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Lassa Fever - Causes, Symptoms and Treatment

Definition:

Lassa fever is an epidemic hemorrhagic fever caused by the Lassa virus, an extremely virulent arenavirus. As many as 100 cases occur annually in western Africa; the disease is rare in the United States. This highly fatal disorder kills 10% to 50% of its victims, but those who survive its early stages usually recover and acquire immunity to secondary attacks.

Causes of Lassa Fever

A chronic infection in rodents, Lassa virus is transmitted to humans by contact with infected rodent urine, feces, and saliva. (This is why Lassa fever sometimes strikes laboratory workers.) Then the virus enters the bloodstream, lymph vessels, and respiratory and digestive tracts. After this, it multiplies in cells of the reticuloendothelial system. In the early stages of this illness, when the virus is in the throat, human transmission may occur through inhalation of infected droplets.

Signs and Symptoms of Lassa Fever

After a 7- to 18-day incubation period, this disease produces a fever that persists for 2 to 3 weeks, exudative pharyngitis, oral ulcers, lymphadenopathy with swelling of the face and neck, purpura, conjunctivitis, and bradycardia. Severe infection may also cause hepatitis, myocarditis, pleural infection, encephalitis, and permanent unilateral or bilateral deafness. Virus multiplication in reticuloendothelial cells causes capillary lesions that lead to erythrocyte and platelet loss, mild to moderate thrombocytopenia (with a tendency to bleeding), and secondary bacterial infection. Capillary lesions also cause focal hemorrhage in the stomach, small intestine, kidneys, lungs, and brain and, possibly, hemorrhagic shock and peripheral vascular collapse.

Diagnosis for Lassa Fever

Isolation of the Lassa virus from throat washings, pleural fluid, or blood confirms the diagnosis. Recent travel to an endemic area and specific antibody titer support the diagnosis. Differential diagnoses include malaria, shigellosis, typhoid, leptospirosis, and rickettsial disease.

Treatment for Lassa Fever

Treatment of Lassa fever includes I.V. ribavirin, l.V. colloids for shock, analgesics for pain, and antipyretics for fever.

Special Considerations and Prevention Tips for Lassa Fever

  • To prevent the spread of this contagious disease, carefully dispose of or dispose of or disinfect all materials contaminated with the infected patient's urine, feces, respiratory secretions, or exudates.
  • Carefully monitor fluid and electrolyte status, vital signs, and intake and output.
  • Watch for and immediately report signs of infection or shock.
  • Strict isolation is necessary for at least 3 weeks, until the patient's throat washings and urine are free from the virus. Watch known contacts closely for at least 3 weeks for signs of the disease.
  • Provide good mouth care. Remember to clean the patient's mouth with a soft bristled toothbrush to avoid irritating his mouth ulcers. Ask your facility's dietary department to supply a soft, bland, nonirritating diet.
  • Immediately report all cases of Lassa fever to the public health authorities in your area.

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