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Eurosurveillance, Volume 11, Issue 30, 27 July 2006
Articles

Citation style for this article: Unit for Surveillance and Communication, Unit for Preparedness and Response, Editorial team. E-alert 24 July: Case of Lassa fever imported into Germany from Sierra Leone. Euro Surveill. 2006;11(30):pii=3008. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3008

E-alert 24 July: Case of Lassa fever imported into Germany from Sierra Leone

Unit for Surveillance and Communication1, Unit for Preparedness and Response1, Editorial team2 (eurosurveillance.weekly@hpa.org.uk)

1European Centre for Disease Prevention and Control, Stockholm, Sweden
2Eurosurveillance editorial office

A 68 year old man who recently travelled from Sierra Leone to Germany via Belgium has been diagnosed with Lassa fever [1].

The patient had a history of progressive neurological deterioration over several months in Sierra Leone. On 5 July 2006, he developed high fever and his neurological symptoms worsened. On 10 July the patient travelled by air from Freetown (Sierra Leone) via Abijian (Ivory Coast) to Brussels, Belgium. All of this journey was in the same aeroplane. In Brussels, the patient changed plane for the connecting flight to Frankfurt, where he arrived on 11 July.

Immediately after arriving, he was taken to the university hospital in Münster. On 16 July, the patient’s condition worsened, and he was intubated and treated in isolation. Although the patient’s clinical presentation was in accordance with his known underlying disease, additional tests for tropical infectious diseases were carried out. On 20 July, IgG for Lassa virus was detected in a cerebrospinal fluid sample and RT-PCR was positive. On 21 July, an RNA-PCR for Lassa virus was detected in blood, urine and sputum.

A message was posted on the confidential European Early warning and Response System on Friday 21 July. While the risk to co-passengers is judged to be low, passengers on the following flights are being traced and contacted to inform them about the risk.

SN Brussels Airlines flight SN 207 on 10 July from Brussels (Belgium) via Freetown (Sierra Leone) to Abidjan (Cote d’Ivoire) in seat rows 23 to 29
SN Brussels Airlines flight SN 207 on 10 July from Freetown (Sierra Leone) via Abidjan (Cote d’Ivoire) to Brussels (Belgium) in seat rows 23 to 29
SN Brussels Airlines flight SN 2607 on 11 July, which departed Brussels (Belgium) to Frankfurt (Germany) at 0630, all seats

The patient has been transferred to a special treatment centre in Frankfurt. Flight crew members as well as aeroplane cleaning personnel are being contacted by public health authorities.

Since 1970, at least 16 cases of Lassa fever have been imported into Europe or North America; in none of these has onward transmission to another person been reported. The last reported imported case into Europe was in 2003 in a soldier from the United Kingdom who had been serving in Sierra Leone [2]. In 2000, a European meeting to discuss the management of Lassa fever cases was held, after several importations in 1999/2000 [3,4,5,6].

The World Health Organization has produced a Lassa fever fact sheet which can be found here: http://www.who.int/mediacentre/factsheets/fs179/en/

This article was first published as an e-alert in Eurosurveillance on 24 July, and was originally available at http://www.eurosurveillance.org/ew/2006/060720.asp#e

References:
  1. ECDC. Lassa fever case in Germany: alert issued concerning airline passengers who flew with infected man. 24 July 2006. http://www.ecdc.europa.eu/index.ph
  2. Lassa fever in a UK soldier recently returned from Sierra Leone - e-alert 10 February. Eurosurveillance Weekly [1812-075X]. 2003 Feb 6;2(6) 030206. Available from: http://www.eurosurveillance.org/ew/2003/030206.asp#1
  3. Jones J. Lassa fever imported to England. Eurosurveillance Weekly 2000; 4: 000311 (http://www.eurosurveillance.org/ew/2000/000316.asp)
  4. Eurosurveillance. Imported case of Lassa fever in the Netherlands. Eurosurveillance Weekly 2000; 4: 000721 (http://www.eurosurveillance.org/ew/2000/000727.asp)
  5. Lieftucht A, Kiehl W. Lassa fever in a German student returning from Ghana and Cote d'Ivoire. Eurosurveillance Weekly 2000; 4: 000119 (http://www.eurosurveillance.org/ew/2000/000119.asp)
  6. Crowcroft N. Management of Lassa Fever in European countries. Euro Surveill 2003; 7(3): 50-52 (http://www.eurosurveillance.org/em/v07n03/0703-227.asp)

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