Lassa fever in pregnancy with a positive maternal and fetal outcome: A case report

Abstract

Background: The signs and symptoms of Lassa fever are initially indistinguishable from other febrile illnesses common in the tropics and complications of pregnancy. Surviving Lassa fever during pregnancy is rare. Only few cases have been documented. The antiviral drug of choice is ribavirin. Case description: A 25-year-old multigravida farmer with fever who was initially thought to have malaria in pregnancy at 29 weeks gestation. Further changes in her clinical state and laboratory tests led to a confirmation of Lassa fever. The Liver enzymes were markedly deranged and the packed cell volume was 27%. She commenced on ribavirin and subsequently was delivered of a live male neonate who was RT PCR negative for Lassa fever virus. Her clinical state improved, repeat RT PCR on day 15 was negative and she made full recovery. Discussion: The case reported had similar clinical features of fever and abdominal pain and resulted in the initial diagnoses of Malaria in pregnancy. When she failed to respond to antimalarial and antibiotics treatments, a strong suspicion of viral hemorrhagic fever was made. At this time the patient was in advanced stage of the disease with bleeding from vagina and puncture sites. On the third day of admission she was delivered of a live male neonate who remained negative after 2 consecutive RT PCR tests for Lassa fever virus. Lassa fever carries a high risk of death to the fetus throughout pregnancy and to the mother in the third trimester. Mothers with Lassa fever improved rapidly after evacuation of the uterus by spontaneous abortion, or normal delivery. She was clinically stable following delivery. Her laboratory investigations were essentially normal. Throughout her management transmission based precautions were observed. None of the six close contacts developed symptoms after been followed up for 21 days. Conclusion: This report adds to the body of literature that individuals can survive Lassa fever during pregnancy with good maternal and fetal outcome.

Public health response to two imported, epidemiologically related cases of Lassa fever in the Netherlands (ex Sierra Leone), November 2019

“…This report shows that LASV can pose an infection risk during routine invasive hospital procedures involving patients in endemic areas, in particular on maternity wards as LASV has a high affinity for placenta and vascular tissues [7,12]. Awareness of the local risks and implementation of standard precautions to reduce the risk of transmission of blood-borne pathogens are essential to prevent nosocomial transmission [8,13].…”

Fatal case of newborn Lassa fever virus infection mimicking late onset neonatal sepsis: a case report from northern Nigeria

“…Our reported case resulted in fatality, but there is some evidence from a case report and a retrospective cohort study to suggest positive newborn outcomes in few pregnant mothers [17,18]. In these cases, Lassa fever was diagnosed early and treated in the third trimester of pregnancy and these were reports of mothers who delivered in specialist or tertiary-level health facilities [17,18]. The mother of our index participant delivered in at home and was not identified as a probable Lassa fever case.…”

Case Report: COVID-19 and Lassa Fever Coinfection in an Ebola Suspected Patient in Guinea

“…Many cases of Lassa fever have been described with specific conditions. 9 – 11 However, the unusual association of two epidemic-prone diseases (Lassa fever and COVID-19) in the context of an ongoing Ebola outbreak is a unique and previously unreported case.…”