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HICprevent

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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Doc with Lassa Fever acquired in Africa in Emory Containment Unit

March 14th, 2016

By Gary Evans, Senior Staff Writer

There has never been a reported cases of Lassa fever transmission in the United States, but given that was also said about Ebola and Zika virus we must certainly hope it remains the case.

The Centers for Disease Control and Prevention has confirmed that a patient admitted to Emory University Hospital’s Serious Communicable Diseases Unit has Lassa fever, a hemorrhagic virus endemic in parts of West Africa. It’s not considered as deadly or as easily transmitted as Ebola, but of course we have seen that incoming exotic diseases do not always follow predicted behavior patterns.

However, Emory’s containment unit is state of the art, and the team led by Bruce Ribner, MD, successfully treated four Ebola patients during that outbreak. There have been Lassa fever patients treated in the U.S. before, including one who died last year in a New Jersey hospital.

The recently admitted Lassa Fever patient is an American physician assistant working for a missionary organization in Togo, West Africa. The virus can be transmitted by infected humans, but only through direct contact with bodily fluids – not through casual contact nor the airborne route.

While Ebola is thought to have an animal reservoir in bats, Lassa is carried in Africa by the "multimammate rat," which can excrete virus in urine and may colonize homes if it finds a food source. Similar to Hantavirus, viral particles from rodent excretions can be inhaled by people, particularly if they are sweeping up or otherwise stirring a contaminated area. It can also be ingested if food is contaminated.

In Africa, health care workers can acquire the virus from patients if proper PPE is not used and they have blood or body fluid exposures. It can also be transmitted through contaminated equipment or needlesticks. Approximately 15%-20% of patients hospitalized in Africa with Lassa fever die from the illness. However, only 1% of all Lassa virus infections – including those in the community -- result in death.