Abstract
Lassa virus is a rodentborne arenavirus responsible for human cases of Lassa fever, a viral hemorrhagic fever, in West Africa and in travelers arriving to non–Lassa-endemic countries from West Africa. We describe a retrospective review performed through literature search of clinical and epidemiologic characteristics of all imported Lassa fever cases worldwide during 1969–2016. Our findings demonstrate that approximately half of imported cases had distinctive clinical features (defined as fever and >1 of the following: pharyngitis, sore throat, tonsillitis, conjunctivitis, oropharyngeal ulcers, or proteinuria). Delays in clinical suspicion of this diagnosis were common. In addition, no secondary transmission of Lassa fever to contacts of patients with low-risk exposures occurred, and infection of high-risk contacts was rare. Future public health investigations of such cases should focus on timely recognition of distinctive clinical features, earlier treatment of patients, and targeted public health responses focused on high-risk contacts.
Highlights
Lassa virus is a rodentborne arenavirus responsible for human cases of Lassa fever, a viral hemorrhagic fever, in West Africa and in travelers arriving to non–Lassa-endemic countries from West Africa
Diagnosis of Lassa fever in patients arriving from West Africa might be challenging for healthcare providers unfamiliar with the spectrum of its clinical presentation, a challenge that is common to the consideration of other viral hemorrhagic fevers in returning travelers [5,6,7]
The 33 cases of imported Lassa fever that occurred during 1969–2016 posed a similar set of challenges: timely diagnosis of a rare infectious disease not endemic to the patient’s destination country, timely treatment, and prevention of Lassa virus transmission to contacts
Summary
Lassa virus is a rodentborne arenavirus responsible for human cases of Lassa fever, a viral hemorrhagic fever, in West Africa and in travelers arriving to non–Lassa-endemic countries from West Africa. Discovered in 1969, Lassa fever is a rodentborne viral hemorrhagic fever endemic to West Africa and caused by Lassa virus [1]. Diagnosis of Lassa fever in patients arriving from West Africa might be challenging for healthcare providers unfamiliar with the spectrum of its clinical presentation, a challenge that is common to the consideration of other viral hemorrhagic fevers in returning travelers [5,6,7]. To quantify the frequency of case-patients having distinctive clinical features, time from patient presentation to clinical suspicion of a Lassa fever diagnosis, and the risk for secondary Lassa virus transmission, we performed a retrospective review of all 33 reported cases of Lassa fever imported from West Africa during 1969–2016
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