored, along with several of the second patient’s contacts.

Another health worker, a physician’s assistant who had been stationed in Togo, has been admitted to Emory University Hospital in Atlanta, Georgia in the United States, where he was diagnosed with lassa fever. According to CNN, the patient was transported to the Atlanta hospital from Togo at the request of the US State Department. The patient currently resides at the Serious Communicable Disease Unit at the university hospital.

Transmission of Lassa Virus

The lassa virus can be transmitted to humans from the feces or urine of infected Mastymos rodents, which breed frequently and are therefore prevalent in many African savannas and forests. Since these rodents are often found in human homes, specifically areas where food is stored, the development of an infection through the consumption of food contaminated with rat droppings is common. Viral transmission can also occur through direct contact of feces or urine if an individual has open cuts or sores, or through inhaling tiny particles of feces in contaminated air.

In addition, if an individual comes in contact with the blood, tissue, secretions or excretions of an infected individual, human-to-human transmission of the virus is possible. This type of transmission mostly occurs in hospital or clinical care settings where proper personal protective equipment (PPE) is either not readily available or not utilized.

Prevention of Lassa Fever Infection

Since the primary carrier of the lassa virus is Mastomys rodents, the CDC recommends that individuals avoid contact with them. Furthermore, those living in areas where lassa fever is prevalent are advised to store food in rodent-proof containers and keep their homes clean to hinder the entrance of the rats into the home. The CDC also discourages the consumption of rats, since this can cause infection.

To avoid person-to-person infection, individuals are advised to wear protective clothing such as masks, gloves, gowns, and goggles around those known to carry the virus. Those individuals working in hospitals or clinics with known lassa cases should sterilize all equipment and tools. Lassa cases should be isolated from other patients, so as to avoid an outbreak. It is important to educate those living in high-risk regions on the preventive measures they can take to avoid infection.
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