Lassa fever: Difference between revisions
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==Background== | ==Background== | ||
*RNA virus of arenaviridae family | *RNA virus of arenaviridae family | ||
* | *Endemic to parts of West Africa | ||
**100,000-300,000 infections every year | **100,000-300,000 infections every year | ||
*Animal vector: Multimammate rat (Mastomys natalensis) | *Animal vector: Multimammate rat (''Mastomys natalensis'') | ||
* | *A type of [[viral hemorrhagic fevers|viral hemorrhagic fever]] | ||
===Transmission=== | ===Transmission=== | ||
| Line 23: | Line 23: | ||
{{Fever in Traveler DDX}} | {{Fever in Traveler DDX}} | ||
== | ==Evaluation== | ||
*IgM or IgG ELISA or RT-PCR may be used to diagnose acute infections | *IgM or IgG ELISA or RT-PCR may be used to diagnose acute infections | ||
*Lymphopenia and elevated transaminases are non-specific, but may indicate worse prognosis | *Lymphopenia and elevated transaminases are non-specific, but may indicate worse prognosis | ||
==Management== | ==Management== | ||
* | *Supportive care is the hallmark of management | ||
*Strict isolation precautions: standard, contact and droplet | |||
**Limit entry and maintain a log of people who enter the room | **Limit entry and maintain a log of people who enter the room | ||
* | *[[Ribavirin]] has been shown to decrease mortality | ||
**Most effective when given early (within 6 days) | **Most effective when given early (within 6 days) | ||
==Disposition== | ==Disposition== | ||
*Admit (consider ICU admission) | |||
*Those that seek medical care are more likely to have serious infections: | *Those that seek medical care are more likely to have serious infections: | ||
**Hospital mortality rates can reach 25% | **Hospital mortality rates can reach 25% | ||
**Overal mortality rates are much less; around 5000 deaths per 100,000-300,000 infections annually | **Overal mortality rates are much less; around 5000 deaths per 100,000-300,000 infections annually | ||
==External Links== | ==External Links== | ||
* | *[http://www.cdc.gov/vhf/lassa/index.html CDC Lassa Fever] | ||
==See Also== | ==See Also== | ||
*[[Viral hemorrhagic | *[[Viral hemorrhagic fevers]] | ||
==References== | ==References== | ||
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[[Category:ID]] | [[Category:ID]] | ||
[[Category: | [[Category:Tropical Medicine]] | ||
Latest revision as of 04:05, 5 October 2016
Background
- RNA virus of arenaviridae family
- Endemic to parts of West Africa
- 100,000-300,000 infections every year
- Animal vector: Multimammate rat (Mastomys natalensis)
- A type of viral hemorrhagic fever
Transmission
- Infected Multimammate rats shed virus in urine and droppings
- Inhalation, ingestion, or direct contact of excrement or soiled food
- Direct contact with bodily fluids of infected human
Clinical Features
- Incubation period: 1-3 weeks
- 80% of infections are mild
- Undiagnosed or low fever, malaise, headache
- 20% of infections are severe
- vomiting, diarrhea, respiratory distress, facial swelling, body pain, hemorrhage, shock
- death within 2 weeks due to multi-system organ failure
- Occasional neurologic symptoms: hearing loss, tremors, encephalitis
Differential Diagnosis
Fever in traveler
- Normal causes of acute fever!
- Malaria
- Dengue
- Leptospirosis
- Typhoid fever
- Typhus
- Viral hemorrhagic fevers
- Chikungunya
- Yellow fever
- Rift valley fever
- Q fever
- Amebiasis
- Zika virus
Evaluation
- IgM or IgG ELISA or RT-PCR may be used to diagnose acute infections
- Lymphopenia and elevated transaminases are non-specific, but may indicate worse prognosis
Management
- Supportive care is the hallmark of management
- Strict isolation precautions: standard, contact and droplet
- Limit entry and maintain a log of people who enter the room
- Ribavirin has been shown to decrease mortality
- Most effective when given early (within 6 days)
Disposition
- Admit (consider ICU admission)
- Those that seek medical care are more likely to have serious infections:
- Hospital mortality rates can reach 25%
- Overal mortality rates are much less; around 5000 deaths per 100,000-300,000 infections annually