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Published Date: 2018-03-10 20:35:44
Subject: PRO/AH/EDR> Lassa fever - West Africa (17): Liberia (MO, NI)
Archive Number: 20180310.5678669
LASSA FEVER - WEST AFRICA (17): LIBERIA (MONTSERRADO, NIMBA)
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International Society for Infectious Diseases
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Date: Thu 8 Mar 2018
Source: Front Page Africa [edited]
http://www.frontpageafricaonline.com/index.php/health/7169-three-cases-of-lassa-fever-confirmed-in-liberia


The National Public Health Institute of Liberia (NPHIL) and the Ministry of Health (MoH) confirmed 3 Lassa fever cases from 2 counties: Montserrado (2) and Nimba (1).

All 3 confirmed cases have died. The 3 cases have undergone safe and dignified burials, and the county health teams are conducting contact tracing on both healthcare workers and community members who had high-risk (i.e. direct) contact with the patients during their symptomatic periods.

No epidemiological link has been established between the 3 confirmed cases that died. A total of 134 contacts have been identified and are currently being followed-up (Montserrado 105, Margibi 25 and Nimba 4) inclusive of 37 healthcare workers. As of 7 Mar 2018, no new confirmed Lassa fever cases have been reported.

Since 1 Jan 2018, a total of 28 suspected cases of Lassa fever have been reported across Liberia, including 12 deaths. Of these, 7 cases have been confirmed by the National Public Health Reference Laboratory: Nimba (4), Montserrado (2) and Bong (1).

Lassa fever is a viral hemorrhagic illness caused by a virus that is transmitted through contact with the urine or feces of infected rodents and through direct contact with body fluids of symptomatic human cases. In recent years, a consistently increasing trend in the number of Lassa fever cases has been observed in Liberia and other countries across West Africa. This includes Nigeria, where an ongoing outbreak has led to 353 confirmed cases with 78 confirmed and 8 probable deaths since 1 Jan 2018.

Symptoms of Lassa fever include vomiting, respiratory distress, chest pain, hiccups, and unexplained bleeding.

Public Health action taken by the National Public Health Institute of Liberia, Ministry of Health and partners are:

- Ensuring that all counties are aware of and prepared for handling any additional Lassa fever cases;
- Disseminating health promotion messages about the signs and symptoms of Lassa fever;
- Re-training Redemption Hospital staff in Lassa fever case management and safe handling of cases;
- Adapting case definition and screening tools and conducting surveillance and contact tracing in affected counties.

An effective treatment called ribavirin is available in the country for Lassa fever and should start as early as possible following symptomatic onset. Therefore, visiting a health facility immediately upon detection of any of the symptoms is critical to both preventing spread of the disease and ensuring safe recovery of the case.

Lassa fever can be prevented by doing the following:
- Keep your home and surroundings clean to keep rats from entering the home.
- Cover your food and drinking water to stop rats from playing in them.
- Dispose of garbage correctly and away from the home.
- Always wash your hands with soap and water.

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Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[Evidently, there have been several cases of Lassa fever in Liberia this year (2018). A previous report of a Lassa fever case in Ghana ex Liberia in February 2018 indicated that the infection was acquired in Guinea. Liberia, also a West African country, is endemic for Lassa virus. Lassa fever cases have been reported sporadically there. The Lassa fever belt in Liberia primarily occupies Lofa, Bong and Nimba counties across the northern tier of counties bordering Guinea. West Africa, including Guinea and Liberia, is endemic for Lassa fever virus.

The situation where these people acquired Lassa fever virus is not indicated in these cases. Virus transmission to humans occurs when people are in contact with the reservoir rodent host, the multimammate mouse (in the genus _Mastomys_) or its excreta, as was likely the situation in these cases. Rodent control has to be undertaken at the village level with individual households employing the preventive measures listed above. This requires an extensive and continuous public education effort. Transmission also occurs in health facilities when personal protective equipment is not employed and barrier-nursing practices are not adequate to protect staff from blood and secretions of infected patients.

Images of the _Mastomys_ mouse, the rodent reservoir of Lassa fever virus, can be seen at https://www.inaturalist.org/taxa/45326-Mastomys-natalensis.

A HealthMap/ProMED-mail map showing the location of both Guinea and Liberia can be accessed at: http://healthmap.org/promed/p/54. - Mod.TY

HealthMap/ProMED-mail maps:
Montserrado County, Liberia: http://healthmap.org/promed/p/34190
Nimba County, Liberia: http://healthmap.org/promed/p/2686]

See Also

Lassa fever - West Africa (09): Liberia ex Guinea 20180210.5620420
Lassa fever - West Africa (08): Liberia ex Guinea 20180209.5618946
Lassa fever - West Africa (07): Nigeria 20180206.5608967
Lassa fever - West Africa (04): Liberia 20170209.4827934
2016
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Lassa fever - West Africa (29): Nigeria, Liberia 20160520.4233773
Lassa fever - West Africa (23): Sweden (VG) ex Liberia, additional information 20160406.4141321
Lassa fever - West Africa (22): Sweden 20160404.4137025
2015
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Lassa fever - USA: (NJ) ex Liberia 20150526.3386913
2014
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Lassa fever - Nigeria, Liberia 20140328.2363217
2013
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Lassa fever - Liberia: (BG) fatal cases 20130911.1937742
2011
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Lassa fever, imported - Sweden (02): (LG) background 20110310.0778
Lassa fever, imported - Sweden: (LG) ex West Africa 20110309.0766
2007
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Lassa fever - Liberia (03) 20070430.1406
Lassa fever - Liberia (02): confirmed 20070413.1235
Lassa Fever - Liberia: RFI 20070410.1210
2006
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Lassa fever - Liberia (02) 20061001.2812
Lassa fever - Liberia: RFI 20060929.2783
2004
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Lassa fever, imported - USA (NJ) ex Liberia (02) 20040930.2700
Lassa fever, imported - USA (NJ) ex Liberia 20040903.2467
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