Lassa Fever Flashcards by Iseoluwa Ojo

Alert Case

Any person who has an __________________ (i.e. Malaria and other likely causes of fever have been ruled out), with or without ________

Any person who died after an unexplained severe illness with ________ and ___________

unexplained fever

bleeding

fever ; bleeding

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Suspected case

 malaise
 Fever
 Headache
 sore throat
 Cough
 Nausea
 Vomiting
 Diarrhea
 Myalgia
________ pain or ________ pain

central chest

retrosternal

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Suspected case

History of contact with ________ or ________ of ________ OR

History of contact with a _______________________ within a period of ________ of onset of symptoms

OR
Any person with ________

excreta or urine of rodents

probable or confirmed Lassa fever case ; 21 days

bleeding

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Probable case
Any suspected case as defined above but who _____________________________.

died without collection of specimen for laboratory testing

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Confirmed case
Any ___________ case with ________________________ (positive _____ antibody, PCR or virus isolation)

suspected

laboratory confirmation

IgM

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The outbreak threshold of Lassa fever is __________ confirmed case of Lassa fever: cases with a history of non-response to anti-malarial or antibiotics.

a single

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Signs of haemorrhage and shock which is strongly suggestive, but these signs often appear ______ in the illness.

late

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Clinical assessment of Lassa fever

Non-specific clinical features: early diagnosis difficult. High index of suspicion.

Detailed clinical examination advised as patient may present at any stage of the disease.

The incubation period is _________.

________ face and neck, __________ and _________ loss are suggestive of
Lassa fever.

___________ seen in only about 20% of Lassa fever patients.
Exclude other causes of _________.

6-21 days.

Swollen ; sore throat

hearing loss ; Hemorrhage

fever.

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Severity of Lassa Fever may depend on a number of factors
 including the body’s ________________
 ______ of ______
 ______ of exposure
 infecting ______
 phase of illness in the case
 virus ______.

natural immune response

mode ; transmission

duration ; dose

strain.

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Lassa fever

virus can be present in semen for up to ________ after clinical recovery

3 months

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Physical examination of a patient with lassa fever

Major

_________-mouth, nose, rectum and/or vagina
________ of the neck and/or face.
________ hemorrhage
Jaundice
_________ ________
________
Persistent _______

Bleeding; Edema

Conjunctiva

Spontaneous abortion

Deafness; Hypotension

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Laboratory diagnosis

Early laboratory diagnosis of Lassa fever
All samples should be considered as __________.
Confirmation of Lassa fever requires ___________________________Labor
atories
Exclude other causes of fever through appropriate investigations

highly infectious.

highly specialized Reference

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Physical examination of a patient with lassa fever

Minor
General malaise
Headache
__________ pain
________ or ________ pain
Cough
Sore throat
________ pain
Diarrhea

Retro-sternal
Muscle or joint

Abdominal

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Laboratory diagnosis

Major
Elevated ______________ (SGOT/AST) 159
IU/l
 Minor
_________
__________ <4000 lU/L

liver transaminases

Proteinuria
Leucopoenia

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Laboratory diagnosis

Major
Elevated ______________ (SGOT/AST) 159
IU/l
 Minor
_________
__________ <4000 lU/L

liver transaminases

Proteinuria
Leucopoenia

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Management of cases

NOTIFICATION
All suspected cases of Lassa fever should be immediately reported to the ________ and State ________ using the immediate/case-based surveillance reporting form (IDSR 001A).

LGA DSNO

Epidemiologist

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Infection prevention and control

_________ room: to limit contact. With dedicated bathroom and toilet
 _________ room: when Lassa is confirmed
The number of staff in contact with the patient should be restricted.

 Infection prevention and control measures by staff for Lassa fever or any VHF
 Staff _________
 Control measures

Holding ; Isolation

protection

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Staff protection

_________ precautions plus _________ precautions
 ________ restriction
 ____________ restriction

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Standard; droplet

Access; Staff number

Control measures

Hand hygiene ( __________ )
_______ gloves
____________ disposable overall or gown
_____ length plastic apron over overall/gown
________ cover e.g. surgical cap

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5 moments

Double

Fluid repellent ; Full length

Head cover

The 5 moments

Moment 1: _______________________
Moment 2: _______________________
Moment 3: _____________ or _____________________
Moment 4: _______________________
Moment 5: _______________________

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Moment 1: before touching a patient
Moment 2:Before a Procedure
Moment 3:After a procedure or body fluid exposure risk
Moment 4:After touching a patient
Moment 5:after touching a patient’s surrounding

Control measures

___________ footwear e.g. surgical boots/shoe covers
 _______ face shield or goggles
 Fluid repellent ___________ used as splash protection.

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Fluid repellent

Full

FFP 2 respirator

FFP 2- = FFP stands for “_________ _________”.

The number 1 to 3 describes the ________ level of the respiratory mask. The higher the number, the more efficiently the mask filters particles such as dust or airborne liquid particles from the air..

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“Filtering Facepiece”.

protection

FFP 2- = FFP stands for “_________ _________”.

The number 1 to 3 describes the ________ level of the respiratory mask. The higher the number, the more efficiently the mask filters particles such as dust or airborne liquid particles from the air..

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“Filtering Facepiece”.

protection

Treatment of Lassa fever

 Urgent or Initial Rx to resuscitate or stabilize
 Definitive Rx: drug of choice for treatment of Lassa fever infection is parenteral __________ and is administered over a period
of _______.
 Outcome is more favorable if treatment is commenced within _________ of onset of symptoms.

