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Control measures following a case of imported Lassa fever from Togo, North Rhine Westphalia, Germany, 2016
- Clara Lehmann1,2 , Matthias Kochanek2,3 , Diana Abdulla2,3 , Stephan Becker4,5 , Boris Böll2,3 , Anne Bunte6 , Daniel Cadar7,8 , Arno Dormann9 , Markus Eickmann4,5 , Petra Emmerich7,10 , Torsten Feldt11 , Christina Frank12 , Jochen Fries13 , Martin Gabriel7,8 , Udo Goetsch14 , René Gottschalk14,15 , Stephan Günther7,8 , Michael Hallek2,3 , Dieter Häussinger11 , Christian Herzog16 , Björn Jensen11 , Felix Kolibay17 , Michael Krakau9 , Georg Langebartels17 , Toni Rieger7,8 , Lars Schaade16 , Jonas Schmidt-Chanasit7,8 , Edgar Schömig18 , Gundolf Schüttfort19 , Alexander Shimabukuro-Vornhagen2,3 , Michael von Bergwelt-Baildon2,3 , Ulrike Wieland20 , Gerhard Wiesmüller6 , Timo Wolf19 , Gerd Fätkenheuer1,2
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View Affiliations Hide AffiliationsAffiliations: 1 German Center for Infection Research (DZIF), Bonn-Cologne, Germany 2 Department I of Internal Medicine, University of Cologne, Germany 3 Centre of Integrated Oncology Köln, University of Cologne, Germany 4 Institute for Virology, Universität Marburg, Germany 5 German Center for Infection Research (DZIF), Gießen-Marburg-Langen, Germany 6 Public Health Department Cologne, Germany 7 Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany 8 German Centre for Infection Research (DZIF), Hamburg, Germany 9 Municipal Hospital of Cologne, Medical Department Holweide, Germany 10 Department of Tropical Medicine and Infectious Diseases, Center of Internal Medicine II, University of Rostock, Rostock, Germany 11 Clinic for Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University, Düsseldorf, Germany 12 Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany 13 Department of Pathology, University of Cologne, Germany 14 Health Protection Authority City of Frankfurt am Main, Germany 15 University Hospital Frankfurt, Institute of Medical Virology, Germany 16 Centre for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin, Germany 17 Department for Clinical Affairs, University of Cologne, Germany 18 Clinical director University of Cologne, Germany 19 University Hospital Frankfurt, Department of Infectious Diseases, Germany 20 Institute of Virology, University of Cologne, GermanyClara Lehmannclara.lehmann uk-koeln.de
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Citation style for this article: Lehmann Clara, Kochanek Matthias, Abdulla Diana, Becker Stephan, Böll Boris, Bunte Anne, Cadar Daniel, Dormann Arno, Eickmann Markus, Emmerich Petra, Feldt Torsten, Frank Christina, Fries Jochen, Gabriel Martin, Goetsch Udo, Gottschalk René, Günther Stephan, Hallek Michael, Häussinger Dieter, Herzog Christian, Jensen Björn, Kolibay Felix, Krakau Michael, Langebartels Georg, Rieger Toni, Schaade Lars, Schmidt-Chanasit Jonas, Schömig Edgar, Schüttfort Gundolf, Shimabukuro-Vornhagen Alexander, von Bergwelt-Baildon Michael, Wieland Ulrike, Wiesmüller Gerhard, Wolf Timo, Fätkenheuer Gerd. Control measures following a case of imported Lassa fever from Togo, North Rhine Westphalia, Germany, 2016. Euro Surveill. 2017;22(39):pii=17-00088. https://doi.org/10.2807/1560-7917.ES.2017.22.39.17-00088 Received: 03 Feb 2017; Accepted: 26 May 2017
Abstract
In a patient transferred from Togo to Cologne, Germany, Lassa fever was diagnosed 12 days post mortem. Sixty-two contacts in Cologne were categorised according to the level of exposure, and gradual infection control measures were applied. No clinical signs of Lassa virus infection or Lassa specific antibodies were observed in the 62 contacts. Thirty-three individuals had direct contact to blood, other body fluids or tissue of the patients. Notably, with standard precautions, no transmission occurred between the index patient and healthcare workers. However, one secondary infection occurred in an undertaker exposed to the corpse in Rhineland-Palatinate, who was treated on the isolation unit at the University Hospital of Frankfurt. After German authorities raised an alert regarding the imported Lassa fever case, an American healthcare worker who had cared for the index patient in Togo, and who presented with diarrhoea, vomiting and fever, was placed in isolation and medevacked to the United States. The event and the transmission of Lassa virus infection outside of Africa underlines the need for early diagnosis and use of adequate personal protection equipment (PPE), when highly contagious infections cannot be excluded. It also demonstrates that larger outbreaks can be prevented by infection control measures, including standard PPE.

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