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PA-45 Lassa fever outbreak investigation, Suakoko district, Bong County, Liberia, 2023
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  1. G Burgess Gbelee1,2,
  2. Louisa K Cassell1,2,
  3. James Kormosee3,
  4. Ralph Jetroh1,
  5. Harriet A Bonful2,
  6. Elijah Paa Edu-Quansah4
  1. 1National Public Health Institute, Liberia, Liberia
  2. 2Ghana Field Epidemiology and Laboratory Training Program, Ghana
  3. 3Bong County Health Team, Liberia
  4. 4African Field Epidemiology Network, Liberia

Abstract

Background Lassa fever causes morbidity and mortality in Africa. An estimated 100,000 to 300,000 cases of Lassa virus infection and 5,000 fatalities occur in West Africa annually. Lassa fever accounts for 10%–16% of hospital admissions in Liberia and Sierra Leone annually. On the 6th of January 2023, the Bong County Health Team confirmed Lassa fever in a student nurse at Phebe Hospital, Liberia. Five additional cases were reported before the 15th of January 2023. We investigated the source, magnitude, identified and traced contacts, and implemented control measures.

Methods We reviewed medical records from December 2022 in the hospital, and interviewed health workers and contacts. We modified the case definition, listed contacts, followed up for 21 days using checklist, and tested suspected cases. We performed descriptive analysis using Microsoft Excel 2016. Results were presented in frequencies, proportions, and median and displayed in tables, graphs, and maps.

Results A total of 15 persons were suspected and tested for the Lassa virus from January 6 - 31, 2023. Of these, 53.3% (8/15) were positive for the Lassa virus, with a case fatality rate of 25% (2/8). Fifty percent (4/8) were health workers. The median age range for the cases was 34 (6–48) years. Males accounted for 62.5% (5/8). Seventy-two contacts were listed, 4.2% (3/72) of the contacts became cases. Forty-two percent (3/7) of the additional cases were health workers linked to the index case. Fifty percent of the cases were imported from other counties. The index was a student nurse who worked in the hospital on December 12, 2022, on a missed Lassa fever case.

Conclusion The outbreak was sporadic, however among the health workers it was hospital-acquired due to a missed case of Lassa fever and improper hygiene measures. We recommend training and supplies for health workers, especially affiliating students.

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