High heart rate at admission as a predictive factor of mortality in hospitalized patients with Lassa fever: An observational cohort study in Sierra Leone

Wauquier, Nadia; Couffignal, Camille; Manchon, Pauline; Smith, Elisabeth; Lungay, Victor; Coomber, Moinya; Weisenfluh, Lauren; Bangura, James; Khan, Sheik Humarr; Jambai, Amara; Gbakima, Aiah A; Yun, Nadezda; Paessler, Slobodan; Schoepp, Randal J.; Morse, Stephen S.; Gonzalez, Jean Paul; Fair, Joseph N.; Vieillard, Vincent

doi:10.1016/j.jinf.2020.01.021

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…These changes in the survivor correlate with transient increase in blood cells and cytokines followed by a lack of detectable Lassa virus in blood and tissues. Commonly observed in viral hemorrhagic fevers, the elevated heart rate has been linked to cell signaling events for vascular endothelial dysfunction which likely explains the transient increase in heart rate and temperature in the survivor [ 43 , 44 ]. Several organs of the survivor, such as the heart, kidney, liver, pancreas, brain, and large intestine, bear vasculitis lesions at day 41 in comparison to intramuscular studies of surviving NHPs beyond the acute stage [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Natural History of Aerosol Induced Lassa Fever in Non-Human Primates

Downs

Shaia

Zeng

et al. 2020

Viruses

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Lassa virus (LASV), an arenavirus causing Lassa fever, is endemic to West Africa with up to 300,000 cases and between 5000 and 10,000 deaths per year. Rarely seen in the United States, Lassa virus is a CDC category A biological agent inasmuch deliberate aerosol exposure can have high mortality rates compared to naturally acquired infection. With the need for an animal model, specific countermeasures remain elusive as there is no FDA-approved vaccine. This natural history of aerosolized Lassa virus exposure in Macaca fascicularis was studied under continuous telemetric surveillance. The macaque response to challenge was largely analogous to severe human disease with fever, tachycardia, hypotension, and tachypnea. During initial observations, an increase trend of activated monocytes positive for viral glycoprotein was accompanied by lymphocytopenia. Disease uniformly progressed to high viremia followed by low anion gap, alkalosis, anemia, and thrombocytopenia. Hypoproteinemia occurred late in infection followed by increased levels of white blood cells, cytokines, chemokines, and biochemical markers of liver injury. Viral nucleic acids were detected in tissues of three non-survivors at endpoint, but not in the lone survivor. This study provides useful details to benchmark a pivotal model of Lassa fever in support of medical countermeasure development for both endemic disease and traditional biodefense purposes.

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Section: Discussionmentioning

confidence: 99%

Natural History of Aerosol Induced Lassa Fever in Non-Human Primates

Downs

Shaia

Zeng

et al. 2020

Viruses

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“…Chances of death are greater in pregnant women and even higher in the third trimester (Price et al 1988;Kenmoe et al 2020). About 90% of total pregnancies can be lost in pregnant women infected with LF (Wauquier et al 2020). Children infected with LF and who have positive antigen tests confront high mortality (63%) (Samuels et al 2021).…”

Section: Mortality Risk Factorsmentioning

confidence: 99%

Pathological Events of Lassa Fever Infection

2023

IJAB

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This chapter discusses the morphology, epidemiology, pathology, mortality risk factors, clinical manifestations, diagnosis, treatment, and prevention of Lassa virus (LASV) with a main focus on pathological events associated with the infection caused by LASV. Lassa fever (LF) also known as the viral hemorrhagic illness is caused by the LASV. It belongs to the family Arenaviridea. It is an animal-borne ailment spread by the common African rat. It is endemic in West Africa. It is a medium-sized virion that measures between 70 and 150 nm and is spherical. It is composed of two ambisense RNA segments. The natural reservoir of this virus is the Mastomys natalensis which is a common rat found in rural West Africa. Humans generally get an infection when they come into contact with the urine, feces, and respiratory secretions of the rats as the virus is shed in the secretions of the rats and also found in the blood. The prevalence of the antibodies to the lassa virus is 21% in Nigeria, 8 to 52% in Sierra Leone, and 4 to 55% in Guinea. LASV primarily affects the endothelial cells and utilizes the alpha-dystroglycan receptors. LASV suppresses the cells of the immune system and prevents the secretion of proinflammatory cytokines. Almost 80% of the patients do not show any kind of symptoms so LF is difficult to diagnose. Infected individuals may show acute to severe LF followed by multiple organ failure that can be seen in the spleen, kidney, and liver. The similarity of symptoms with other diseases is quite challenging in the recognition of the infected ones. Supportive treatment is the basis for the management of LF. Ribavirin is a broadspectrum antiviral drug that is a guanosine analogue and owes a fine activity against LASV. In conclusion, LF is a crucial rodent-borne (zoonotic) illness. Suitable training of medical personnel and health care workers is essential in the treatment and prevention of infection. Vaccine development, preventive measures, and the development of drugs other than ribavirin or the modification of the existing drugs are the major suggestions to diminish LF.

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“…Although 7 ribavirin regimens were reported in IND 16666, the treatment durations and administration routes were not clear. In all studies except Samuels et al (35), detailed information regarding the supportive treatment used was lacking.Three studies reported malaria screening and the use of antimalarial drugs and antibiotics before Lassa fever confirmation (14,34,36).…”

Section: Study Characteristicsmentioning

confidence: 99%

Lack of Evidence for Ribavirin Treatment of Lassa Fever in Systematic Review of Published and Unpublished Studies1

Cheng¹,

French²,

Salam³

et al. 2022

Emerg. Infect. Dis.

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In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.Medscape, LLC designates this Journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 75% minimum passing score and complete the evaluation at http://www.medscape.org/journal/eid; and (4) view/print certificate. For CME questions, see page 1744.

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High heart rate at admission as a predictive factor of mortality in hospitalized patients with Lassa fever: An observational cohort study in Sierra Leone

Cited by 6 publications

References 10 publications

Natural History of Aerosol Induced Lassa Fever in Non-Human Primates

Natural History of Aerosol Induced Lassa Fever in Non-Human Primates

Pathological Events of Lassa Fever Infection

Lack of Evidence for Ribavirin Treatment of Lassa Fever in Systematic Review of Published and Unpublished Studies1

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