Volume 16, Number 10—October 2010
Dispatch
Imported Lassa Fever, Pennsylvania, USA, 2010
Valerianna Amorosa
, Adam MacNeil, Ryan McConnell, Ami Patel, Katherine E. Dillon, Keith Hamilton, Bobbie Rae Erickson, Shelley Campbell, Barbara Knust, Deborah L. Cannon, David M. Miller, Craig Manning, Pierre E. Rollin, and Stuart T. Nichol
, Adam MacNeil, Ryan McConnell, Ami Patel, Katherine E. Dillon, Keith Hamilton, Bobbie Rae Erickson, Shelley Campbell, Barbara Knust, Deborah L. Cannon, David M. Miller, Craig Manning, Pierre E. Rollin, and Stuart T. Nichol
Table A1
Timeline of illness for a patient with Lassa fever, Pennsylvania, USA, 2010
| Test results | Jan 13–17† | 18 Jan 18‡ | Jan 19§ | Jan 20 | Jan 21 | Jan 22 | Jan 23 | Jan 24 | Jan 25 | Jan 26 | Jan 27 | Jan 28–29 | Jan 30–Feb 3 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Hospital laboratory testing | |||||||||||||
| Highest temperature | 101.0 °F (Jan 17) | 103.0°F | 103.3°F | 103.2°F | 101.0°F | 101.8°F | 100.4°F | 99.2°F | 101.0°F | 101.0°F | 101.0°F | Low 100s°F | Low 99s°F |
| Pulse | 99 (Jan 17) | 80s | 90s | 81–103 (EKG normal) | 100–110s | 100–110 | 98–100 | 90s | 94–114 | 91–102 | 85–110 | 84–100 | ND |
| Leukocytes | 2.7 | 3 | 4.7 | 5.5 | 5.1 | ND | ND | 6.5 (normal diff) | ND | ND | ND | ND | ND |
| Hemoglobin | 13.5 | 13.9 | 13.7 | 14 | 13.9 | ND | ND | 13.2 | ND | ND | ND | ND | ND |
| Platelets | 53 | 54 | 61 | 74 | 89 | ND | ND | 236 | ND | ND | ND | ND | ND |
| Sodium | 133 | 134 | 131 | 136 | 132 | 136 | ND | 137 | ND | ND | ND | ND | ND |
| Aspartate aminotranferase | 43 | ND | ND | 194 | 161 | 121 | ND | 191 | ND | ND | 92 | ND | ND |
| Alamine aminotransferase | 28 | ND | ND | 140 | 153 | 134 | ND | 185 | ND | ND | 161 | ND | ND |
| Alkaline phosphatase | 50 | ND | ND | 44 | ND | ND | ND | 96 | ND | ND | 95 | ND | ND |
| Total bilirubin | 0.4 | ND | ND | 0.7 | ND | ND | ND | ND | ND | ND | ND | ND | ND |
| International normalized ratio | ND | ND | 1.1 | 1 | ND | ND | ND | ND | ND | ND | ND | ND | ND |
| Partial thromboplastin time | ND | ND | 38.6 | 30 | ND | ND | ND | ND | ND | ND | ND | ND | ND |
| Culture |
Blood 2× (−), Urine (−) |
Blood 2× (−), Stool (−) |
Blood 2× (−) |
Blood 2× (−), Vibrio spp. (−), Stool (−) |
Blood 2× (−) |
||||||||
| Diagnostic testing for Lassa virus | |||||||||||||
| Antigen | NA | NA | − | − | − | − | − | − | − | − | NA | − | − |
| IgG | NA | NA | − | − | − | − | − | − | − | − | NA | − | − |
| IgM | NA | NA | − | − | − | − | 400 | 1,600 | 1,600 | 6,400 | NA | 6,400 | 6,400 |
| Real-time PCR | NA | NA | + | + | + | + | + | + | + | + | NA | + | +/−¶ |
| Isolation | NA | NA | + | + | + | + | + | + | + | + | NA | + | − |
*EKG, electrocardiogram; ND, not done; NA, not available; −, negative; Ig, immunoglobulin; +, positive.
†Lactate dehydrogenase 235; thick and thin blood smears for malaria negative; monoscreen negative; urine 2–5 erythrocytes, 100 protein; rapid respiratory panel negative.
‡Chest radiograph negative; HIV 1+2 antibody evaluation negative; Clostridium difficile testing negative; cryptosporidium and Giardia spp. immunoassays negative.
§Chest radiograph negative; hepatitis B surface antibody negative; dengue IgG enzyme immunoassay negative; IgM enzyme immunoassay negative.
¶Sample from January 30 was PCR positive; samples from January 31 and February 1 were PCR negative.
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