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Lassa haemorrhagic fever (LHF)
Related Subjects: |Fever in a traveller |Malaria Falciparum |Malaria Non Falciparum |Viral Haemorrhagic Fevers (VHF) |Lassa fever |Dengue |Marburg virus disease |AIDS HIV |Yellow fever |Ebola Virus |Leptospirosis | Crimean-Congo haemorrhagic fever |African Trypanosomiasis (Sleeping sickness) |American Trypanosomiasis (Chagas Disease) |Incubation Periods |Notifiable Diseases UK
🦠 Lassa Fever is an acute viral haemorrhagic illness. Most infections are asymptomatic or mild (≈80%), but severe disease can cause haemorrhage, multi-organ failure, and death. An estimated 100,000–300,000 infections occur annually with around 5,000 deaths. Mortality is particularly high in the third trimester of pregnancy.
📍 About
- Zoonotic acute viral illness, spread by the multimammate rat (Mastomys species).
- Endemic in parts of West Africa - Sierra Leone, Liberia, Guinea, Nigeria.
- First described in Lassa, Nigeria (1969).
🧬 Aetiology
- Caused by a single-stranded RNA virus from the Arenaviridae family.
- Reservoir = chronically infected rodents that shed virus in urine/faeces.
🩺 Clinical Features
- Incubation: 1–3 weeks post exposure.
- Mild disease: fever, malaise, weakness, headache.
- Severe disease: haemorrhage (gums, eyes, nose), chest/abdominal pain, facial swelling, shock.
- Complications: encephalitis, tremor, deafness (≈1/3 survivors), multi-organ failure.
- Pregnancy: very high mortality, especially in 3rd trimester.
🔬 Investigations
- ELISA for IgM/IgG and Lassa antigen.
- RT-PCR in the early acute phase (diagnostic gold standard).
- Supportive labs: FBC, U&E, LFTs; but ⚠️ all samples must be processed in high-level containment labs in UK.
🧤 Infection Control
- Isolate immediately in a negative pressure room if suspected.
- Strict PPE: gowns, gloves, goggles, masks/respirators.
- Decontamination: sterilise equipment, dispose of contaminated materials safely.
💊 Management
- Ribavirin - effective if given early in disease course.
- Supportive care: fluid/electrolyte balance, oxygenation, BP support, treat coinfections.
- Prevention: rodent control, rodent-proof food storage, hygiene in endemic areas.
📚 References
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