Management of a Lassa fever outbreak, Rhineland-Palatinate, Germany, 2016

Ehlkes, Lutz; George, Maja; Samosny, Gerhard; Burckhardt, Florian; Vogt, Manfred; Bent, Stefan; Jahn, Klaus; Zanger, Philipp

doi:10.2807/1560-7917.es.2017.22.39.16-00728

Cited by 34 publications

(23 citation statements)

References 22 publications

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“…First identified in 1969 in Nigeria,11 Lassa fever is now endemic in West Africa including Nigeria, Sierra Leone, Guinea, Liberia, Benin, Ghana and Mali and has spread to neighbouring countries (figure 1). 12–15 In some areas, 10%–16% of people admitted to hospitals every year have LASV 1. Cases have also been identified in Germany,13 15 16 the Netherlands,17 18 Sweden,19 the USA,20–22 the UK23 24 and Japan,25 largely imported after travel in West Africa 17 26–28.…”

Section: Introductionmentioning

confidence: 99%

Diagnostics for Lassa fever virus: a genetically diverse pathogen found in low-resource settings

Mazzola

Kelly-Cirino

2019

BMJ Glob Health

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Lassa fever virus (LASV) causes acute viral haemorrhagic fever with symptoms similar to those seen with Ebola virus infections. LASV is endemic to West Africa and is transmitted through contact with excretions of infected Mastomys natalensis rodents and other rodent species. Due to a high fatality rate, lack of treatment options and difficulties with prevention and control, LASV is one of the high-priority pathogens included in the WHO R&D Blueprint. The WHO LASV vaccine strategy relies on availability of effective diagnostic tests. Current diagnostics for LASV include in-house and commercial (primarily research-only) laboratory-based serological and nucleic acid amplification tests. There are two commercially available (for research use only) rapid diagnostic tests (RDTs), and a number of multiplex panels for differential detection of LASV infection from other endemic diseases with similar symptoms have been evaluated. However, a number of diagnostic gaps remain. Lineage detection is a challenge due to the genomic diversity of LASV, as pan-lineage sensitivity for both molecular and immunological detection is necessary for surveillance and outbreak response. While pan-lineage ELISA and RDTs are commercially available (for research use only), validation and external quality assessment (EQA) is needed to confirm detection sensitivity for all known or relevant strains. Variable sensitivity of LASV PCR tests also highlights the need for improved validation and EQA. Given that LASV outbreaks typically occur in low-resource settings, more options for point-of-care testing would be valuable. These requirements should be taken into account in target product profiles for improved LASV diagnostics.

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Section: Introductionmentioning

confidence: 99%

Diagnostics for Lassa fever virus: a genetically diverse pathogen found in low-resource settings

Mazzola

Kelly-Cirino

2019

BMJ Glob Health

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“…2 LASV is transmitted via ingestion or inhalation exposure to excretions by its primary reservoir, the Mastomys rat, as well as through person-to-person transmission following exposure to blood, tissue, secretions, or excretions of LASV-infected individuals. 3 Imported cases of Lassa fever have been reported in the United States 4 and Europe, 5 and nosocomial infections have occurred in nearly every recorded outbreak. 6 The clinical symptoms of Lassa infection include fever, malaise, severe edema, blood loss, and acute hemorrhagic fever which are associated with a high mortality rate.…”

Section: Introductionmentioning

confidence: 99%

Immunogenicity of a protective intradermal DNA vaccine against lassa virus in cynomolgus macaques

Jiang

Banglore

Cashman

et al. 2019

Human Vaccines & Immunotherapeutics

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Lassa virus (LASV) is a hemorrhagic fever virus of the Arenaviridae family with high rates of mortality and co-morbidities, including chronic seizures and permanent bilateral or unilateral deafness. LASV is endemic in West Africa and Lassa fever accounts for 10-16% of hospitalizations annually in parts of Sierra Leone and Liberia according to the CDC. An ongoing outbreak in Nigeria has resulted in 144 deaths in 568 cases confirmed as LASV as of November 2018, with many more suspected, highlighting the urgent need for a vaccine to prevent this severe disease. We previously reported on a DNA vaccine encoding a codon-optimized LASV glycoprotein precursor gene, pLASV-GPC, which completely protects Guinea pigs and nonhuman primates (NHPs) against viremia, clinical disease, and death following lethal LASV challenge. Herein we report on the immunogenicity profile of the LASV DNA vaccine in protected NHPs. Antigen-specific binding antibodies were generated in 100% (6/6) NHPs after two immunizations with pLASV-GPC. These antibodies bound predominantly to the assembled LASV glycoprotein complex and had robust neutralizing activity in a pseudovirus assay. pLASV-GPC DNA-immunized NHPs (5/6) also developed T cell responses as measured by IFNγ ELISpot assay. These results revealed that the pLASV-GPC DNA vaccine is capable of generating functional, LASV-specific T cell and antibody responses, and the assays developed in this study will provide a framework to identify correlates of protection and characterize immune responses in future clinical trials.

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“…We describe a strain of Lassa virus representing a new lineage that was isolated from a cluster of human infections with an epidemiologic link to Togo (Technical Appendix) ( 6 , 7 ). The clinical courses of the 3 case-patients and medical and public health interventions are described elsewhere ( 8 – 10 ). …”

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confidence: 99%