Lassa Fever Death in Iowa After West African Travel

Lassa Fever Death in Iowa After West African Travel

October 29, 2024   602

The death reported in Iowa involved a middle-aged resident who recently returned from West Africa, where Lassa fever is endemic. The Iowa Department of Health and Human Services confirmed that the patient contracted the virus abroad and later died after experiencing symptoms in the U.S.

Overview of Lassa Fever

Lassa fever is a viral hemorrhagic illness endemic to West Africa, caused by the Lassa virus. This disease is primarily transmitted through contact with urine or feces of infected rodents, specifically the multimammate rat (Mastomys natalensis). It can also spread through exposure to bodily fluids from infected individuals. Each year, West Africa reports 100,000–300,000 cases, with around 5,000 deaths​

CDC

Lassa Fever Prevention Measures

Preventing Lassa fever focuses on minimizing contact with infected rodents and preventing human-to-human transmission. Since there is currently no vaccine, the primary prevention strategies include:

1. Rodent Control

  • Store food in sealed, rodent-proof containers to prevent contamination.
  • Keep living areas clean and dispose of waste far from homes to discourage rodents.
  • Use pets, such as cats, to control rodent populations in households.

2. Personal Protective Measures

  • Wear personal protective equipment (PPE) such as masks, gloves, and gowns when caring for infected patients.
  • Healthcare providers should follow strict infection control protocols, especially in endemic areas, to prevent nosocomial infections.

3. Travel Precautions

  • Travelers to West Africa should avoid contact with rodents and maintain hygiene to reduce the risk of exposure.
  • Monitor health for symptoms of Lassa fever for 21 days after returning from high-risk areas.

4. Isolation and Infection Control in Healthcare Settings

  • Infected individuals should be isolated to prevent person-to-person transmission.
  • Healthcare facilities should implement robust infection prevention protocols, including PPE and safe disposal of medical waste.

5. Community Education and Awareness

  • Educating the public in endemic areas about the risks of Lassa fever and preventive measures is critical.
  • Health organizations promote awareness campaigns to reduce rodent exposure and improve hygiene practices in affected regions.

The Iowa Case: A Rare Imported Incident

On October 28, 2024, Iowa health officials confirmed a fatal case of Lassa fever in a resident who had recently traveled to West Africa. Although the risk of local transmission is very low, the incident underscores the importance of early detection, particularly in returning travelers.

“Timely detection and patient isolation are essential to controlling outbreaks,” notes Anna RN, Director of Patient Services. She stresses the need for healthcare providers to ask patients about recent travel history when symptoms align with viral hemorrhagic fevers.


Symptoms and Complications

Lassa fever symptoms typically appear 7–21 days after exposure. Most cases (80%) are mild, featuring:

  • Fever
  • Fatigue
  • Headache
  • Cough and sore throat

However, around 20% of infections progress to severe illness, causing:

  • Bleeding from the mouth, nose, or gastrointestinal tract
  • Respiratory distress
  • Organ inflammation, including pericarditis or hepatitis
  • Neurological symptoms like confusion or seizures

Severe complications are particularly dangerous for pregnant women, with a fetal mortality rate nearing 75% during infection

 

Diagnosis and Treatment

Diagnosing Lassa fever can be challenging since symptoms overlap with malaria, dengue, and Ebola. Testing involves laboratory analysis of blood, urine, or throat swabs to detect viral RNA or antibodies.

The antiviral drug Ribavirin is most effective when administered early in the course of the disease. Supportive treatments—such as rehydration, oxygen therapy, and management of electrolyte imbalances—improve patient outcomes​

Cleveland Clinic

 

Prevention Strategies

Currently, there is no vaccine available for Lassa fever. Preventing infection requires avoiding exposure to rodents and maintaining good hygiene. Key strategies include:

  • Storing food in rodent-proof containers
  • Wearing protective equipment (PPE) when caring for infected individuals
  • Isolating patients with confirmed or suspected infections to prevent nosocomial transmission

Healthcare providers are advised to monitor exposed individuals closely, especially those traveling from West Africa​


Outlook and Mortality Rates

While the overall mortality rate for Lassa fever is approximately 1%, hospitalized patients with severe symptoms have a fatality rate of 15–20%. Pregnant individuals face a much higher risk, with maternal mortality reaching 30% during the third trimester. Even among survivors, about 25% experience hearing loss, which can be permanent in some cases​

ProLife

Author
ProLife Home Care