Date: Thu 8 Feb 2018
Source: WPXI [edited]
Authorities in Guinea announced the 1st death from Lassa fever in more than 2 decades [Thu 8 Feb 2018], heightening anxiety about another haemorrhagic fever in the West African country where an Ebola epidemic 1st emerged.
The Ebola outbreak in late 2013 went on to kill more than 11,000 people in part because local authorities and the international community were slow to act when cases 1st popped up in a rural part of the deeply impoverished nation.
In a government statement, health authorities confirmed that at least one person was dead and more than 2 dozen others had been monitored for possible symptoms. However, critics questioned why the government was only now making the news public when the victim died [Thu 11 Jan 2018].
Further complicating the situation was the fact that the Guinean citizen died across the border in Liberia - the same way that Ebola initially spread. Guinea's government had vowed to improve its response to crises after initial efforts were disorganized and met with mistrust. "This official silence in the face of an epidemic is the reason I buried 8 members of my family who became victims of Ebola," said student [AB] in the capital, Conakry.
Authorities in Guinea, though, said appropriate contact tracing was done and that there was nothing for people to fear. "None of the patient's contacts in Liberia became sick or tested positive for Lassa," the statement said. It did not mention whether Liberian authorities had been informed. It said the World Health Organization was told 2 days after the death.
There is no approved vaccine for Lassa fever, whose symptoms are similar to Ebola. After starting as a fever with aches and pains it can progress to headache, vomiting and diarrhea. According to WHO, severe cases can cause victims to bleed from the mouth and nose.
Like Ebola, Lassa fever can be spread through contact with the bodily fluids of sick people. Humans also can contract it from eating food that has been tainted by the urine or feces of rodents.
Dr. Sakoba Keita, who coordinated Guinea's national response to the Ebola outbreak from 2014-2016, told private radio station Espace FM that the new Lassa fever case was the country's 1st known one since 1996.
The disease, however, has long existed in West Africa. Nigerian authorities have reported more than 440 suspected cases throughout the country so far this year , according to the non-governmental organization known as ALIMA. At least 40 people are believed to have died from Lassa fever there. [Byline: Krista Larson and Boubacar Diallo]
[This is the 1st Lassa fever case that ProMED-mail has posted for Guinea. The report above indicates that the affected individual actually died in Liberia, but implies 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 Lass fever virus, although cases are far fewer than in Nigeria. The situation where the person acquired Lassa fever virus is not indicated in this case. Lassa fever remains a problem in West Africa because the virus is endemic there.
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 this case. Rodent control has to be undertaken at the village level with individual households. 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, as happened with the cases of the 10 healthcare workers in Nigeria. Early in the course of Lassa fever, patients present with a general febrile disease with symptoms common to a variety of infections, including malaria, making it more difficult for healthcare workers to know when personal protective equipment should be used.
Images of the _Mastomys_ mouse, the rodent reservoir of Lassa fever virus, can be seen at