UK - Lassa fever cases identified in England, following travel to West Africa - 1 death

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Source: https://www.gov.uk/government/news/l...to-west-africa

Lassa fever cases identified in England, following travel to West Africa
Two people have been diagnosed with Lassa fever in England, confirms the UK Health Security Agency.
From:
UK Health Security Agency
Published
9 February 2022
Last updated
9 February 2022 — See all updates


A further probable case of Lassa fever is under investigation. The cases are within the same family in the East of England and are linked to recent travel to West Africa.

Lassa fever is an acute viral haemorrhagic illness caused by Lassa virus. People usually become infected with Lassa virus through exposure to food or household items contaminated with urine or faeces of infected rats – present in a number of West African countries where the disease is endemic. The virus can also be spread through infected bodily fluids.

Most people with Lassa fever will make a full recovery, however severe illness can occur in some individuals. One of the cases has recovered, while the other will receive specialist care at the Royal Free London NHS Foundation Trust.

The probable case is receiving care at Bedfordshire Hospitals NHS Foundation Trust. The High Consequence Infectious Disease Network is engaged with their ongoing care.

Dr Susan Hopkins, Chief Medical Advisor at UKHSA said:

We can confirm that 2 cases of Lassa fever have been identified in England, and a further probable case is under investigation. The cases are within the same family and are linked to recent travel to West Africa.

Cases of Lassa fever are rare in the UK and it does not spread easily between people. The overall risk to the public is very low. We are contacting the individuals who have had close contact with the cases prior to confirmation of their infection, to provide appropriate assessment, support and advice.

UKHSA and the NHS have well established and robust infection control procedures for dealing with cases of imported infectious disease and these will be reinforced.

Prior to these cases, there have been 8 cases of Lassa fever imported to the UK since 1980. The last 2 cases occurred in 2009. There was no evidence of onward transmission from any of these cases.

Dr Sir Michael Jacobs, consultant in infectious diseases at the Royal Free London, said:

The Royal Free Hospital is a specialist centre for treating patients with viral haemorrhagic fevers, including Lassa fever.

Our secure unit is run by a highly-trained and experienced team of doctors, nurses, therapists and laboratory staff and is designed to ensure our staff can safely treat patients with these kind of infections.

People living in endemic areas of West Africa with high populations of rodents are most at risk of Lassa fever. Imported cases rarely occur elsewhere in the world. Such cases are almost exclusively in people who work in endemic areas in high-risk occupations, such as medical or other aid workers.

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[Shiloh]

Source: https://www.euronews.com/next/2022/0...s-it-a-concern

Lassa fever: A patient in the UK has died of the virus but what is it and how dangerous is it?
Two cases of Lassa fever have been detected in the UK, the first cases in the country for over a decade.
By Ian Smith • Updated: 11/02/2022 - 17:42

A person in the UK has died after contracting Lassa fever, health officials have said.

Two cases were announced earlier this week with a third individual under investigation. The UK Health Security Agency (UKHSA) confirmed on Friday that the third case was Lassa fever and the patient had died.

The cases are within the same family and are linked to recent travel to west Africa. They are the first cases identified in the UK since 2009.

The patient was being treated by Bedfordshire Hospitals NHS Foundation Trust.

A spokesperson said: "We confirm the sad death of a patient at our trust, who had confirmed Lassa fever. We send our deepest condolences to their family at this difficult time...

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https://www.independent.co.uk/news/health/lassa-fever-hospital-incident-infection-b2013420.html

Lassa fever: Major incident declared at hospital after more cases


NHS staff at hospital in the East of England forced to isolated after treating Lassa fever patient

....
Three cases of the Ebola-like virus have been confirmed in the UK and one patient has died, the UK Health Security Agency has confirmed.

Staff who were in direct contact with one of the three patients at a hospital in Cambridge have been advised to self-isolate.

