Lassa fever. Part 2. Laboratory diagnostics, treatment, development of medications

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Abstract

Globalization and high-speed means of transportation contribute to the spread of infections dangerous to humans. Airborne pathogens have pandemic potential as currently shown in case of the novel coronavirus SARS-CoV-2. Natural focal Lassa fever (LF) common in West African countries, in 35 cases was registered in non-endemic geographical areas because any person infected with Lassa virus (LASV) is a long-term source of infection (up to two months). Cases of person-to-person infection in endemic territories are described. In Germany, the facts of secondary virus transmission from patients to doctors have been recorded during the examination and blood collection from an apparently healthy person as well as during the autopsy of a deceased subjects due to severe LF course. Nonspecific malaise symptoms in LF are also characteristic of numerous other diseases common on the African continent, e.g., malaria and typhoid fever or viral infections such as yellow fever, Chikungunya, dengue and Zika, monkey pox and Ebola virus disease. In this regard, there may be similar dermatological manifestations. Timely detection of cases and differential diagnosis are crucial to ensure safe patient care and use of affordable antiviral therapy for LL provided by the drug Ribavirin. Research methods for studying LASV use polymerase chain reaction (PCR) for detecting viral RNA, electron microscopy, isolation of infectious virus cultured sensitive cells, indirect immunofluorescence reaction, enzyme immunoassay (ELISA) and immunochromatographic assays for the detection of antibodies and/or antigen as well as immunoblotting. Currently, test kits based on molecular and genetic methods are mainly used for LF laboratory diagnostics. Since the 1980s, ribavirin has been used to treat patients with LF. The serum accumulation of the drug in large quantities causes hemolysis, development of anemia and impaired renal function. In this regard, treatment options are being considered with decline in its concentration due to combined use with other antiviral drugs. A search for new therapeutic agents capable of inhibiting viral replication at disease early stage has been in progress due to lack of any approved vaccines.

About the authors

Elena I. Kazachinskaia

Research Institute of Virology, Federal Research Center of Fundamental and Translational Medicine, Siberian Branch of Russian Academy of Sciences; State Research Centre of Virology and Biotechnology “Vector”, Federal Service for the Oversight of Consumer Protection and Welfare (Rospotrebnadzor)

Author for correspondence.
Email: lena.kazachinskaia@mail.ru
ORCID iD: 0000-0002-1856-6147

PhD, MD (Biology), Leading Researcher, Department of Experimental Modeling of Pathogenesis of Infectious Diseases, Leading Researcher, Department of Bioengineering

Russian Federation, Novosibirsk; Koltsovo, Novosibirsk region, 630559

V. S. Aripov

State Research Centre of Virology and Biotechnology “Vector”, Federal Service for the Oversight of Consumer Protection and Welfare (Rospotrebnadzor)

Email: aripov_vs@vector.nsc.ru

PhD Candidate, Junior Researcher, Department of Bioengineering

Russian Federation, Koltsovo, Novosibirsk region, 630559

A. V. Ivanova

State Research Centre of Virology and Biotechnology “Vector”, Federal Service for the Oversight of Consumer Protection and Welfare (Rospotrebnadzor)

Email: Ivanova_av@vector.nsc.ru

PhD (Biology), Senior Researcher, Department of Bioengineering

Russian Federation, Koltsovo, Novosibirsk region, 630559

A. M. Shestopalov

Research Institute of Virology, Federal Research Center of Fundamental and Translational Medicine, Siberian Branch of Russian Academy of Sciences

Email: shestopalov2@mail.ru

PhD, MD (Biology), Professor, Head of the Department of Experimental Modeling of Pathogenesis of Infectious Diseases

Russian Federation, Novosibirsk

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