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Ribavirin

10 days.

six days

Suspected case For established contact with a confirmed case: commence _____________ while awaiting lab result OR if symptoms support a classic case of Lassa fever

Ribavirin immediately

Supportive therapy Oxygenation if respiratory rate> _____ breaths/ min. ____________ monitoring. Treatment of complicating infections.  Appropriate fluid and electrolyte balance.  Group and cross-match of blood and transfusion

20 Blood pressure

Precautions to take when treating Lassa fever  _________ are contraindicated due to risk of bleeding  Avoid __________ injections to avoid hematoma  Use __________ to clean the mouth of patient instead of hard toothbrush  Any ___________ should be cleaned and dressed gently  Avoid _____________ , _______________ insertion as much as possible

NSAIDS ; intramuscular cotton wool ; skin ulcers nasogastric tube ; urinary catheter

Precautions to take when treating Lassa fever  DO NOT remove ___________ from previous bleeding sites.  NEVER ________ needles.  For pregnant patients, _______ vaginal examination should be done only infrequently.  Patients experiencing seizures should be given _______ and put under ______________.  Do not enter patient’s room or get in contact with a patient without putting on ___________.

old blood clots RECAP; gentle diazepam; oxygen concentrator full PPE

Poor prognostic factors in Lassa fever _________ women _________ cases Tremors/seizures Serum AST > _______ IU/ml _______ commencement of Ribavirin (after ______ day of onset of illness)

Pregnant ; Bleeding 150 ; Late 10th

Contacts are categorized into: Category 1:____-risk contacts Category 2: ____-risk contacts Category 3: _______-risk contacts

No Low High

Category 1: No-risk contacts  No ____________ with the patient or body fluids.  _________ contact, e.g. sharing a room with the patient, without direct contact with body fluids or other potentially infectious material.  Handling of laboratory specimens under _________ conditions

direct contact Casual contained

Category 2: low-risk contacts  ________ contact with the patient, e.g. routine medical/nursing care, OR  Handling _________ wearing _______ personal protective equipment, OR  ________ of laboratory containment (with or without ?) direct contact with specimen

Direct ; body fluids appropriate ; Breach without

Post-exposure prophylaxis for high risk contacts Although experience is limited, post-exposure prophylaxis with _______ should be considered for high-risk contacts of confirmed cases.  The prophylactic regimen is Ribavirin 500mg by _____ every ________ for __________

Ribavirin mouth 6hours 7 days

Category 3: high-risk contacts  ___________ exposure of skin or mucous membranes to potentially infectious blood or body fluids, including clothing and bedding.  This includes __________ handling of clinical/laboratory specimens; mucosal exposure to ________; _________ injury and kissing and/or sexual contact.

Unprotected ; unprotected splashes; needle-stick

Discharge criteria The decision to discharge a patient should be taken on _________ grounds, and supported by _________ results A _____________ means that the virus can no longer be detected in the blood and the patient is unlikely to be infectious with casual contact.

clinical grounds laboratory results negative PCR

Disinfection  All clothes should be disinfected by soaking them for _________ in a ___% _________ solution, then wash with _________, rinse with _________ and then _________.  Very dirty clothes should be _________, replacement clothing to be brought by family members.  All discharged patients should take a shower with ____% _________ solution before putting on his/her replacement clothes.  They should avoid any contact with items in the isolation ward.

30 minutes; 0.5% chlorine soap ; water ; air-dry. burnt 0.05% chlorine

Disinfection  The patient should go to the ___________ where hands and feet will be sprayed.  The hospital belongings like bed, mattress (with plastic protection) and buckets need to be disinfected with _________ and may __________ by another patient.  Sheets should be ________ and eating utensils properly __________.

patient exit 0.5% chlorine burned ; disposed.

Safely prepare the dead bodies  The burial must take place as ________ as possible after preparation of the remains at the hospital  Prepare the body with care in order to avoid the risk of ________.  Strive to respect the cultural practices and religious beliefs of the family, as long as they do not result in a risk of transmission.  Let the family understand that certain practices that entail a risk of transmission would be abandoned. Find an influential member of the family to ensure that dangerous practices like _________ and ________ the dead body should be avoided.

early transmission. touching washing

To prepare the body at the hospital  Wear __________ clothing as recommended for members of staff of the isolation area; wear a _______ pair of thick rubber gloves.  Disinfect the body by spraying ______________ (0.5% Solution) on the body and adjacent regions.  Put the body in a ________, which should be tightly closed. Spray with ___________ (0.5% Solution).

protective ; second household bleach body bag ; household bleach

To prepare the body at the hospital If there is no body bag, wrap the body in _____ thick ______ materials, which should be soaked with ____________ diluted at 0.5% solution.  wrap the body in ________ (plastic kitchen table cover), which should be attached with a ____________. Spray with household bleach diluted at 0.5% Solution.

two thick cotton household bleach plastic plastic adhesive tape

Safely transport the body  Take the ________ route possible for safety reasons  limit any possibility of transmission through accidental contact.  Any member of the safe burial team who needs to touch or handle the body during the transportation should ____________________________ as those worn in the isolation area  The driver of the vehicle ________________________________ if s/he does not have any contact with the body.

shortest wear the same protective clothes does not need to wear protective clothes

Prepare the burial site The tomb must be at least _________ deep. Explain to the family that it is not possible to see the body and help the family to understand why the burial ceremony should be restricted to the family alone.

two metres

The safe burial team who will disinfect the vehicle should wear protective clothes. Wash the interior of the vehicle where the body was placed with a household bleach solution at 0.5% Solution. Leave the bleach solution to act for ____________. Rinse abundantly with clean water and let it dry.

10 minutes

Lassa Fever Flashcards

(44 cards)