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Lassa fever: 10 years on

BMJ 1998; 316 doi: (Published 17 January 1998) Cite this as: BMJ 1998;316:237
  1. David Cummins, is consultant haematologist
  1. Harefield Hospital, Middlesex

    “We tell ourselves that pestilence is a mere bogey of the mind, a bad dream that will pass away. But it doesn’t always pass away and, from one bad dream to another, it is men who pass away”-Albert Camus, The Plague

    The fever came on gradually over a couple of days. Then one afternoon, in the hospital grounds, I had a rigor. My fever seemed out of place in the intense, tropical heat. Within hours I became seriously unwell.

    Segbwema lies in the rain forest of eastern Sierra Leone, an area of rolling hills, rutted roads, and diamond mines. I was researching Lassa fever, a disease highly endemic in the region and a leading cause of death. The natural host of Lassa virus is Mastomys natalensis, one of several types of rat that live in and around the village houses; most human infections are acquired through contamination of broken skin with the rodent's urine. It has been estimated that in the whole of west Africa there may be up to 300 000 human Lassa virus infections each year. Many patients experience a mild, flu-like illness, but some deteriorate rapidly, developing facial oedema, encephalopathy, haemorrhage, and shock. Such patients usually die.

    I …

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