Management of viral haemorrhagic fever in the Netherlands

Two cases of Lassa fever have been reported in the Netherlands since viral haemorrhagic fevers became notifiable diseases in 1978. In 1980, an expatriate from Burkina Faso who was not seriously ill was confirmed by laboratory tests after his discharge from hospital. The second case occured in 2000: the patient died on the 11th day of admission to hospital. The problems we faced in the management of this case and the contact investigation - more than one hundred contacts - highlighted the need for national recommendations in the Netherlands.

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Domestic risk factors for increased rodent abundance in a Lassa fever endemic region of rural Upper Guinea

Scientific Reports ◽

10.1038/s41598-021-00113-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Julia Clark ◽

Laith Yakob ◽

Moussa Douno ◽

Joseph Lamine ◽

N.’Faly Magassouba ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Lassa Fever ◽

Mastomys Natalensis ◽

Haemorrhagic Fever ◽

Endemic Region ◽

Simple Process ◽

Viral Haemorrhagic Fever ◽

Rodent Abundance ◽

Multimammate Rat

AbstractLassa fever (LF) is a viral haemorrhagic fever endemic in West Africa and spread primarily by the multimammate rat, Mastomys natalensis. As there is no vaccine, reduction of rodent-human transmission is essential for disease control. As the household is thought to be a key site of transmission, understanding domestic risk factors for M. natalensis abundance is crucial. Rodent captures in conjunction with domestic surveys were carried out in 6 villages in an area of rural Upper Guinea with high LF endemicity. 120 rodent traps were set in rooms along a transect in each village for three nights, and the survey was administered in each household on the transects. This study was able to detect several domestic risk factors for increased rodent abundance in rural Upper Guinea. Regression analysis demonstrated that having > 8 holes (RR = 1.8 [1.0004–3.2, p = 0.048), the presence of rodent burrows (RR = 2.3 [1.6–3.23, p = 0.000003), and being in a multi-room square building (RR = 2.0 [1.3–2.9], p = 0.001) were associated with increased rodent abundance. The most addressable of these may be rodent burrows, as burrow patching is a relatively simple process that may reduce rodent entry. Further study is warranted to explicitly link domestic rodent abundance to LF risk, to better characterize domestic risk factors, and to evaluate how household rodent-proofing interventions could contribute to LF control.

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Molecular confirmation of Lassa fever imported into Ghana

African Journal of Laboratory Medicine ◽

10.4102/ajlm.v5i1.288 ◽

2016 ◽

Vol 5 (1) ◽

Cited By ~ 4

Author(s):

Joseph H.K. Bonney ◽

Edward O. Nyarko ◽

Sally-Ann Ohene ◽

Joseph Amankwa ◽

Ralph K. Ametepi ◽

...

Keyword(s):

West Africa ◽

Gene Segment ◽

Lassa Fever ◽

Molecular Diagnostic ◽

Military Hospital ◽

Lassa Virus ◽

Haemorrhagic Fever ◽

Blood Samples ◽

Viral Haemorrhagic Fever ◽

Close Contacts

Background: Recent reports have shown an expansion of Lassa virus from the area where it was first isolated in Nigeria to other areas of West Africa. Two Ghanaian soldiers on a United Nations peacekeeping mission in Liberia were taken ill with viral haemorrhagic fever syndrome following the death of a sick colleague and were referred to a military hospital in Accra, Ghana, in May 2013. Blood samples from the soldiers and five asymptomatic close contacts were subjected to laboratory investigations.Objective: We report the results of these investigations to highlight the importance of molecular diagnostic applications and the need for heightened awareness about Lassa fever in West Africa.Methods: We used molecular assays on sera from the two patients to identify the causativeorganism. Upon detection of positive signals for Lassa virus ribonucleic material by two differentpolymerase chain reaction assays, sequencing and phylogenetic analyses were performed.Results: The presence of Lassa virus in the soldiers’ blood samples was shown by L-gene segment homology to be the Macenta and las803792 strains previously isolated in Liberia, with close relationships then confirmed by phylogenetic tree construction. The five asymptomatic close contacts were negative for Lassa virus.Conclusions: The Lassa virus strains identified in the two Ghanaian soldiers had molecular epidemiological links to strains from Liberia. Lassa virus was probably responsible for the outbreak of viral haemorrhagic fever in the military camp. These data confirm Lassa fever endemicity in West Africa.

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Community hygiene against lassa fever disease and its predictors in a Nigerian rural settlement

European Journal of Public Health ◽

10.1093/eurpub/ckz185.588 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

A A Gobir ◽

C L Ejembi ◽

A A Aliyu ◽

M B Garba ◽

C J C Igboanusi ◽

...

