Review of cases of nosocomial Lassa fever in Nigeria: the high price of poor medical practice

Fisher‐Hoch, Susan P.; Tomori, Oyewale; Nasidi, A.; Perez-Oronoz, Gilda; Fakile, Yetunde; Hutwagner, Lori; McCormick, Joseph B.

doi:10.1136/bmj.311.7009.857

Cited by 319 publications

(296 citation statements)

References 8 publications

(6 reference statements)

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“…It is an acute, highly infectious zoonotic disease whose public health importance is heightened by its nosocomial spread especially in areas endemicity [8].…”

Section: Introductionmentioning

confidence: 99%

Lassa Fever Epidemic in Nigeria - Outbreak Investigation, Risk Factors and Empirical Analysis from 2012 To 2016

Saka¹,

Gubio²,

Kerecvel³

et al. 2017

J Comm Pub Health Nurs

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Lassa haemorrhagic fever caused by the Lassa virus is an acute, highly infectious zoonotic disease. Magnitude of disease is becoming greater with increasing mortality and morbidity and spread to other area in Nigeria. The study accessed outbreak outcome, risk factors and empirical analysis from 2012 to 2016.Active case search conducted included health facilities that treated confirmed and suspect cases, as well as their residential and business premises using questionnaire and Laboratory analysis. All cases were identified based on the adopted case definition of a person with severe illness of <3 weeks duration and temperature ≥ 38ºC. Individuals with potential direct exposure to Lassa virus through contact with a case were risk assessed. Evidence from data LF cases recorded for five years were analysis using Epi Info 6.A total of Eight (8) cases were seen during the period of investigation. Three (3) was confirmed, one of the confirmed case who was a doctor died. Case fatality rate is 37.5%. Over 50% of the cases are aged between 25-40 years. Median age is 26 year with range 1-55years. Five of the eight cases (62.5%) are males. 100% of patients live in Markudi but 86.5% are Ibo settlers. Out of the 53 contacts that were assessed for risk, 25 (47.2%) were categorized as no risk, 25 (47.2%) were categorized as low risk, while 3 (5.6%) were high risk contacts. Between the period of five years 5051 cases conformed, with 3891 death from LF with case fatality of 77.03%. Risk factors for transmission not limited ethical believe, ignorance and misinformation.LF infection is on increase, affecting both health and non-health workers Over half of the contacts had direct contact with this case. Adopting proper standard precautions in hospitals as well as communities is recommended.

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“…It is an acute, highly infectious zoonotic disease whose public health importance is heightened by its nosocomial spread especially in areas endemicity [8].…”

Section: Introductionmentioning

confidence: 99%

Lassa Fever Epidemic in Nigeria - Outbreak Investigation, Risk Factors and Empirical Analysis from 2012 To 2016

Saka¹,

Gubio²,

Kerecvel³

et al. 2017

J Comm Pub Health Nurs

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“…(23). Nosocomial transmission has been documented in resource-poor settings (11). LASV is a category A select agent requiring biosafety level 4 facilities for safe handling.…”

mentioning

confidence: 99%

Efficient Rescue of Recombinant Lassa Virus Reveals the Influence of S Segment Noncoding Regions on Virus Replication and Virulence

Albariño

Bird

Chakrabarti

et al. 2011

J Virol

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Lassa virus (LASV), is a significant cause of severe, often fatal, hemorrhagic fever in humans throughout western Africa, with an estimated 100,000 infections each year. No vaccines are commercially available. We report the development of an efficient reverse genetics system to rescue recombinant LASV and to investigate the contributions of the long 5 and 3 noncoding regions (NCRs) of the S genomic segment to in vitro growth and in vivo virulence. This work demonstrates that deletions of large portions of these NCRs confer an attenuated phenotype and are a first step toward further insights into the high virulence of LASV.

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“…While hospital-amplified VHF outbreaks have been linked to unacceptable needle-sharing and absence of basic infection control precautions in some institutions [7,12,13], the vast majority of documented VHF outbreaks involving hospitals have seen nosocomial transmission due to inadequate isolation facilities and because gloves and expensive protective clothing were not always used by attending personnel [13][14][15][16]. As most in-patients in often overcrowded, under-resourced and understaffed hospitals in equatorial Africa have a fever of infectious origin, highest-level barrier precautions cannot feasibly be implemented, nor do most common infections require them.…”

Section: Introductionmentioning

confidence: 99%

“…It is probable that only a fraction of outbreaks are detected and reported even though VHFs are classified as notifiable diseases [49]. An outbreak at the Masango Hospital, for instance, was only documented retrospectively, following investigation of the widely publicized 1995 connected outbreak in Kikwit [25] and a Lassa fever outbreak in Nigeria was only confirmed after death of the last infected case, a physician [7]. Moreover, just as outbreaks may be unreported, case reporting within recorded outbreaks is likely underestimated.…”

Section: Introductionmentioning

confidence: 99%

“…Because person-to-person transmission via infected body fluids is common, delays to detection mean that hospitals can and do amplify epidemics when they occur [7,8]. Routine hospital infection control precautions can prevent the spread of most pathogens within hospitals but for some high-risk agents, special barrier precautions, such as isolation of patients and post-contact decontamination of health workers, are necessary.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic schemes for reducing epidemic size of african viral hemorrhagic fever outbreaks

Okeke

Manning

2014

J Infect Dev Ctries

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Introduction: Viral hemorrhagic fever (VHF) outbreaks, with high mortality rates, have often been amplified in African health institutions due to person-to-person transmission via infected body fluids. By collating and analyzing epidemiological data from documented outbreaks, we observed that diagnostic delay contributes to epidemic size for Ebola and Marburg hemorrhagic fever outbreaks. Methodology: We used a susceptible-exposed-infectious-removed (SEIR) model and data from the 1995 outbreak in Kikwit, Democratic Republic of Congo, to simulate Ebola hemorrhagic fever epidemics. Our model allows us to describe the dynamics for hospital staff separately from that for the general population, and to implement health worker-specific interventions. Results: The model illustrates that implementing World Health Organization/US Centers for Disease Control and Prevention guidelines of isolating patients who do not respond to antimalarial and antibacterial chemotherapy reduces total outbreak size, from a median of 236, by 90% or more. Routinely employing diagnostic testing in post-mortems of patients that died of refractory fevers reduces the median outbreak size by a further 60%. Even greater reductions in outbreak size were seen when all febrile patients were tested for endemic infections or when febrile health-care workers were tested. The effect of testing strategies was not impaired by the 1-3 day delay that would occur if testing were performed by a reference laboratory. Conclusion: In addition to improving the quality of care for common causes of febrile infections, increased and strategic use of laboratory diagnostics for fever could reduce the chance of hospital amplification of VHFs in resource-limited African health systems.

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Review of cases of nosocomial Lassa fever in Nigeria: the high price of poor medical practice

Cited by 319 publications

References 8 publications

Lassa Fever Epidemic in Nigeria - Outbreak Investigation, Risk Factors and Empirical Analysis from 2012 To 2016

Lassa Fever Epidemic in Nigeria - Outbreak Investigation, Risk Factors and Empirical Analysis from 2012 To 2016

Efficient Rescue of Recombinant Lassa Virus Reveals the Influence of S Segment Noncoding Regions on Virus Replication and Virulence

Diagnostic schemes for reducing epidemic size of african viral hemorrhagic fever outbreaks

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