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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)

Main Article

Table A1

Timeline of illness for a patient with Lassa fever, Pennsylvania, USA, 2010

Test results Jan 13–17† 18 Jan 18‡ Jan 19§ Jan 20 Jan 21 Jan 22 Jan 23 Jan 24 Jan 25 Jan 26 Jan 27 Jan 28–29 Jan 30–Feb 3
Hospital laboratory testing
Highest temperature 101.0 °F (Jan 17) 103.0°F 103.3°F 103.2°F 101.0°F 101.8°F 100.4°F 99.2°F 101.0°F 101.0°F 101.0°F Low 100s°F Low 99s°F
Pulse 99 (Jan 17) 80s 90s 81–103 (EKG normal) 100–110s 100–110 98–100 90s 94–114 91–102 85–110 84–100 ND
Leukocytes 2.7 3 4.7 5.5 5.1 ND ND 6.5 (normal diff) ND ND ND ND ND
Hemoglobin 13.5 13.9 13.7 14 13.9 ND ND 13.2 ND ND ND ND ND
Platelets 53 54 61 74 89 ND ND 236 ND ND ND ND ND
Sodium 133 134 131 136 132 136 ND 137 ND ND ND ND ND
Aspartate aminotranferase 43 ND ND 194 161 121 ND 191 ND ND 92 ND ND
Alamine aminotransferase 28 ND ND 140 153 134 ND 185 ND ND 161 ND ND
Alkaline phosphatase 50 ND ND 44 ND ND ND 96 ND ND 95 ND ND
Total bilirubin 0.4 ND ND 0.7 ND ND ND ND ND ND ND ND ND
International normalized ratio ND ND 1.1 1 ND ND ND ND ND ND ND ND ND
Partial thromboplastin time ND ND 38.6 30 ND ND ND ND ND ND ND ND ND
Culture
Blood 2× (−), Urine (−)
Blood 2× (−), Stool (−)
Blood 2× (−)
Blood 2× (−), Vibrio spp. (−), Stool (−)
Blood 2× (−)








Diagnostic testing for Lassa virus
Antigen NA NA NA
IgG NA NA NA
IgM NA NA 400 1,600 1,600 6,400 NA 6,400 6,400
Real-time PCR NA NA + + + + + + + + NA + +/−¶
Isolation NA NA + + + + + + + + NA +

*EKG, electrocardiogram; ND, not done; NA, not available; −, negative; Ig, immunoglobulin; +, positive.
†Lactate dehydrogenase 235; thick and thin blood smears for malaria negative; monoscreen negative; urine 2–5 erythrocytes, 100 protein; rapid respiratory panel negative.
‡Chest radiograph negative; HIV 1+2 antibody evaluation negative; Clostridium difficile testing negative; cryptosporidium and Giardia spp. immunoassays negative.
§Chest radiograph negative; hepatitis B surface antibody negative; dengue IgG enzyme immunoassay negative; IgM enzyme immunoassay negative.
¶Sample from January 30 was PCR positive; samples from January 31 and February 1 were PCR negative.

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