A Case of Lassa Fever Diagnosed at a Community Hospital—Minnesota 2014

Abstract

BackgroundIn April 2014, a 46-year-old returning traveler from Liberia was transported by emergency medical services to a community hospital in Minnesota with fever and altered mental status. Twenty-four hours later, he developed gingival bleeding. Blood samples tested positive for Lassa fever RNA by reverse transcriptase polymerase chain reaction.MethodsBlood and urine samples were obtained from the patient and tested for evidence of Lassa fever virus infection. Hospital infection control personnel and health department personnel reviewed infection control practices with health care personnel. In addition to standard precautions, infection control measures were upgraded to include contact, droplet, and airborne precautions. State and federal public health officials conducted contract tracing activities among family contacts, health care personnel, and fellow airline travelers.ResultsThe patient was discharged from the hospital after 14 days. However, his recovery was complicated by the development of near complete bilateral sensorineural hearing loss. Lassa virus RNA continued to be detected in his urine for several weeks after hospital discharge. State and federal public health authorities identified and monitored individuals who had contact with the patient while he was ill. No secondary cases of Lassa fever were identified among 75 contacts.ConclusionsGiven the nonspecific presentation of viral hemorrhagic fevers, isolation of ill travelers and consistent implementation of basic infection control measures are key to preventing secondary transmission. When consistently applied, these measures can prevent secondary transmission even if travel history information is not obtained, not immediately available, or the diagnosis of a viral hemorrhagic fever is delayed.

A Review of Hearing Loss Associated with Zika, Ebola, and Lassa Fever

“…Audiometry was used to characterize HL in five of 11 studies. 20,[56][57][58][59][60][61][62][63][64][65][66][67][68][69] The mean pure-tone average (PTA) for all reported data was 66.5 dB, which is consistent with severe HL. This measurement was gathered from 139 (15.5%) of 898 individuals with an average age of 33.7 years.…”

“…Fifteen articles discussing LF and subsequent complications in 1,207 individuals were included in this review (Table 3). 20,[56][57][58][59][60][61][62][63][64][65][66][67][68][69] Of 15 articles, 11 presented HL data. 20,[56][57][58][59][60][61][62][63][64][65] Across studies, 53 (6.0%) of 898 individuals were found to have some degree of HL using audiometric evaluation and survey instruments.…”

“…20,[56][57][58][59][60][61][62][63][64][65][66][67][68][69] Of 15 articles, 11 presented HL data. 20,[56][57][58][59][60][61][62][63][64][65] Across studies, 53 (6.0%) of 898 individuals were found to have some degree of HL using audiometric evaluation and survey instruments. 20,[56][57][58][59][60][61][62][63][64] Thirty-eight (71.7%) affected individuals were found to have bilateral HL, and 15 (28.3%) individuals demonstrated unilateral HL.…”

“…Eleven of 22 individuals were found to have residual HL at 1 year, and one reported residual loss 4 years after the initial infection. 20,[57][58][59]62,63 At the end of the 1 year period, nine of these individuals were found to have severe HL, including three cases of bilateral HL and six cases of unilateral. 20 Cummins and colleagues included three FIGURE 1.…”

Acute kidney injury and mortality in pediatric Lassa fever versus question of access to dialysis

“…In particular, little is known about the prevalence of AKI in hospitalized pediatric patients with Lassa fever (LF). LF has a high CFR of 16%-50% among hospitalized patients (Frame, 1989;Okokhere et al, 2018), is endemic in many West African countries (Fichet-Calvet and Rogers, 2009;Gibb et al, 2017), and is the most exported VHF to non-endemic countries (Choi et al, 2018;Kofman et al, 2019).…”