[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]
Open Forum Infect Dis. 2018 Jul 16;5(7):ofy131. doi: 10.1093/ofid/ofy131. eCollection 2018 Jul.
A Case of Lassa Fever Diagnosed at a Community Hospital-Minnesota 2014.
Choi MJ1, Worku S2, Knust B3, Vang A4, Lynfield R1, Mount MR2, Objio T4, Brown S3, Griffith J1, Hulbert D2, Lippold S4, Ervin E3, Ströher U3, Holzbauer S1, Slattery W2, Washburn F4, Harper J1, Koeck M1, Uher C2, Rollin P3, Nichol S3, Else R2, DeVries A1.
Author information: 1 Minnesota Department of Health, St. Paul, Minnesota. 2 Mercy Hospital, Allina Health, Coon Rapids, Minnesota. 3 Viral Special Pathogens Branch, Atlanta, Georgia. 4 Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia.
In April 2014, a 46-year-old returning traveler from Liberia was transported by emergency medical services to a community hospital in Minnesota with fever and altered mental status. Twenty-four hours later, he developed gingival bleeding. Blood samples tested positive for Lassa fever RNA by reverse transcriptase polymerase chain reaction.
Blood and urine samples were obtained from the patient and tested for evidence of Lassa fever virus infection. Hospital infection control personnel and health department personnel reviewed infection control practices with health care personnel. In addition to standard precautions, infection control measures were upgraded to include contact, droplet, and airborne precautions. State and federal public health officials conducted contract tracing activities among family contacts, health care personnel, and fellow airline travelers.
The patient was discharged from the hospital after 14 days. However, his recovery was complicated by the development of near complete bilateral sensorineural hearing loss. Lassa virus RNA continued to be detected in his urine for several weeks after hospital discharge. State and federal public health authorities identified and monitored individuals who had contact with the patient while he was ill. No secondary cases of Lassa fever were identified among 75 contacts.
Given the nonspecific presentation of viral hemorrhagic fevers, isolation of ill travelers and consistent implementation of basic infection control measures are key to preventing secondary transmission. When consistently applied, these measures can prevent secondary transmission even if travel history information is not obtained, not immediately available, or the diagnosis of a viral hemorrhagic fever is delayed.
KEYWORDS: Lassa fever; contact tracing; infection control; sensorineural hearing loss
PMID: 30035149 PMCID: PMC6049013 DOI: 10.1093/ofid/ofy131
Keywords: Lassa fever; USA; Minnesota.