Lassa fever historical perspective

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

Overview

The first case of documented Lassa fever was reported in 1969 following the death of 2 nurses in Lassa, Nigeria.

Historical Perspective

• In 1955-1956, epidemics with clinical and epidemiological resemblance to Lassa fever were reported in Eastern Province and Sierra Leone.
• The first case of documented Lassa fever was reported in 1969 following the death of 2 nurses in Lassa, Nigeria. Prior to that, similar cases in West Africa were reported and thought to be caused by Lassa fever given the clinical and epidemiological resemblance of the presentation to Lassa fever.

• Administration of ribavirin for the treatment of Lassa fever was first introduced by Joe McCormick in 1979.
• Lassa fever is uncommon outside West Africa. Only 6 patients with Lassa fever have historically been hospitalized in USA (all 6 patients had recently traveled to West Africa). The most recent case of Lassa fever in USA was reported in May 2015.
  

Year of import	Clinical features	From	To
1969	Fever, malaise, headache, nausea, sore throat, epigastric/right upper quadrant tenderness, pleural effusion, facial/cervical edema, dysphagia, elevated transaminases, cough, dyspnea, pulmonary infiltrates, epiglottal edema, lethargy, nystagmus, lightheadedness, dizziness without vertigo, ataxia, alopecia	Nigeria	New York
1975	Abdominal pain, diarrhea, fever, headache, myalgia, arthralgia, conjunctival injection, lymphadenopathy, weight loss, pleuritic chest pain, pleural effusion, unilateral deafness	Sierra Leone	Washington, DC
1976	Abdominal cramps, nausea, vomiting, diarrhea, fatigue, headache, retroorbital pain, neck/back pain, paresthesias, right ear pain, fever, vertigo, syncope, dysmorphopsias, alopecia, weight loss, ecchymoses, insomnia, depression, hypotension, left-sided facial weakness, right-sided Babinski reflex, Weber test lateralized to the left	Sierra Leone	Washington, DC
1989	Shaking chills, fever, sore throat, myalgia, headache, dysphagia, bloody diarrhea, elevated transaminases, hypotension, adult respiratory distress syndrome, death	Nigeria	Chicago, IL
2004	Chills, fever, sore throat, diarrhea, back pain, adult respiratory distress syndrome, death	Sierra Leone and Liberia	Trenton, New Jersy
2015	Fever, sore throat, tiredness, death	Liberia	New Jersy

Data from the Center of Disease Control and Prevention, as of May 2015

^{A physician examining a patient with Lassa fever patient in West Africa in 1977. Image retrieved from the Centers for Disease Control and Prevention (CDC) - Lassa Fever History}