Keyword(s):

Sampling Technique ◽

Lassa Fever ◽

West African ◽

World Health ◽

Food Storage ◽

African Countries ◽

Cross Sectional ◽

Effective Prevention ◽

Viral Haemorrhagic Fever ◽

Hygiene Measures

Abstract Background Lassa fever disease (LFD) is a viral haemorrhagic fever that is endemic in some West african countries where an estimated 300,000 to 500,000 cases and 5000 deaths occur yearly. The World Health Organization described it as a global health threat. At community level, its prevention relies on promoting good “community hygiene”. This study was conducted to assess practice of community hygiene measures against LFD and its associated factors. Methods A cross-sectional, community based descriptive study conducted during a LFD epidemic in a a rural community of Nigeria. An interviewer-administered questionnaire was used to collect data from 556 adult respondents, selected using systematic random sampling technique. Data was analyzed using SPSS. Results A majority of the respondents were females (52.9%). Educational attainment was significantly associated with safe food storage at the multivariate level (aOR= 1.31, 95% CI: 1.10-1.54,P= 0.002) while having a good knowledge of LFD was a significant predictor of maintaining good housing standards (aOR= 3.73, 95% CI: 1.09-12.80,P=0.036). Conclusions Predictors of practice of community hygiene against LFD include education and having an excellent knowledge of LFD. To improve community hygiene practices in the community, there is need for a comprehensive LFD behavior change communication intervention. Key messages Cubing the global threat of LFD depends on its effective prevention in endemic West African communities. This study shows that such preventive measures are poor and there is need for more response to address the problem.

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Period prevalence and identification challenges of viral haemorrhagic fever suspect cases in a tertiary referral hospital in Guinea: a cross-sectional, retrospective study of triage and emergency room patient profiles

BMC Infectious Diseases ◽

10.1186/s12879-020-05573-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Manuel Raab ◽

Lisa M. Pfadenhauer ◽

Vinh-Kim Nguyen ◽

Dansira Doumbouya ◽

Michael Hoelscher ◽

...

Keyword(s):

Clinical Practice ◽

Emergency Room ◽

Retrospective Chart Review ◽

Laboratory Diagnostics ◽

Haemorrhagic Fever ◽

Case Definitions ◽

Tertiary Referral Hospital ◽

Cross Sectional ◽

Viral Haemorrhagic Fever ◽

Suspect Case

Abstract Background A functioning Viral Haemorrhagic Fever (VHF) surveillance system in countries at risk for outbreaks can reduce early transmission in case of an outbreak. Surveillance performance depends on the application of suspect case definitions in daily clinical practice. Recommended suspect case criteria during outbreaks are designed for high sensitivity and include general symptoms, pyrexia, haemorrhage, epidemiological link and unexplained death in patients. Non-outbreak criteria are narrower, relying on the persistence of fever and the presence of haemorrhagic signs. Methods This study ascertains VHF suspect case prevalence based on outbreak and non-outbreak criteria in a Guinean regional hospital for a period of three months. The study further describes clinical trajectories of patients who meet non-outbreak VHF suspect case criteria in order to discuss challenges in their identification. We used cross-sectional data collection at triage and emergency room to record demographic and clinical data of all admitted patients during the study period. For the follow-up study with description of diagnostic trajectories of VHF suspect cases, we used retrospective chart review. Results The most common symptoms of all patients upon admission were fever, tiredness/weakness and abdominal pain. 686 patients met EVD outbreak criteria, ten adult patients and two paediatric patients met study-specific non-outbreak VHF suspect case criteria. None of the suspect cases was treated as VHF suspect case and none tested positive for malaria upon admission. Their most frequent discharge diagnosis was unspecific gastrointestinal infection. The most common diagnostic measures were haemoglobin level and glycaemia for both adults and for children; of the requested examinations for hospitalized suspect cases, 36% were not executed or obtained. Half of those patients self-discharged against medical advice. Conclusions Our study shows that the number of VHF suspect cases may vary greatly depending on which suspect case criteria are applied. Identification of VHF suspect cases seems challenging in clinical practice. We suggest that this may be due to the low use of laboratory diagnostics to support certain diagnoses and the non-application of VHF suspect case definitions in clinical practice. Future VHF suspect case management should aim to tackle such challenges in comparable hospital settings.

