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Viral Hemorrhagic Fevers: Lassa, Machupo, Junin. Remy Schneider Jazmin Jerez. Arenavirus Structure. Single-stranded, bi-segmented RNA genome Large segment (7200nt), small one (3500nt) Lipid envelope with 8-10nm club-shaped projections. South American Fever Viruses Background.

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arenavirus structure
Arenavirus Structure
  • Single-stranded, bi-segmented RNA genome
  • Large segment (7200nt), small one (3500nt)
  • Lipid envelope with 8-10nm club-shaped projections
south american fever viruses background
South American Fever VirusesBackground
  • Junin Virus : Argentine hemorrhagic fever (AHF)
    • 1950’s emergence plagued the Buenos Aires region
    • The peak frequency is during corn harvesting between March and June
    • Case fatality rate of 20%
  • Machupo Virus: Bolivian hemorrhagic fever (BHF)
    • First documented in 1959 and first isolated in 1963
    • Case fatality rate is 20%
reservoir
Reservoir
  • Junin virus
    • Calomys laucha or Calomys musculinus
    • 75% of infected people are male agricultural workers
    • Contaminated by inhalation of infected aerosols or from rodents caught in mechanical harvesters
  • Machupo virus
    • Calomys callosus
symptoms
Symptoms
  • Junin/Machupo virus:
    • Incubation 7-16 days with slow onset of symptoms
    • First symptoms: fever, malaise, headache, muscular pains, anorexia, nausea and vomiting
    • Between third and fifth day: dehydration, hypotension, infrequent urination, bradycardia
    • Hemorrhagic phase:
      • Begins with petechiae (blood spots) on upper trunk and oral mucosa
      • Hemorrhaging starts from nose, gums, stomach and intestines where severe blood loss results in hypotensive shock and neurological crisis
remedies
Remedies
  • Junin
    • Immune plasma therapy
    • Herbal: NDGA-compound in Larra divaricata leaf resin & aromatic plant oils from Argentina
    • Candid 1, live-attenuated vaccine
      • Induces neutralizing antibody response
      • Developes virus-specific antibody-dependant cellular cytotoxicity
  • Machupo
    • immune plasma therapy from survivors
    • Ribavirin
    • Candid 1 gives some protection from BHF
lassa fever virus
Lassa Fever Virus
  • Background
    • Discovered in 1969 when two missionary nurses died in Lassa, Nigeria, W. Africa
    • It expands to Guinea, Liberia, Sierra Leone
    • 100 to 300 thousand cases per year with approx. 5,000 deaths
case study
Case Study
  • New Jersey, 2004
    • Liberia-born US resident travels to West Africa. He begins to feel feverish, with chills, severe soar throat, diarrhea, and back pain. He travels back to Newark, is then admitted to a hospital in Trenton where he eventually dies.
reservoir transmission
Reservoir/Transmission
  • Multimammate rat (Mastomys natalensis)
    • High breed frequency
    • Virus shed in urine and feces
    • Instinctual scavengers
  • Person to person contact through exchange of bodily fluids only
  • Nosocomial transmission
symptoms11
Symptoms
  • Incubation period of 6-21 days
  • 80% of human infections are asyptomatic
  • Onset is slow: fever, weakness, & malaise
  • Few days: headache, pharyngitis, muscle pain, retrostinal & abdominal pain, nausea, vomiting, conjunctivitis, diarrhea, cough, & proteinuria
  • Severe cases:
    • facial swelling, lung cavity fluid, hemorrhaging, hyopotension,
    • Neurological problems: tremors, encephalitis, hair loss, gait disturbance, deafness
  • 95% deathrate among pregnant women & spontaneous abortion
remedies12
Remedies
  • Antiviral therapy (Ribavirin)
    • Acts via lethal mutagenesis
  • 1989 study: Rhesus monkeys injected with mopeia & vaccinia (V-LSGPC) viruses and escaped death
  • Non-Specific control: fluid replacement (electrolyte balance), blood transfusion, fighting of hypotension
    • Hemmorrhaging treated with clotting factor and/or platelet repacement
  • Promising vaccine
    • Developed by USAMDRID (2005)
    • Attentuated recombinant stomatitis virus vector expressing the Lassa viral glycoprotein
prevention
Prevention
  • Nosocomial: Complete equipment sterilization & protective clothing
  • House to house rodent trapping
  • Better food storage & hygiene
  • Cautious handling of rodent if used as food source
references
References
  • http://en.wikipedia.org/wiki/Lassa_fever_virus
  • http://en.wikipedia.org/wiki/Machupo_virus
  • http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/lassaf.htm
  • http://www.who.int/mediacentre/factsheets/en/
  • S. P. Fisher-Hoch; J. B. McCormick; D. Auperin; B. G. Brown; M. Castor; G. Perez; S. Ruo; A. Conaty; L. Brammer; S. Bauer. Proceedings of the National Academy of Sciences of the United States of America, Vol. 86, No. 1. (Jan. 1, 1989), pp. 317-321
  • Duschatzky CB; Possetto ML; Talarico LB; García CC; Michis F; Almeida NV; de Lampasona MP; Schuff C; Damonte Ebf. Antiviral chemistry & chemotherapy. [Antivir Chem Chemother] 2005; Vol. 16 (4), pp. 247-51
  • MMWR: Morbidity & Mortality Weekly Report, 10/1/2004, Vol. 53 Issue 38, p894