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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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/content/10.2807/1560-7917.ES.2017.22.39.17-00088
2017-09-28
2020-08-10
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2017.22.39.17-00088
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References

  1. Macher AM, Wolfe MS. Historical Lassa fever reports and 30-year clinical update. Emerg Infect Dis. 2006;12(5):835-7.  https://doi.org/10.3201/eid1205.050052  PMID: 16704848 
  2. World Health Organization (WHO). Emergencies preparedness, response. Epidemic focus. Geneva: WHO; [Accessed 20 Jun 2016]. Available from: http://www.who.int/csr/disease/epidemic-focus/lassa-fever/en/
  3. Fichet-Calvet E, Rogers DJ. Risk maps of Lassa fever in West Africa. PLoS Negl Trop Dis. 2009;3(3):e388.  https://doi.org/10.1371/journal.pntd.0000388  PMID: 19255625 
  4. Richmond JK, Baglole DJ. Lassa fever: epidemiology, clinical features, and social consequences. BMJ. 2003;327(7426):1271-5. https://doi.org/10.1136/bmj.327.7426.1271  PMID: 14644972 
  5. World Health Organization (WHO). Emergencies preparedness, response. Lassa Fever – Benin. Geneva: WHO; [Accessed 10 Jul 2016]. Available from: http://www.who.int/csr/don/19-february-2016-lassa-fever-benin/en/
  6. Fisher-Hoch SP, Tomori O, Nasidi A, Perez-Oronoz GI, Fakile Y, Hutwagner L, et al. Review of cases of nosocomial Lassa fever in Nigeria: the high price of poor medical practice. BMJ. 1995;311(7009):857-9.  https://doi.org/10.1136/bmj.311.7009.857  PMID: 7580496 
  7. European Centre for Disease Prevention and Control (ECDC). Rapid Risk Assessment. Lassa fever in Nigeria, Benin, Togo, Germany and USA. Stockholm: ECDC; 23 March 2016. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/RRA-Lassa-fever-Germany-march-2016.pdf
  8. Holmes GP, McCormick JB, Trock SC, Chase RA, Lewis SM, Mason CA, et al. Lassa fever in the United States. Investigation of a case and new guidelines for management. N Engl J Med. 1990;323(16):1120-3.  https://doi.org/10.1056/NEJM199010183231607  PMID: 2215580 
  9. Ehlkes L, George M, Samosny G, Burckhardt F, Vogt M, Bent S, et al. Management of a Lassa fever outbreak, Rhineland-Palatinate, Germany, 2016. Euro Surveill. 2017;22(39).  https://doi.org/10.2807/1560-7917.ES.2017.22.39.16-00728 
  10. Wirtz A, Niedrig M, Fock R. Management of patients in Germany with suspected viral haemorrhagic fever and other potentially lethal contagious infections. Euro Surveill. 2002;7(3):36-42. PMID: 12631943 
  11. Vieth S, Drosten C, Lenz O, Vincent M, Omilabu S, Hass M, et al. RT-PCR assay for detection of Lassa virus and related Old World arenaviruses targeting the L gene. Trans R Soc Trop Med Hyg. 2007;101(12):1253-64.  https://doi.org/10.1016/j.trstmh.2005.03.018  PMID: 17905372 
  12. Olschläger S, Lelke M, Emmerich P, Panning M, Drosten C, Hass M, et al. Improved detection of Lassa virus by reverse transcription-PCR targeting the 5′ region of S RNA. J Clin Microbiol. 2010;48(6):2009-13.  https://doi.org/10.1128/JCM.02351-09  PMID: 20351210 
  13. Emmerich P, Günther S, Schmitz H. Strain-specific antibody response to Lassa virus in the local population of west Africa. J Clin Virol. 2008;42(1):40-4.  https://doi.org/10.1016/j.jcv.2007.11.019  PMID: 18164653 
  14. Raabe VN, Kann G, Ribner BS, Morales A, Varkey JB, Mehta AK, et al. Favipiravir and Ribavirin Treatment of Epidemiologically Linked Cases of Lassa Fever. Clin Infect Dis. 2017;65(5):855-9. Available from: https://doi.org/10.1093/cid/cix406
  15. World Health Organization (WHO). Emergencies preparedness, response. Lassa Fever – Togo. Geneva: WHO; 23 Mar 2016. Available from: http://www.who.int/csr/don/23-march-2016-lassa-fever-togo/en/
  16. World Health Organization (WHO). Emergencies preparedness, response. Lassa Fever – Germany. Geneva: WHO; [Accessed 17 Sep 2017]. Available from: http://www.who.int/csr/don/23-march-2016-lassa-fever-germany/en/
  17. Kitching A, Addiman S, Cathcart S, Bischop L, Krahé D, Nicholas M, et al. A fatal case of Lassa fever in London, January 2009. Euro Surveill. 2009;14(6):19117. PMID: 19215723 
  18. Jacobs M, Aarons E, Bhagani S, Buchanan R, Cropley I, Hopkins S, et al. Post-exposure prophylaxis against Ebola virus disease with experimental antiviral agents: a case-series of health-care workers. Lancet Infect Dis. 2015;15(11):1300-4.  https://doi.org/10.1016/S1473-3099(15)00228-5  PMID: 26321189 
  19. Haas WH, Breuer T, Pfaff G, Schmitz H, Köhler P, Asper M, et al. Imported Lassa fever in Germany: surveillance and management of contact persons. Clin Infect Dis. 2003;36(10):1254-8.  https://doi.org/10.1086/374853  PMID: 12746770 
  20. World Health Organization (WHO). Media centre. Lassa fever. Geneva: WHO; [Accessed 2 May 2016]. Available from: http://www.who.int/mediacentre/factsheets/fs179/en/
  21. Mylne AQ, Pigott DM, Longbottom J, Shearer F, Duda KA, Messina JP, et al. Mapping the zoonotic niche of Lassa fever in Africa. Trans R Soc Trop Med Hyg. 2015;109(8):483-92.  https://doi.org/10.1093/trstmh/trv047  PMID: 26085474 
  22. Gozel MG, Dokmetas I, Oztop AY, Engin A, Elaldi N, Bakir M. Recommended precaution procedures protect healthcare workers from Crimean-Congo hemorrhagic fever virus. Int J Infect Dis. 2013;17(11):e1046-50.  https://doi.org/10.1016/j.ijid.2013.05.005  PMID: 23816412 
