title: Endemic Lassa fever in Liberia. I. Clinical and epidemiological aspects at Curran Lutheran Hospital, Zorzor, Liberia.
abstract: In a study to assess the epidemiological and clinical aspects of endemic Lassa fever (LF) in Liberia at Curran Lutheran Hospital (CLH), 44 cases were diagnosed by virological and serological techniques over a 22-month period. During one calendar month, testing of febrile patients admitted to the medical-surgical ward revealed six cases of LF, 13% of all febrile cases and 17% of those who were tested. As the study progressed the diagnostic skills of the hospital staff improved. The most common mistake was the diagnosis of a case of LF as pneumonia; the most potentially serious diagnostic problem was differentiating LF from typhoid fever, a readily treatable infection. LF may also mimic other diseases such as aseptic meningitis, pelvic inflammatory disease, gastroenteritis or arbovirus infection. We found a previously unreported symptom of LF, rib tenderness typical of costochondritis. The mortality rate in the medical-surgical ward was 5.4%; the over-all case-fatality rate was 13.6%. Women outnumbered men by nearly three to one, and had a higher mortality particularly noted in the pregnant. LF is common at CLH, and as many as 100 cases may occur annually at this hospital.
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007835:Lassa Fever / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D007958:Leukocyte Count; D007988:Liberia; D008297:Male; D008875:Middle Aged