Lassa Fever (LF) continues to be an endemic acute viral hemorrhagic fever (VHF) illness in Nigeria. Many suspected cases of LF infection have subsequently been confirmed negative and raises concerns as to what the diagnosis of such patients could be. Hence this study was to determine the causative agents of unconfirmed LF among initially suspected cases in South Western Nigeria.
In this retrospective study, blood samples originally collected from 233 suspected cases of a LF outbreak response at Owo and Ose LGAs of Ondo State, were transported in triple level packaging and stored at -80°C. All samples were screened for LF IgM and IgG markers and LF PCR. Forty-five out of the stored plasma samples were randomly retrieved and analyzed for presence of IgM for seven other VHF viruses; Chikungunya (CHIK), West Nile (WN), Rift Valley fever (RVF), Yellow fever (YF), Dengue fever (DEN), Zika and Crimean-Congo hemorrhagic fever (CCHF).
Out of 45 samples screened, 1 (2.2%) was positive for YF IgM antibody. The same sample was previously confirmed LF positive by PCR. This LF and YF co-infection was from a male, 23-year old individual.
The presence of co-infections of LF and YF draw to limelight the need to be broad minded in exploring for the presence of other VHF viruses in outbreaks. Further studies are needed to decipher the diagnosis of LF suspected cases.
Frame JD, Baldwin JM, Gocke DJ, Troup JM. Lassa Fever, a New Virus Disease of Man from West Africa I, Clinical Description and Pathological Findings. American Journal of Tropical Medicine and Hygiene. 1970; 19(4): 670-676.
Ogbu O, Ajuluchukwu E, Uneke C. Lassa fever in West Africa sub-region: an overview. Journal of Vector Borne Diseases. 2007; 44(1): 1–11.
Tomori O, Fabiyi A, Sorungbe A, Smith A, McCormick JB. Viral hemorrhagic fever antibodies in Nigerian populations. American Journal of Tropical Medicine and Hygiene. 1988; 38: 407-410.
Maxmen A. Deadly Lassa-fever outbreak tests Nigeria's revamped health agency. Nature. 2018; 555(7697): 421-422.
World Health Organization. Disease Outbreak News; Lassa Fever-Nigeria. [Internet] 2022. [updated 2022 Jan 23; cited 2022 Feb 6]; Available from: https://www.who.int/emergencies/disease-outbreak-news/item/lassa-fever---nigeria
Baba M, Logue CH, Oderinde B, Abdulmaleek H, Williams J, Lewis J, et al. Evidence of arbovirus co-infection in suspected febrile malaria and typhoid patients in Nigeria. Journal of Infection in Developing Countries. 2013; 7(1): 051-059.
Quartz Africa. Nigeria is already dealing with a deadlier viral outbreak than the coronavirus epidemic. [Internet] 2022. [updated 2020 Mar 9; cited 2022 Apr 6]. Available from: https://qz.com/africa/1814567/coronavirus-less-deadly-than-nigeria-lassa-fever-viral-outbreak/
Nigeria Centre for Disease Control. Lassa fever situation report (PDF). [Internet] 2020. [Cited 2021 Nov 22]; Available from: https://ncdc.gov.ng/themes/common/files/sitreps/bfd8f028748ff5ded5edc9c25308fdad.pdf
USAMRIID's Medical Management of Biological Casualties Handbook. 6th ed. Fort Dietrich, Maryland: U.S. Army Medical Research Institute of Infectious Diseases, 2005: 74.
Cleri DJ, Ricketti AJ, Porwancher RB, Ramos-Bonner LS, Vernaleo JR. Viral hemorrhagic fevers: current status of endemic disease and strategies for control. Infectious Disease Clinics of North America. 2006; 20(2): 359-93.
Virgin HW, Wherry EJ, Ahmed R. Redefining chronic viral infection. Cell. 2009; 138(1): 30-50.
Towner JS, Rollin PE, Bausch DG, Sanchez A, Crary SM, Vincent M, et al. Rapid diagnosis of Ebola hemorrhagic fever by reverse transcription-PCR in an outbreak setting and assessment of patient viral load as a predictor of outcome. Journal of Virology. 2004; 78: 4330–41.
Escadafal C, Faye O, Sall AA, Faye O, Weidmann M, Strohmeier O, et al. Rapid molecular assays for the detection of yellow fever virus in low-resource settings. PLoS Neglected Tropical Diseases. 2014; 8: e2730.
Mohamed N, Nilsson E, Johansson P, Klingström J, Evander M, Ahlm C, et al. Development and evaluation of a broad reacting SYBR-green based quantitative real-time PCR for the detection of different hantaviruses. Journal of Clinical Virology. 2013; 56:280-5.
Drosten C, Gottig S, Schilling S, Asper M, Panning M, Schmitz H, et al. Rapid detection and quantification of RNA of Ebola and Marburg viruses, Lassa virus, Crimean-Congo hemorrhagic fever virus, Rift Valley fever virus, dengue virus, and yellow fever virus by real-time reverse transcription-PCR. Journal of Clinical Microbiology. 2002; 40: 2323-30.
Salu OB, Amoo OS, Shaibu JO, Abejegah C, Ayodeji O, Musa AZ, et al. Monitoring of Lassa virus infection in suspected and confirmed cases in Ondo State, Nigeria. Pan African Medical Journal. 2020; 36(253).
Shaibu JO, Salu, OB, Amoo OS, Idigbe I, Musa AZ, Ezechi OC, et al. Immunological screening of Lassa Virus among Health workers and Contacts of patients of Lassa fever in Ondo State. Immunobiology. 2021; 226(3): 152076.
Sineh Sepehr K, Baradaran B, Majidi J, Abdolalizadeh, J, Aghebati L, Zare Shahneh F. Mass-Production and Characterization of Anti-CD20 Monoclonal Antibody in Peritoneum of Balb/cMice. Advanced Pharmaceutical Bulletin. 2013; 3(1): 109-113.
Abdolmaleki F, Zamani Z, Talebi S. Evaluation of Human Anti IgG Polyclonal Antibody Production Conjugated with Peroxidase in Egg Yolk. Iranian Journal of Public Health. 2019; 48(7): 1326-1334.
Va´zquez S, Cabezas S, Pe´rez AB, Pupo M, Ruiz D, Calzada N, et al. Kinetics of antibodies in sera, saliva, and urine samples from adult patients with primary or secondary dengue 3 virus infections. International Journal of Infectious Diseases. 2007; 11: 256-262.
Vazquez S, Valdes O, Pupo M, Delgado I, Alvarez M, Pelegrino JL, et al. MAC-ELISA and ELISA inhibition methods for detection of antibodies after yellow fever vaccination. Journal of Virological Methods. 2003; 110: 179-84.
Edwards HM, Counihan H, Bonnington C, Achan J, Hamade P, Tibenderana JK. The impact of malaria coinfection on Ebola virus disease outcomes: A systematic review and meta-analysis. PLoS One. 2021; 16(5): e0251101.
Tangpukdee N, Duangdee C, Wilairatana P, Krudsood S. Malaria diagnosis: a brief review. Korean Journal of Parasitology. 2009; 47(2): 93-102.
This work is licensed under a Creative Commons Attribution 4.0 International License.