Early-onset sensorineural hearing loss in Lassa fever.
Lassa fever (LF) is a viral hemorrhagic disease which affects one-fourth to two million people annually with the fatality rate of about 10,000. It is associated with sensorineural hearing loss (SNHL) usually at the convalescent stage. Recently, cases of SNHL at the acute phase have been reported. This study was done to further investigate the incidence and features of SNHL in acute phase of LF. It is a prospective case-control study of LF patients seen with acute SNHL conducted between July 2007 and April 2009 at Irrua Specialist Teaching Hospital Nigeria. The diagnosis of acute LF was based on the clinical features and detection of IgM antibodies and/or positive Lassa virus-specific reverse transcriptase-polymerase chain reaction using primers S36+ and LVS 339 while SNHL was diagnosed clinically and confirmed with PTA and speech discrimination tests. Patients with other acute febrile illnesses were used as control. Statistical analysis was done using SPSS version 11 and Fisher's exact test while level of significance was set at p < 0.05. Out of the 37 confirmed cases of LF, 5 (13.5%) and none (0%) of the control developed early-onset SNHL (p = 0.03). Forty percent of the cases studied had negative IgM. The audiograms showed involvement at all frequency groups with pure tone average 65-85 dB and the speech discrimination 20-40%. The overall case fatality rate was 27.0%, and for early SNHL cases 60.0% (p > 0.05). The incidence of SNHL in LF infection is about 13.5% and could be a reflection of a worse disease process. There is possibility of direct viral invasion aside immunological reaction as a causative mechanism.
Ibekwe
T S
TS
Lassa Fever Research and Diagnostic Centre, Irrua Specialist Teaching Hospital, Irrua, Nigeria. ibekwets@yahoo.com
Okokhere
P O
PO
Asogun
D
D
Blackie
F F
FF
Nwegbu
M M
MM
Wahab
K W
KW
Omilabu
S A
SA
Akpede
G O
GO
D000158:Acoustic Impedance Tests; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007835:Lassa Fever / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D020133:Reverse Transcriptase Polymerase Chain Reaction; D055815:Young Adult
Emerg Infect Dis. 2005 Oct;11(10):1642-4
16355508
J Vector Borne Dis. 2007 Mar;44(1):1-11
17378212
Emerg Infect Dis. 2006 May;12(5):835-7
16704848
BMJ. 2003 Nov 29;327(7426):1271-5
14644972
JAMA. 1990 Oct 24-31;264(16):2119
2214082
Vestn Ross Akad Med Nauk. 2007;(12):40-4
18225506
J Laryngol Otol. 1953 Aug;67(8):466-73
13085048
J Clin Microbiol. 2000 Jul;38(7):2670-7
10878062
Otolaryngol Head Neck Surg. 1992 Mar;106(3):226-9
1589210
Antiviral Res. 2008 Apr;78(1):103-15
18241935
Trans R Soc Trop Med Hyg. 1997 Jul-Aug;91(4):379-81
9373625
Acta Otolaryngol. 2006 Dec;126(11):1124-7
17043035
J Med Case Rep. 2009 Jan 29;3:36
19178735
Am J Trop Med Hyg. 1970 Jul;19(4):670-6
4246571
Microbes Infect. 2002 Jan;4(1):43-50
11825774
Bull World Health Organ. 1975;52(4-6):609-13
1085216
Euro Surveill. 2002 Mar;7(3):42-4
12631944
Trop Doct. 2005 Jan;35(1):16-7
15712534
ASHA. 1981 Jul;23(7):493-500
7052898
Nihon Rinsho. 2005 Dec;63(12):2154-60
16363688
J Infect Dis. 1987 Mar;155(3):456-64
3805773
J Clin Microbiol. 1990 Dec;28(12):2689-92
2279999
BMJ. 1995 Sep 30;311(7009):857-9
7580496
JAMA. 1990 Oct 24-31;264(16):2093-6
2214077
Euro Surveill. 2002 Mar;7(3):48-50
12631946
Science. 1974 Jul 19;185(4147):263-5
4833828
PLoS Negl Trop Dis. 2009;3(3):e388
19255625
Otol Neurotol. 2008 Jun;29(4):464-9
18434930
Euro Surveill. 2002 Mar;7(3):50-2
12631947
Ann Emerg Med. 2005 Mar;45(3):323-6
15726058
J Infect Dis. 2001 Aug 1;184(3):345-9
11443561
Euro Surveill. 2009 Feb 12;14(6):
19215723