B]. Lassa virus infection

Notes
  • The disease is common in sections of West Africa where the multimammate rat is common.
  • Transmitted from food or other items that have been contaminated with multimammate rat excreta.
  • Statistics: Global annual incidence: 300,000 - 500,000; annual death rate: 5,000; overall mortality rate - 1%; mortality rate of the hospitalized patients - 15-20%. Incubation period – 6 to 21 days
Symptoms
  • Mainly asymptomatic (80%)
  • Fever
  • General weakness
  • Malaise
  • Mucosal bleeding
  • Bloody diarrhea
  • Hematemesis
  • Facial swelling
  • Muscle fatigue
  • Conjunctivitis
  • Dysphagia
  • Seizures
  • Encephalitis
  • Meningitis
  • Hepatitis
  • Tachycardia
  • Hypotension as well as hypertension
  • Cough
  • Chain pain
  • Deafness (25% of cases)
Diagnosis
  • Definitive diagnosis is available in Reference Laboratories
  • ELISA test for antigen and IgM
  • RT-PCR
  • Virus isolation by cell culture
  • Full blood count (lymphopenia and thrombocytopenia are common)
Differential
  • Ebola
  • Marburg
  • Malaria
  • Typhoid
  • Yellow fever
  • Shigellosis
Prevention
  • Keeping rodents out of homes and food supplies
  • Effective personal hygiene
  • Effective wearing of the Personal Protective Equipment (PPE) such as gloves, masks, laboratory coats, and goggles are advised while in contact with an infected person.
  • Samples of Lassa virus should be handle in an equipped laboratories under maximum biological containment conditions.
Management
  • Supportive care with rehydration and symptomatic treatment.
  • Early treatment with ribavirin

Either:

_Tabs Ribavirin 2000mg Stat then 1000mg QID x 4/7 then 500mg QID x 5/7

Or;

 _Inj Ribavirin 17mg/kg (max.1000mg per dose) then  17mg/kg (max.1000mg per dose) QID 4/7 then 8mg / kg (max.500mg per dose) QID x 5/7.

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