Safe intensive-care management of a severe case of Lassa fever with simple barrier nursing techniques

Lassa virus is an arenavirus of rodents widespread in rural areas of western Africa. Human infections are primarily due to contact with the natural host, the multimammate rat Mastomys natalensis.2 In the early 1970s nosocomial outbreaks involving expatriate medical staff in Nigeria, Liberia, and Sierra Leone led to concern over the possibility of man-to-man transmission of the virus. Subsequently some Western authorities introduced stringent requirements for containment of the patient to protect hospital and laboratory staff.6 - In eastern Sierra Leone in February, 1985, a British midwife working in hospital A was admitted to a Lassa fever referral centre in hospital B. She became critically ill and required intensive medical and nursing care, including surgery, without which she would not have survived. Difficulties encountered in repatriating her for diagnosis and management unavailable in Sierra Leone are described, and experience with this case has implications for the medical care and safe handling of Lassa fever in both endemic and nonendemic areas.