BACKGROUND: Lassa fever is an acute viral haemorrhagic disease endemic in Nigeria. The 2018 Lassa fever outbreak in Nigeria was unprecedented, with 8% of all cases occurring among healthcare workers (HCWs). A disproportionately high number of these infections occurred in HCWs working in a tertiary health facility in Nigeria. This paper describes the cluster of Lassa fever infections among HCWs in a treatment centre and the lessons learnt. METHODS: We analysed clinical, epidemiological and laboratory data from surveillance and laboratory records kept during the 2018 outbreak. Interviews were conducted with surviving HCWs using a questionnaire developed specifically for the investigation of Lassa fever infections in HCWs. Descriptive analysis of the data was performed in Microsoft excel. RESULTS: The index case was a 15-year-old male who presented at the health facility with fever and uncontrolled nasopharyngeal bleeding, following a recent uvulectomy by a traditional healer. Overall, 16 HCWs were affected (15 confirmed and 1 probable) with five deaths (CFR-31.6%). Of the 15 confirmed cases, five (33.3%) were asymptomatic. Nine HCWs were direct contacts of the index case; the remaining six HCWs had no direct contact with the index case. HCW interviews identified a low index of suspicion for Lassa fever leading to inadequate infection prevention and control (IPC) practices as possible contributing factors to nosocomial transmission. CONCLUSION: Maintaining a high index of suspicion for Lassa fever in all patients, especially in endemic areas, is essential in adhering to adequate IPC practices in health facilities in order to prevent nosocomial transmission of Lassa fever among HCWs. There is a need to continually train and sensitise HCWs on strict adherence to IPC measures while providing care, irrespective of a patient's provisional diagnosis. Crown
BACKGROUND: Lassa fever is an acute viral haemorrhagic disease endemic in Nigeria. The 2018 Lassa fever outbreak in Nigeria was unprecedented, with 8% of all cases occurring among healthcare workers (HCWs). A disproportionately high number of these infections occurred in HCWs working in a tertiary health facility in Nigeria. This paper describes the cluster of Lassa fever infections among HCWs in a treatment centre and the lessons learnt. METHODS: We analysed clinical, epidemiological and laboratory data from surveillance and laboratory records kept during the 2018 outbreak. Interviews were conducted with surviving HCWs using a questionnaire developed specifically for the investigation of Lassa fever infections in HCWs. Descriptive analysis of the data was performed in Microsoft excel. RESULTS: The index case was a 15-year-old male who presented at the health facility with fever and uncontrolled nasopharyngeal bleeding, following a recent uvulectomy by a traditional healer. Overall, 16 HCWs were affected (15 confirmed and 1 probable) with five deaths (CFR-31.6%). Of the 15 confirmed cases, five (33.3%) were asymptomatic. Nine HCWs were direct contacts of the index case; the remaining six HCWs had no direct contact with the index case. HCW interviews identified a low index of suspicion for Lassa fever leading to inadequate infection prevention and control (IPC) practices as possible contributing factors to nosocomial transmission. CONCLUSION: Maintaining a high index of suspicion for Lassa fever in all patients, especially in endemic areas, is essential in adhering to adequate IPC practices in health facilities in order to prevent nosocomial transmission of Lassa fever among HCWs. There is a need to continually train and sensitise HCWs on strict adherence to IPC measures while providing care, irrespective of a patient's provisional diagnosis. Crown
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Authors: Robert J Fischer; Jyothi N Purushotham; Neeltje van Doremalen; Sarah Sebastian; Kimberly Meade-White; Kathleen Cordova; Michael Letko; M Jeremiah Matson; Friederike Feldmann; Elaine Haddock; Rachel LaCasse; Greg Saturday; Teresa Lambe; Sarah C Gilbert; Vincent J Munster Journal: NPJ Vaccines Date: 2021-03-02 Impact factor: 7.344
Authors: Nneka M Chika-Igwenyi; Rebecca E Harrison; Christina Psarra; Julita Gil-Cuesta; Maria Gulamhusein; Emeka O Onwe; Robinson C Onoh; Uche S Unigwe; Nnennaya A Ajayi; Ugochukwu U Nnadozie; Chiedozie K Ojide; Damian U Nwidi; Obumneme Ezeanosike; Emeka Sampson; Azuka S Adeke; Collins N Ugwu; Uchenna Anebonam; Jacques K Tshiang; Jacob Maikere; Anthony Reid Journal: PLoS Negl Trop Dis Date: 2021-03-08
Authors: Laura Merson; Josephine Bourner; Sulaiman Jalloh; Astrid Erber; Alex Paddy Salam; Antoine Flahault; Piero L Olliaro Journal: PLoS Negl Trop Dis Date: 2021-09-21
Authors: Brian M Sullivan; Saori Sakabe; Jessica N Hartnett; Nhi Ngo; Augustine Goba; Mambu Momoh; John Demby Sandi; Lansana Kanneh; Beatrice Cubitt; Selma D Garcia; Brian C Ware; Dylan Kotliar; Refugio Robles-Sikisaka; Karthik Gangavarapu; Luis Branco; Philomena Eromon; Ikponmwosa Odia; Ephraim Ogbaini-Emovon; Onikepe Folarin; Sylvanus Okogbenin; Peter O Okokhere; Christian Happi; Juan Carlos de la Torre; Pardis C Sabeti; Kristian G Andersen; Robert F Garry; Donald S Grant; John S Schieffelin; Michael B A Oldstone Journal: PLoS Pathog Date: 2020-03-06 Impact factor: 6.823