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Lassa Fever:- More About The Virus+pics by finalboss(m): 8:52am On Jan 16, 2016 |
Lassa fever or Lassa hemorrhagic fever ( LHF )
is an acute viral hemorrhagic fever caused by
the Lassa virus and first described in 1969 in
the town of Lassa, in Borno State , Nigeria .[1]
Lassa fever is a member of the Arenaviridae
virus family. Similar to ebola, [2] clinical cases
of the disease had been known for over a
decade, but had not been connected with a
viral pathogen.
Lassa frequently infects people in West Africa.
It results in 300,000 to 500,000 cases annually
and causes about 5,000 deaths each year. [3]
Outbreaks of the disease have been observed
in Nigeria , Liberia , Sierra Leone , Guinea , and
the Central African Republic. The primary
animal host of the Lassa virus is the Natal
multimammate mouse ( Mastomys natalensis),
an animal found in most of sub-Saharan
Africa. [4] The virus is probably transmitted by
contact with the feces or urine of animals
accessing grain stores in residences. [4] Given
its high rate of incidence, Lassa fever is a
major problem in affected countries. [5][6]
Signs and symptoms:-----+--
In 80% of cases, the disease is asymptomatic ,
but in the remaining 20%, it takes a
complicated course. The virus is estimated to
be responsible for about 5,000 deaths
annually. The fever accounts for up to one-
third of deaths in hospitals within the affected
regions and 10 to 16% of total cases.[7]
After an incubation period of six to 21 days, an
acute illness with multiorgan involvement
develops. Nonspecific symptoms include fever,
facial swelling, and muscle fatigue, as well as
conjunctivitis and mucosal bleeding. The other
symptoms arising from the affected organs
are:
Gastrointestinal tract
Nausea
Vomiting (bloody)
Diarrhea (bloody)
Stomach ache
Constipation
Dysphagia (difficulty swallowing)
Hepatitis
Cardiovascular system
Pericarditis
Hypertension
Hypotension
Tachycardia (abnormally high heart rate)
Respiratory tract
Cough
Chest pain
Dyspnoea
Pharyngitis
Pleuritis
Nervous system
Encephalitis
Meningitis
Unilateral or bilateral hearing deficit
Seizures
Clinically, Lassa fever infections are difficult to
distinguish from other viral hemorrhagic fevers
such as Ebola and Marburg, and from more
common febrile illnesses such as malaria .
The virus is excreted in urine for 3-9 weeks
and in semen for three months.
Cause:-------
Mastomys natalensis, the natural
reservoir of the Lassa fever virus
Lassa virus is zoonotic (transmitted from
animals), in that it spreads to humans from
rodents, specifically multimammate mice
( Mastomys natalensis). [8] This is probably the
most common mouse in equatorial Africa,
ubiquitous in human households and eaten as
a delicacy in some areas. [8] In these rodents,
infection is in a persistent asymptomatic state.
The virus is shed in their excreta (urine and
feces), which can be aerosolized. In fatal
cases, Lassa fever is characterized by impaired
or delayed cellular immunity leading to
fulminant viremia .
Infection in humans typically occurs by
exposure to animal excrement through the
respiratory or gastrointestinal tracts. Inhalation
of tiny particles of infectious material (aerosol)
is believed to be the most significant means of
exposure. It is possible to acquire the infection
through broken skin or mucous membranes
that are directly exposed to infectious material.
Transmission from person to person has also
been established, presenting a disease risk for
healthcare workers. Frequency of transmission
by sexual contact has not been established.
Diagnosis:----
A range of laboratory investigations are
performed to diagnose the disease and assess
its course and complications. An ELISA test for
antigen and IgM antibodies give 88%
sensitivity and 90% specificity for the presence
of the infection. Other laboratory findings in
Lassa fever include lymphopenia (low white
blood cell count), thrombocytopenia (low
platelets), and elevated aspartate
aminotransferase levels in the blood. Lassa
fever can also be found in cerebrospinal fluid .
[9] In West Africa, where Lassa is most
prevalent, it is difficult for doctors to diagnose
due to the absence of proper equipment to
perform tests. [10] In cases with abdominal
pain , diagnoses in countries where Lassa is
endemic are often made for other illnesses,
such as appendicitis and intussusception ,
delaying treatment with ribavirin.
Treatment:----------->
All persons suspected of Lassa fever infection
should be admitted to isolation facilities and
their body fluids and excreta properly disposed
of.
Early and aggressive treatment using ribavirin
was pioneered by Joe McCormick in 1979.
After extensive testing, early administration
was determined to be critical to success.
Additionally, ribavirin is almost twice as
effective when given intravenously as when
taken by mouth. [14] Ribavirin is a prodrug
which appears to interfere with viral replication
by inhibiting RNA-dependent nucleic acid
synthesis , although the precise mechanism of
action is disputed. [15] The drug is relatively
inexpensive, but the cost of the drug is still
very high for many of those in West African
states. Fluid replacement, blood transfusion,
and fighting hypotension are usually required.
Intravenous interferon therapy has also been
used. [citation needed ]
When Lassa fever infects pregnant women late
in their third trimester, induction of delivery is
necessary for the mother to have a good
chance of survival. [16] This is because the
virus has an affinity for the placenta and other
highly vascular tissues. The fetus has only a
one in ten chance of survival no matter what
course of action is taken; hence, the focus is
always on saving the life of the
mother. [citation needed ] Following delivery,
women should receive the same treatment as
other Lassa fever patients.
Work on a vaccine is continuing, with multiple
approaches showing positive results in animal
trials. [citation needed ]
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Re: Lassa Fever:- More About The Virus+pics by Jibabs2(m): 11:01am On Jan 16, 2016 |
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