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[Shiloh]

Source: https://www.who.int/emergencies/dise...rthern-ireland


Lassa Fever – United Kingdom of Great Britain and Northern Ireland

21 February 2022


On 9 February 2022, WHO was notified by the United Kingdom health authorities of two laboratory confirmed cases and one probable case of Lassa fever. As of 18 February, three cases have been confirmed and one death has been reported. These are the first reported Lassa fever cases in the United Kingdom since 2009, and represents the second known case of secondary transmission of Lassa fever in Europe.
The first case travelled to Mali in late 2021, where Lassa fever is endemic. After returning to the United Kingdom, the individual developed symptoms of fever, fatigue and loose stool, and was subsequently hospitalized. The first case has now recovered. The second and third cases were family members of the first case and did not travel to Mali. Both were admitted to the hospital and the third case has sadly died.
On 8 February, samples from both the first and second cases were laboratory confirmed positive for Lassa virus by PCR. The third case was initially provided care as a probable case of Lassa fever and the diagnosis was confirmed on 9 February.

Public health response

Incident responses have been activated by health authorities in the United Kingdom to coordinate the clinical and public health management of these cases.
People with exposure to the cases were identified through robust contact tracing activities. Low and high risk contacts are being followed up for 21 days after their last exposure. Post-exposure prophylaxis has been offered to high-risk contacts with the most significant exposures. Systems are in place to assess and manage any contacts who may develop symptoms during the follow up period.

WHO risk assessment

Lassa fever is an acute viral haemorrhagic fever illness that is primarily transmitted to humans via contact with food or household items contaminated with infected Mastomys rats’ urine or faeces. Human-to-human transmission is rare but can occur through direct contact with the blood, urine, faeces, or other bodily secretions, particularly in health care settings. It can cause severe disease in about 20% of patients. The case fatality ratio (CFR) is 1% overall and 15% in severely ill patients. Early recognition and initiation of patient care decrease the CFR and public health impact.
Lassa fever is endemic in Mali and sporadic cases have been exported to Europe from countries in West Africa where the disease is endemic, such as Sierra Leone, Togo, Liberia and Nigeria in recent years. However, the secondary transmission of Lassa fever through human contacts is known to be extremely rare when appropriate infection prevention and control precautions and laboratory biosafety measures are applied. The only secondary transmission of Lassa fever reported in Europe was in 2016 from Germany, when the secondary case performed post-mortem care of a fatal case.
Human-to-human transmission occurs in both community and health care settings, where the virus may be spread by contaminated medical equipment, such as reused needles, as well as direct contact with bodily secretions. Health care workers are at risk if caring for Lassa fever patients in the absence of appropriate infection prevention and control (IPC) practices, although information from recent imported cases in Europe show that secondary transmission of Lassa virus is rare when standard IPC precautions are followed. The possibility of additional secondary cases related to transmission in a health care setting cannot currently be excluded, but is considered very unlikely in the community.

WHO advice

Prevention of Lassa fever in endemic countries relies on community engagement and promoting hygienic conditions to discourage rodents from entering homes. Family members and health care workers should always be careful to avoid contact with blood and body fluids while caring for sick individuals.
In health care settings, staff should consistently implement standard IPC measures when caring for patients to prevent nosocomial infections. Health care workers caring for patients with suspected or confirmed Lassa virus, or handling their clinical specimens, should reinforce standard and contact precautions, comprising appropriate hand hygiene, rational use of personal protective equipment (PPE), environmental cleaning, isolation, safe injections practices and safe burial practices. In order to avoid any direct contact with blood and body fluids and/or splashes onto facial mucosa (eyes, nose, mouth) when providing direct care for a patient with suspected or confirmed Lassa virus, personal protective equipment should include: 1) clean non-sterile gloves; 2) clean, non-sterile fluid resistant gown; and 3) protection of facial mucosa against splashes (mask and eye protection, or a face shield).
Given the nonspecific presentation of viral haemorrhagic fevers, isolation of ill travellers and consistent implementation of standard and contact precautions is key to preventing secondary transmission. When consistently applied, these measures can prevent secondary transmission even if travel history information is not obtained, not immediately available, or the diagnosis of a viral haemorrhagic fever is delayed.
There is currently no approved vaccine. Early supportive care with rehydration and symptomatic treatment improves survival.
Considering the seasonal increases of cases between December and March, countries in West Africa that have endemic Lassa fever are encouraged to strengthen their related surveillance systems to enhance early detection and treatment of cases, and to reduce the case fatality rate, as well as to strengthen cross border collaboration...

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