Lassa-Fieber

Fleischer, K; Köhler, Bernd; Kirchner, Armin; Schmid, Jörg

doi:10.1007/pl00002133

Cited by 11 publications

(4 citation statements)

References 3 publications

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“…Patients with Lassa fever should be isolated in the clinical setting and treated by the use of barrier nursing techniques or protective respirators [15], as was done for the described patient [9]. The importance of universal precautions for control of nosocomial infections was underlined by the relatively high number of hospital staff who were found to be at risk because of unprotected contacts before the diagnosis was established.…”

Section: Conclusion and Discussionmentioning

confidence: 99%

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Imported Lassa Fever in Germany: Surveillance and Management of Contact Persons

et al. 2003

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This study sought to assess the risk of secondary transmission after import of Lassa fever into Europe. A total of 232 persons exposed to a case of Lassa fever imported into Germany were identified. The level of exposure was determined for 157 persons (68%), and 149 (64%) were tested serologically. High-risk or close contact was reported by 30 (19%) of 157 persons. No symptomatic secondary infections were observed. However, Lassa virus-specific immunoglobulin G antibodies were detected in a serum sample obtained from a physician who examined the index patient on day 9 of illness. The physician received ribavirin prophylaxis and did not develop symptoms of Lassa fever. On the basis of these data, the contact was classified as having a probable secondary infection. The study indicates a low risk of transmission during the initial phase of symptomatic Lassa fever, even with high-risk exposures. The risk may increase with progression of disease and increasing virus load.

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Section: Conclusion and Discussionmentioning

confidence: 99%

“…She died of hemorrhage and organ failure on day 14 of illness [9]. The viral RNA concentration in serum, as measured by real-time PCR, was initially 10 5 -10 6 RNA copies/mL and was increasing to 110 8 copies/mL concomitant with disease progression [10].…”

Section: Index Patientmentioning

confidence: 99%

Imported Lassa Fever in Germany: Surveillance and Management of Contact Persons

et al. 2003

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“…Haemorrhage within the solid organs contained in the abdomen and pelvis, with the accompanying release of some enzymes which may contribute to tissue necrosis and pain 12,14. Bleeding into the wall of the gall bladder may erroneously lead to diagnosis of cholecystitis when symptoms such as right hypochondrial pains and tenderness on examination of right hypochondrium are felt by the patients in such cases.…”

Section: Resultsmentioning

confidence: 99%

Acute abdominal pain in patients with lassa fever: Radiological assessment and diagnostic challenges

2014

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Background:To highlight the problems of diagnosis and management of acute abdomen in patients with lassa fever. And to also highlight the need for high index of suspicion of lassa fever in patients presenting with acute abdominal pain in order to avoid surgical intervention with unfavourable prognosis and nosocomial transmission of infections, especially in Lassa fever-endemic regions.Materials and Methods:A review of experiences of the authors in the management of lassa fever over a 4-year period (2004-2008). Literature on lassa fever, available in the internet and other local sources, was studied in November 2010 and reviewed.Results:Normal plain chest radiographic picture can change rapidly due to pulmonary oedema, pulmonary haemorrhage and acute respiratory distress syndrome. Plain abdominal radiograph may show dilated bowels with signs of paralytic ileus or dynamic intestinal obstruction due to bowel wall haemorrhage or inflamed and enlarged Peyer's patches. Ultrasound may show free intra-peritoneal fluid due to peritonitis and intra-peritoneal haemorrhage. Bleeding into the gall bladder wall may erroneously suggest infective cholecystitis. Pericardial effusion with or without pericarditis causing abdominal pain may be seen using echocardiography. High index of suspicion, antibody testing for lassa fever and viral isolation in a reference laboratory are critical for accurate diagnosis.Conclusion:Patients from lassa fever-endemic regions may present with features that suggest acute abdomen. Radiological studies may show findings that suggest acute abdomen but these should be interpreted in the light of the general clinical condition of the patient. It is necessary to know that acute abdominal pain and vomiting in lassa fever-endemic areas could be caused by lassa fever, which is a medical condition. Surgical option should be undertaken with restraint as it increases the morbidity, may worsen the prognosis and increase the risk of nosocomial transmission.

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“…Recently, highly contagious, life-threatening diseases have become of common interest not only because of some rare and dramatic cases that appeared in travellers after their return from tropical countries to Germany but also because of the possibility of bioterroristic attacks [1][2][3]. Such diseases are viral hemorrhagic fever caused by Ebola, Marburg, Lassa or Krim-Kongo virus, smallpox and monkeypox as well as pneumonic plague [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

A Concept for Blood Supply in Patients with Highly Contagious, Life-Threatening Diseases

Strobel¹,

Schmidt²

2004

Transfus Med Hemother

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Background: Highly contagious, life-threatening diseases such as viral hemorrhagic fever (caused by Ebola, Marburg, Lassa or Krim-Kongo virus), orthopox virus infection, or pneumonic plague require special isolation of the patient for protection of the medical staff and the public. As blood and other body fluids from these patients may be dangerous for the laboratory staff, laboratory examinations must also be done under special safety conditions. Situation: In Germany, clinical centers for intensive care of patients with highly contagious diseases have been established in Berlin, Frankfurt/M., Hamburg, Leipzig, and Munich. For practical reasons, the patients’ samples for urgent routine laboratory examinations cannot be sent over long distances to one of the two biosafety level 4 laboratories in Germany (in Hamburg and Marburg), but have to be examined at the clinical unit, obeying the biosafety regulations. Concept: As it is not allowed to examine blood samples from patients with highly contagious, life-threatening diseases in our routine laboratory, blood group serological tests will be performed within the isolation unit in a separate room near the patient’s room. An especially trained laboratory staff member wearing the special protection clothing will do the tests using routine laboratory methods with minimal modifications. To avoid production of aerosols, no washing procedures with fluids will be done. To reduce the risk of injuries, only plastic materials will be used. Therefore, we will perform all tests using the gel card centrifugation method. All waste will be separately collected and disinfected before leaving the unit. Reagents and hardware will stay within the unit. The ABO bedside test of the patient will be omitted because we will use only blood group O red blood cell concentrates in this setting. Limitations: Our concept is designed for the blood supply of one or two patients with highly contagious, life-threatening diseases hospitalized in the unit at the same time. If a markedly greater number of such patients have to be isolated and treated under provisional conditions, the routine standards for blood supply probably can no longer be maintained.

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Lassa-Fieber

Cited by 11 publications

References 3 publications

Imported Lassa Fever in Germany: Surveillance and Management of Contact Persons

Imported Lassa Fever in Germany: Surveillance and Management of Contact Persons

Acute abdominal pain in patients with lassa fever: Radiological assessment and diagnostic challenges

A Concept for Blood Supply in Patients with Highly Contagious, Life-Threatening Diseases

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