  23. Crowcroft NS. Management of Lassa fever in European countries. Euro Surveill. 2002;7(3):50-2. PMID: 12631947 
  24. Lopaz MA, Amela C, Ordobas M, Dominguez-Berjon MF, Alvarez C, Martinez M, et al. Working group of Ebola outbreak investigation team of Madrid. First secondary case of Ebola outside Africa: epidemiological characteristics and contact monitoring, Spain, September to November 2014. Euro Surveill. 2015;20(1):21003.  https://doi.org/10.2807/1560-7917.ES2015.20.1.21003  PMID: 25613651 
  25. Gozel MG, Dokmetas I, Oztop AY, Engin A, Elaldi N, Bakir M. Recommended precaution procedures protect healthcare workers from Crimean-Congo hemorrhagic fever virus. Int J Infect Dis. 2013;17(11):e1046-50.  https://doi.org/10.1016/j.ijid.2013.05.005  PMID: 23816412 
Control measures following a case of imported Lassa fever from Togo, North Rhine Westphalia, Germany, 2016
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Clara+Lehmann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lehmann Clara</a> , <a href="/search?value1=Matthias+Kochanek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kochanek Matthias</a> , <a href="/search?value1=Diana+Abdulla&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Abdulla Diana</a> , <a href="/search?value1=Stephan+Becker&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Becker Stephan</a> , <a href="/search?value1=Boris+B%C3%B6ll&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Böll Boris</a> , <a href="/search?value1=Anne+Bunte&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bunte Anne</a> , <a href="/search?value1=Daniel+Cadar&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cadar Daniel</a> , <a href="/search?value1=Arno+Dormann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dormann Arno</a> , <a href="/search?value1=Markus+Eickmann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Eickmann Markus</a> , <a href="/search?value1=Petra+Emmerich&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Emmerich Petra</a> , <a href="/search?value1=Torsten+Feldt&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Feldt Torsten</a> , <a href="/search?value1=Christina+Frank&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Frank Christina</a> , <a href="/search?value1=Jochen+Fries&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fries Jochen</a> , <a href="/search?value1=Martin+Gabriel&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gabriel Martin</a> , <a href="/search?value1=Udo+Goetsch&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Goetsch Udo</a> , <a href="/search?value1=Ren%C3%A9+Gottschalk&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gottschalk René</a> , <a href="/search?value1=Stephan+G%C3%BCnther&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Günther Stephan</a> , <a href="/search?value1=Michael+Hallek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hallek Michael</a> , <a href="/search?value1=Dieter+H%C3%A4ussinger&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Häussinger Dieter</a> , <a href="/search?value1=Christian+Herzog&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Herzog Christian</a> , <a href="/search?value1=Bj%C3%B6rn+Jensen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jensen Björn</a> , <a href="/search?value1=Felix+Kolibay&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kolibay Felix</a> , <a href="/search?value1=Michael+Krakau&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Krakau Michael</a> , <a href="/search?value1=Georg+Langebartels&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Langebartels Georg</a> , <a href="/search?value1=Toni+Rieger&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rieger Toni</a> , <a href="/search?value1=Lars+Schaade&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schaade Lars</a> , <a href="/search?value1=Jonas+Schmidt-Chanasit&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schmidt-Chanasit Jonas</a> , <a href="/search?value1=Edgar+Sch%C3%B6mig&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schömig Edgar</a> , <a href="/search?value1=Gundolf+Sch%C3%BCttfort&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schüttfort Gundolf</a> , <a href="/search?value1=Alexander+Shimabukuro-Vornhagen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Shimabukuro-Vornhagen Alexander</a> , <a href="/search?value1=Michael+von+Bergwelt-Baildon&option1=author&noRedirect=true" class="nonDisambigAuthorLink">von Bergwelt-Baildon Michael</a> , <a href="/search?value1=Ulrike+Wieland&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wieland Ulrike</a> , <a href="/search?value1=Gerhard+Wiesm%C3%BCller&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wiesmüller Gerhard</a> , <a href="/search?value1=Timo+Wolf&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wolf Timo</a> , <a href="/search?value1=Gerd+F%C3%A4tkenheuer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fätkenheuer Gerd</a> </span>. Control measures following a case of imported Lassa fever from Togo, North Rhine Westphalia, Germany, 2016. <a href="/content/ecdc">Euro Surveill.</a> 2017;22(39):pii=17-00088. <a href="https://doi.org/10.2807/1560-7917.ES.2017.22.39.17-00088" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2017.22.39.17-00088</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 03 Feb 2017;&nbsp;&nbsp; <span class="generated">Accepted</span>: 26 May 2017 </span> </p>
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