Lassa Fever Encephalopathy: Lassa Virus in Cerebrospinal Fluid but Not in Serum

Abstract

The pathogenesis of neurologic complications of Lassa fever is poorly understood. A Nigerian patient had fever, disorientation, seizures, and blood-brain barrier dysfunction, and Lassa virus was found in cerebrospinal fluid (CSF) but not in serum. The concentration of Lassa virus RNA in CSF corresponded to 1 x 10(3) pfu/mL, as determined by a quantitative real-time polymerase chain reaction assay. To characterize the Lassa virus in CSF, the 3.5-kb S RNA was sequenced. In the S RNA coding sequences, the CSF strain differed between 20% and 24.6% from all known prototype strains. These data suggest that Lassa virus or specific Lassa virus strains can persist in the central nervous system and thus contribute to neuropathogenesis. Lassa virus infection should be considered in West African patients or in travelers returning from this area who present only with fever and neurologic signs.

Inhibition of Different Lassa Virus Strains by Alpha and Gamma Interferons and Comparison with a Less Pathogenic Arenavirus

“…The study was performed with a representative set of three low-passage strains of Lassa virus belonging to three phylogenetic lineages (11,25) (Table 1). The strains were isolated from humans with different clinical courses of Lassa fever.…”

A case report on Lassa fever and hearing loss: A rare occurrence and review of the literature

“…Research has also shown that the strain of Lassa viruses found at the West African coast varies in its amino-acid sequence (genome) and tends to elaborate exaggerated immune responses, involving high titres of IgG and IgM 14,15 . This increases the risk of inhabitants of endemic areas of Lassa fever with sub-clinical infections from previous exposures to stand a higher risk of developing SNHL during their lifetime.…”

Review of Lassa fever, an emerging old world haemorrhagic viral disease in sub-Saharan Africa

“…Infection during pregnancy can lead to fetal death (because the virus has high affinity for placenta and other highly vascularized tissues), abortion, including loss of newborn (in 90% of cases) or maternal death. [3,26,27] Serious congenital defects or abnormalies are common sequelae in children born with Lassa fever infection [27,28].…”

“…This constitutes part of the late Stage of the illness manifesting as neurological complications including encephalopathy or encephalitis (Table 3) [28]. The virus can be detected in the urine of infected patient for 3-9 weeks and in semen for up to three months [2].…”

“…The virus can be detected in the urine of infected patient for 3-9 weeks and in semen for up to three months [2]. [8] Richmond et al, (2003) [11] Emound et al, (1982); [21] WHO, (2015; [23] Bausch et al, (2001); [24] Gunther et al, (2001) [28].…”