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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 L. Cannon, David M. 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

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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Page created: September 07, 2011
Page updated: September 07, 2011
Page reviewed: September 07, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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