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Open Access Case Report

Capacity building permitting comprehensive monitoring of a severe case of Lassa hemorrhagic fever in Sierra Leone with a positive outcome: Case Report

Jessica N Grove1, Luis M Branco12, Matt L Boisen3, Ivana J Muncy3, Lee A Henderson4, John S Schieffellin5, James E Robinson5, James J Bangura67, Mbalu Fonnie8, Randal J Schoepp9, Lisa E Hensley10, Alhassan Seisay6, Joseph N Fair7 and Robert F Garry1*

Author Affiliations

1 Tulane University Department of Microbiology and Immunology, New Orleans, LA, USA

2 Autoimmune Technologies, LLC, New Orleans, LA, USA

3 Corgenix Medical Corporation, Broomfield, CO, USA

4 Vybion, Inc., Ithaca, NY, USA

5 Tulane University Department of Pediatrics, Section of Infectious Disease, New Orleans, LA, USA

6 Ministry of Health and Sanitation Workplace Health, Sierra Leone

7 The Global Viral Forecasting Initiative, San Francisco, CA

8 Kenema Government Hospital Lassa Fever Ward, Kenema, Sierra Leone

9 Applied Diagnostics Branch, Diagnostic Systems Division, U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD, USA

10 Viral Therapeutics Branch, Virology Division, U.S. Army Medical Research Institute of Infectious Diseases Diagnostic Systems Division, Fort Detrick, MD, USA

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Virology Journal 2011, 8:314  doi:10.1186/1743-422X-8-314

Published: 20 June 2011

Abstract

Lassa fever is a neglected tropical disease with a significant impact on the health care system of endemic West African nations. To date, case reports of Lassa fever have focused on laboratory characterisation of serological, biochemical and molecular aspects of the disease imported by infected individuals from Western Africa to the United States, Canada, Europe, Japan and Israel. Our report presents the first comprehensive real time diagnosis and characterization of a severe, hemorrhagic Lassa fever case in a Sierra Leonean individual admitted to the Kenema Government Hospital Lassa Fever Ward. Fever, malaise, unresponsiveness to anti-malarial and antibiotic drugs, followed by worsening symptoms and onset of haemorrhaging prompted medical officials to suspect Lassa fever. A recombinant Lassa virus protein based diagnostic was employed in diagnosing Lassa fever upon admission. This patient experienced a severe case of Lassa hemorrhagic fever with dysregulation of overall homeostasis, significant liver and renal system involvement, the interplay of pro- and anti-inflammatory cytokines during the course of hospitalization and an eventual successful outcome. These studies provide new insights into the pathophysiology and management of this viral illness and outline the improved infrastructure, research and real-time diagnostic capabilities within LASV endemic areas.