Lassa fever laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Ammu Susheela, M.D. [2]

Synonyms and keywords: Lassa hemorrhagic fever; LHF

Overview

There is a range of laboratory investigations that are performed to diagnose the disease and assess its course and complications. 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. Research has been done in the last few years, by a team of specialists, in order to diagnose the Lassa fever on a molecular level. Potentially infectious diagnostic specimens are routinely handled and tested in U.S. laboratories in a safe manner, by closely following the standard safety precautions..

Lab tests

• The next table summarizes the lab tests and laboratory findings.

Laboratory findings

Lab tests	Laboratory findings
Complete Blood Count (CBC)	Lymphocytopenia (low white blood cell counts), Thrombocytopenia (low platelets)
Liver function tests	Elevated aspartate aminotransferase (AST)
Urinalysis	Proteinuria in urine analysis
Chest X-rays	Chest X-rays shows basilar pneumonitis and pleural effusions.

Laboratory Findings

• Lymphopenia (low white blood cell counts)
• Thrombocytopenia (low platelets)
• Elevated aspartate aminotransferase (AST)
• Proteinuria in urine analysis.
• The virus itself may be cultured in 7 to 10 days.
• Chest X-rays shows basilar pneumonitis and pleural effusions.

Guidance for Collection, Transport, and Submission of Specimens for Virus Testing in the United States

• Lassa virus is graded as bio safety level 4 according to CDC classification.
• Ideally, specimens should be taken when a symptomatic patient reports to a healthcare facility and is suspected of having an exposure to the disease. However, if the onset of symptoms is <3 days, a later specimen may be needed to completely rule-out virus, if the first specimen tests negative.
• A minimum volume of 4 mL of whole blood preserved with EDTA is preferred but whole blood preserved with sodium polyanethol sulfonate, citrate, or clot activator can be submitted for testing.
• Specimens should be shipped at 2-8°C or frozen on cold-packs. Do not submit specimens in glass containers to CDC. Do not submit specimens preserved in heparin tubes.

TRANSPORTING SPECIMENS WITHIN THE HOSPITAL / INSTITUTION

• Specimens should be placed in a durable, leak-proof secondary container for transport within a facility. To reduce the risk of breakage or leaks, do not use any pneumatic tube system for transporting suspected virus specimen.
• Packing and shipping infectious substances must be performed by people trained and certified in compliance with DOT or International Air Transport Association requirements.