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Volume 16, Number 10—October 2010

Dispatch

Imported Lassa Fever, Pennsylvania, USA, 2010

Valerianna AmorosaComments to Author , Adam MacNeil, Ryan McConnell, Ami Patel, Katherine E. Dillon, Keith Hamilton, Bobbie Rae Erickson, Shelley Campbell, Barbara Knust, Deborah Cannon, David Miller, Craig Manning, Pierre E. Rollin, and Stuart T. Nichol
Author affiliations: Author affiliations: University of Pennsylvania, Philadelphia, Pennsylvania, USA (V. Amorosa, R. McConnell, K.E. Dillon, K. Hamilton); Philadelphia Veterans Affairs Medical Center, Philadelphia (V. Amorosa); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (A. MacNeil, A. Patel, B.R. Erickson, S. Campbell, B. Knust, D. Cannon, D. Miller, C. Manning, P.E. Rollin, S.T. Nichol); Philadelphia Department of Health, Philadelphia (A. Patel)

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Table

Day by day symptoms and clinical information for a man 47 years of age with Lassa fever, Pennsylvania, USA, 2010*

Date
Symptoms
Examination findings
Bowel movements
Clinical information
Clinical action
Jan 13–17
Fevers and chills, sore throat, arthralgias, diffuse abdominal pain
NA
NA
NA
NA
Jan 18
Fevers and chills, sore throat, watery diarrhea, diffuse abdominal pain.
Prominent parotids, posterior cervical lymphadenopathy, slight spleen tip
12

Contact isolation ordered.
Jan 19
Fevers and chills, sore throat, substernal chest pain with inspiration and when lying supine, diarrhea, diffuse abdominal pain. Arthralgias resolve.
Slight tonsillar exudates, slight spleen tip
»18
Tests for Clostridium difficile, cryptosporidium, Giardia spp., thick and thin blood smears for malaria, Epstein-Barr virus, and respiratory virus panel; all negative
Contact precautions. Blood samples to test for Lassa virus drawn.
Jan 20
Fevers and chills; sore throat; substernal chest pain, worse when lying down; diarrhea. Abdominal pain improving.
Slight tonsillar exudates, slight spleen tip
3
HIV negative
EKG done, ribavirin requested, airborne precautions
Jan 21
Fevers and chills, sore throat, diarrhea. Chest pain resolves. Abdominal pain improving.
Slight spleen tip
5
Stool culture negative
Held off on ribavirin. CDC received specimen.
Jan 22
Fevers and chills, sore throat. Diarrhea resolves. Abdominal pain resolves.
Prominent sternocleidomastoid muscles
NA

Stopped IV fluids.
Jan 23
Fevers and chills, sore throat
Prominent sternocleidomastoid muscles
3, formed
PCR positive for Lassa virus

Jan 24
Fevers and chills, sore throat
Prominent sternocleidomastoid muscles
NA


Jan 25
Fevers and chills. Sore throat improves.
Prominent sternocleidomastoid muscles
3, formed


Jan 26
Fevers and chills. Sore throat improves.
Neck less prominent
NA


Jan 27
Fevers and chills. Sore throat resolves.
Decreased parotid enlargement and lymphadenopathy
NA


Jan 28–29
Fevers and chills

NA


Jan 30–Feb 3
Fever resolves

NA


*NA, not available; EKG, electrocardiogram; IV, intravenous; CDC, Centers for Disease Control and Prevention.

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