About Lujo Hemorrhagic Fever

What it is

Lujo hemorrhagic fever (LUHF) is a disease caused by the Lujo virus. The Lujo virus spreads to people through contact with infected rodents or their urine, droppings, or saliva. Scientists are still learning about LUHF, and do not know which rodent species spreads the virus.

Most knowledge of LUHF comes from the only outbreak, which occurred in 2008. The outbreak began in Zambia when a person became sick after exposure to an infected rodent. This first patient sought care in a South African healthcare facility. There, four healthcare workers caring for the patient also became infected. Four out of the five cases were fatal.

Signs and symptoms

The symptoms of LUHF resemble those of severe Lassa fever. LUHF starts with fever accompanied by headache and muscle pain.

The disease increases in severity, with:

• A rash of the face and torso
• Face and neck swelling
• Sore throat
• Diarrhea

Bleeding is not a typical symptom of LUHF.

In fatal cases, a brief improvement was followed by rapid deterioration, trouble breathing, and problems with the heart and brain/nerves.

Death occurred 10 to 13 days after symptoms began.

How long it takes for signs to show

People with LUHF start experiencing symptoms about 7 to 13 days after they were exposed to the virus.

Risk factors

People who work in fields in southern Africa are at greatest risk for LUHF. They are more likely to have contact with the rodent that spreads the virus. Sexual partners of these field workers may also be at greater risk.

Healthcare providers and laboratory workers without proper personal protective equipment (PPE) are also at risk.

How it spreads

LUHF is caused by infection with the Lujo virus, which is spread by rodents. People usually get LUHF when they are exposed to infected rodents or their urine, droppings, or saliva. This can occur by:

• Breathing in air with an infected rodent's urine, droppings, or nesting materials
  • This may occur when cleaning or sweeping.
• Touching objects contaminated by an infected rodent
• Being bitten or scratched by an infected rodent
• Eating food contaminated by an infected rodent

Infection can also happen after a person has contact with bodily fluids of a person with LUHF.

If a pregnant person is infected, there is a risk of miscarriage.

The Lujo virus can spread in healthcare settings when not using proper PPE or properly sterilizing equipment.

Prevention

If you are in a place where LUHF occurs, avoid areas with rodent infestations or signs of rodent infestation, like droppings.

Healthcare providers should use different PPE depending on the state of the patient:

• Use PPE for clinically stable VHF patients if the patient with suspected LUFH is clinically stable.
• Use PPE for clinically unstable VHF patients if the patient has confirmed LUHF or is clinically unstable.

Researchers studying Lujo virus must work only in Biosafety Level 4 (BSL-4) laboratories, which have stringent safety and security conditions. In the United States, Lujo virus is classified as a Select Agent.

Testing and diagnosis

If a healthcare worker suspects LUHF, they can perform laboratory tests to diagnose the disease.

Healthcare providers can diagnose LUHF with blood tests that detect the Lujo virus. They can also do antibody tests to tell if someone had the virus in the past. However, these tests should only be done in a high containment laboratory with good laboratory practices.

Clinicians should notify their health department if a patient has recently been in an area with LUHF and has compatible symptoms.

Treatment and recovery

There is no cure for LUHF. Patients should receive supportive care, including rest, hydration, and treatment of symptoms.

The drug Ribavirin may hold promise in the treatment of LUHF.