Lujo viral hemorrhagic fever: considering diagnostic capacity and preparedness in the wake of recent Ebola and Zika virus outbreaks

Abstract

Lujo virus is a novel Old World arenavirus identified in Southern Africa in 2008 as the cause of a viral hemorrhagic fever (VHF) characterized by nosocomial transmission with a high case fatality rate of 80% (4/5 cases). Whereas this outbreak was limited, the unprecedented Ebola virus disease outbreak in West Africa, and recent Zika virus disease epidemic in the Americas, has brought into acute focus the need for preparedness to respond to rare but potentially highly pathogenic outbreaks of zoonotic or arthropod-borne viral infections. A key determinant for effective control of a VHF outbreak is the time between primary infection and diagnosis of the index case. Here, we review the Lujo VHF outbreak of 2008 and discuss how preparatory measures with respect to developing diagnostic capacity might be effectively embedded into existing national disease control networks, such as those for human immunodeficiency virus, tuberculosis, and malaria.

NRP2 and CD63 Are Host Factors for Lujo Virus Cell Entry

“…The 2014–2016 outbreak of EBOV in West Africa underscores the challenges of controlling hemorrhagic fever viruses with profound impacts on human health (Simulundu et al, 2016). Deciphering the interplay between virus and host is not only paramount to understanding mechanisms of pathogenesis but may aid the development of antivirals.…”

Molecular Mechanisms Underlying the Cellular Entry and Host Range Restriction of Lujo Virus

“…The nosocomial transmission in this outbreak indicated that LUJV caused human-to-human transmission. Since then, patients with LUJV infection have never been reported, and LUJV has never been detected in any animal species ( 5 , 6 ). Although LUJV is classified into the OW arenavirus group because of its discovery in Africa, it is phylogenetically distinct from the other OW arenaviruses, including LASV ( 1 ).…”

“…In general, rodents are natural reservoirs of mammarenaviruses, except for Tacaribe virus isolated from an artibeus bat ( 2 , 4 ). A natal multimammate mouse ( Mastomys natalensis ) is known to be the natural host of LASV; however, the reservoirs of LUJV are still unknown ( 5 , 6 ). To establish effective countermeasures against arenavirus infections, it is important to understand the molecular basis of their pathogenicities and host ranges.…”

Common Themes in Zoonotic Spillover and Disease Emergence: Lessons Learned from Bat- and Rodent-Borne RNA Viruses

“…Following illness, she was flown to Johannesburg, South Africa to be treated at a private hospital. There, four healthcare workers were exposed and became ill and three died [ 274 ]. Among the hantaviruses, there have been documented cases of person-to-person transmission only for the South American Andes orthohantavirus (ANDV) which have occurred in Argentina and Chile [ 267 , 275 , 276 , 277 , 278 , 279 ].…”