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Managing the risk of viral haemorrhagic fever transmission in a non-high-level intensive care unit: experiences from a case of Crimean-Congo haemorrhagic fever in Scotland

Journal of Hospital Infection ◽

10.1016/j.jhin.2016.02.023 ◽

2016 ◽

Vol 93 (3) ◽

pp. 304-308 ◽

Cited By ~ 4

Author(s):

K.M. Roy ◽

S. Ahmed ◽

T. Inkster ◽

A. Smith ◽

G. Penrice

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Haemorrhagic Fever ◽

Viral Haemorrhagic Fever ◽

Crimean Congo Haemorrhagic Fever ◽

High Level

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Viral haemorrhagic fever

Clinical Medicine ◽

10.7861/clinmedicine.15-1-61 ◽

2015 ◽

Vol 15 (1) ◽

pp. 61-66 ◽

Cited By ~ 9

Author(s):

Caoimhe Nic Fhogartaigh ◽

Emma Aarons

Keyword(s):

Haemorrhagic Fever ◽

Viral Haemorrhagic Fever

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Antiviral Therapy of Haemorrhagic Fevers and Arbovirus Infections

Antiviral Therapy ◽

10.1177/135965359800300201 ◽

1998 ◽

Vol 3 (2) ◽

pp. 53-79

Author(s):

Mike Bray ◽

John Huggins

Keyword(s):

New World ◽

Protective Efficacy ◽

Rift Valley Fever Virus ◽

Antiviral Drug ◽

Drug Effects ◽

Lassa Fever ◽

Interferon Α ◽

Haemorrhagic Fever ◽

Valley Fever

RNA viruses of the families Arena-, Bunya-, Filo-, Flavi-and Togaviridae cause illness in humans ranging from mild, non-specific febrile syndromes to fulminant, lethal haemorrhagic fever. They are transmitted from animals to humans and from human to human by arthropods, aerosols or contact with body fluids. Antiviral compounds, convalescent plasma and interferon inhibit many of these agents in vitro and in virus-infected animals. Drug or plasma treatment is now in use for several human diseases, and would probably be beneficial for a number of others for which there is only limited treatment experience. Success is linked to early diagnosis and initiation of therapy. Ribavirin is used to treat Lassa fever and haemorrhagic fever with renal syndrome, and would probably be effective for Crimean-Congo haemorrhagic fever and for all New World arenavirus diseases. The value of ribavirin in the early treatment of hantavirus pulmonary syndrome is under evaluation. Convalescent plasma is the therapy of choice for Argentine haemorrhagic fever, and would also probably be effective for other New World arenaviruses and some other infections if a safe supply of plasma could be maintained. Ribavirin and interferon-α have both shown protective efficacy in non-human primates infected with Rift Valley fever virus. No effective therapy has yet been identified for filovirus infections, but results in animal models are encouraging. More clinical research is urgently needed. Even if placebo-controlled drug trials cannot be performed, conscientious reports of the results of therapy in limited numbers of patients can still provide evidence of antiviral drug effects.

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The tip of the iceberg: incompleteness of measles reporting during a large outbreak in The Netherlands in 2013–2014

Epidemiology and Infection ◽

10.1017/s0950268818002698 ◽

2018 ◽

Vol 147 ◽

Cited By ~ 4

Author(s):

T. Woudenberg ◽

F. Woonink ◽

J. Kerkhof ◽

K. Cox ◽

W.L.M. Ruijs ◽

...

Keyword(s):

The Netherlands ◽

Vaccination Coverage ◽

National Level ◽

Notifiable Disease ◽

National Register ◽

Notifiable Diseases ◽

Measles Outbreak ◽

Large Outbreak ◽

Completeness Of Reporting

AbstractMeasles is a notifiable disease, but not everyone infected seeks care, nor is every consultation reported. We estimated the completeness of reporting during a measles outbreak in The Netherlands in 2013–2014. Children below 15 years of age in a low vaccination coverage community (n= 3422) received a questionnaire to identify measles cases. Cases found in the survey were matched with the register of notifiable diseases to estimate the completeness of reporting. Second, completeness of reporting was assessed by comparing the number of susceptible individuals prior to the outbreak with the number of reported cases in the surveyed community and on a national level.We found 307 (15%) self-identified measles cases among 2077 returned questionnaires (61%), of which 27 could be matched to a case reported to the national register; completeness of reporting was 8.8%. Based on the number of susceptible individuals and number of reported cases in the surveyed community and on national level, the completeness of reporting was estimated to be 9.1% and 8.6%, respectively. Estimating the completeness of reporting gave almost identical estimates, which lends support to the credibility and validity of both approaches. The size of the 2013–2014 outbreak approximated 31 400 measles infections.

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