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