Review of Lassa fever, an emerging old world haemorrhagic viral disease in sub-Saharan Africa

Abstract

Lassa fever is an acute immunosuppressive illness of increasing public health concern causing severe morbidity and significant mortality (Case fatality rate (CFR) ≥ 50%) especially in epidemic cases. Although Lassa fever has emerged (following its first detection (1969) in Lassa town, Nigeria) as one of the most prevalent and debilitating viral haemorrhagic fevers endemic in West Africa region (Nigeria inclusive), yet, the control/prevention of the regular outbreak of the disease has become an herculean task in the areas affected; there is inadequate healthcare facility (including Laboratory/diagnostic and care centres), poor socioeconomic environment, lack of awareness among the populace and presence of favourable ecologic niche for the survival and propagation of the natural host and reservoir mouse (Mastomys natalensis) of Lassa virus . Lassa fever is mainly transmitted by contact with excretions and secretions of infected rats via foods and water as well as exposure to other contaminated items. Lassa virus is a member of an Old World Arenariruses, of family Arenaviridae. It is an enveloped, single-stranded (SS) bisegmented RNA virus with ability to replicate very rapidly. It consists of 4 lineages; 3 members are identified as ancenstral strains found in Nigeria, while the fourth is domiciled in other West Africa Countries. Lassa virus infects almost every tissue in human body resulting in multisystemic dysfunction. The incubation period is generally between 6 to 21 days resulting in 3 stages of clinical manifestation viz: Acute phase characterized by flu-like, non-specific illness; haemorrhagic phase accompanied with gastrointestinal symptoms and cardiovascular/neurologic complications. Currently, there is no clinically certified Lassa fever vaccine thus complicating deterrent or preventive measures. Hence, there is need for intensification of educational programs for the populace on the useful control measures against Lassa fever. The stakeholders need to prioritize intervention and support program and also speed up the processes leading to the production of effective vaccine to limit the menace of Lassa fever outbreak and associated morbidity, fatality and high socio-economic cost.

Keywords: Lassa fever, endemic, epidemic, reservoir rodent, West Africa