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Lassa Fever Natural History and Clinical Management

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Lassa Fever: Epidemiology, Immunology, Diagnostics, and Therapeutics

Part of the book series: Current Topics in Microbiology and Immunology ((CT MICROBIOLOGY,volume 440))

Abstract

Lassa fever is caused by Lassa virus (LASV), an Old World Mammarenavirus that is carried by Mastomys natalensis and other rodents. It is endemic in Sierra Leone, Nigeria, and other countries in West Africa. The clinical presentation of LASV infection is heterogenous varying from an inapparent or mild illness to a fatal hemorrhagic fever. Exposure to LASV is usually through contact with rodent excreta. After an incubation period of 1–3 weeks, initial symptoms such as fever, headache, and fatigue develop that may progress to sore throat, retrosternal chest pain, conjunctival injection, vomiting, diarrhea, and abdominal pain. Severe illness, including hypotension, shock, and multiorgan failure, develops in a minority of patients. Patient demographics and case fatality rates are distinctly different in Sierra Leone and Nigeria. Laboratory diagnosis relies on the detection of LASV antigens or genomic RNA. LASV-specific immunoglobulin G and M assays can also contribute to clinical management. The mainstay of treatment for Lassa fever is supportive care. The nucleoside analog ribavirin is commonly used to treat acute Lassa fever but is considered useful only if treatment is begun early in the disease course. Drugs in development, including a monoclonal antibody cocktail, have the potential to impact the management of Lassa fever.

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Authors and Affiliations

  1. Lassa Fever Program, Kenema Government Hospital, Ministry of Health, Kenema, Sierra Leone

    Donald S. Grant & Robert J. Samuels

  2. College of Medicine and Allied Health Sciences (COMAHS), University of Sierra Leone, Freetown, Sierra Leone

    Donald S. Grant

  3. School of Medicine, Department of Microbiology and Immunology, Tulane University, New Orleans, LA, 70112, USA

    Robert F. Garry

  4. Zalgen Labs, Frederick, MD, 21703, USA

    Robert F. Garry

  5. Global Virus Network (GVN), Baltimore, MD, 21201, USA

    Robert F. Garry

  6. School of Medicine, Department of Pediatrics, Tulane University, New Orleans, LA, 70112, USA

    John S. Schieffelin

Authors
  1. Donald S. Grant
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  2. Robert J. Samuels
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  3. Robert F. Garry
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  4. John S. Schieffelin
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Corresponding author

Correspondence to John S. Schieffelin .

Editor information

Editors and Affiliations

  1. Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA, USA

    Robert Garry

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Grant, D.S., Samuels, R.J., Garry, R.F., Schieffelin, J.S. (2023). Lassa Fever Natural History and Clinical Management. In: Garry, R. (eds) Lassa Fever: Epidemiology, Immunology, Diagnostics, and Therapeutics. Current Topics in Microbiology and Immunology, vol 440. Springer, Cham. https://doi.org/10.1007/82_2023_263

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