Ribavirin lassa fever

Ribavirin alone can’t cure Lassa fever —Scientists

Contrary to what the National Centre for Disease Control wants Nigerians to believe, Ribavirin, the only drug currently being used in the treatment of Lassa fever, does not suppress viral transmission, viral production, or enhance immune response. Ribavirin only efficiently suppresses the replication of Lassa virus in vitro in a test tubeand shows only moderate efficacy in reducing presence of viruses in the blood in a living organism. Writing about the disease, the scientists said, clinically, Lassa fever is difficult to distinguish from other endemic febrile illnesses in West Africa, noting that its symptoms include fever, pharyngitis, gastrointestinal complaints, and cough. Workers stitch medical clothing and protective gear at a small factory in Peshawar, Pakistan, on April 8, Turkish and Russian armored vehicles are seen during the third Turkish-Russian joint land patrol at M4 road in Idlib, Syria, on April 8, Navy music band play outside a housing complex in an effort to boost morale in Colombo, Sri Lanka, on April 8, Policemen stand guard during an operation to ensure the curfew declared by the government in El Callao, Peru, on April 8, A riot police officer demands a clearance letter to be on the road from a water delivery truck driver, in Harare, Zimbabwe, on April 8, A man walks past a line of people waiting to collect their pension in La Paz, Bolivia, on April 8, The SRC increased their employees to meet the increased demand on ambulances since the novel coronavirus appeared and the kingdom imposed a curfew. A man works from his home while his wife is seen playing a video game during a two-week curfew, as part of the Egyptian government's plan to contain the spread of COVID, in Cairo, Egypt, on April 6, Police officers control civilians during a total lockdown amid concerns about the spread of the coronavirus disease, in Kinshasa, Democratic Republic of Congo, on April 6, People reach for a bag of food thrown from a truck at a distribution run by a Haitian government program amid the spread of the coronavirus disease, in Port-au-Prince, Haiti, on April 6, A hawker sells masks on street during the government-imposed lockdown in Dhaka, Bangladesh, on April 6, A journalist talks to the camera on Paseo de la Reforma avenue as the coronavirus disease continues in Mexico City, Mexico, on April 6, Performers wear masks as a precaution against coronavirus on Charles Bridge in Prague, Czech Republic, on April 6, Police officers wear gloves and face masks as they stand guard in a street of Santiago, Chile, on April 6,amid the coronavirus pandemic. A woman wearing a protective mask signs documents to register as an unemployed in front of a local labor office in Sofia, Bulgaria, on April 6, Men build a booth that will help health workers to test COVID patients safely during the 14th day of the lockdown imposed by the government, in Bhaktapur, Nepal, on April 6, People are seen praying outside a church on the occasion of Palm Sunday in Kampala, Uganda, on April 5, A staff from German embassy checks passenger's passports as they wait for a flight back home, at Tribhuvan International Airport in Kathmandu, Nepal, on April 4, A group of women are seen at the street in Lima, Peru, on April 4, The Punch.

Determining Ribavirin’s mechanism of action against Lassa virus infection

Cite This Article. In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Emerging Infectious Diseases. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1. All other clinicians completing this activity will be issued a certificate of participation. Disclosure: Jude Rutledge has disclosed no relevant financial relationships. Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships. Lassa fever LF is endemic to Nigeria, where the disease causes substantial rates of illness and death. In this article, we report an analysis of the epidemiologic and clinical aspects of the LF outbreak that occurred in Nigeria during January 1—May 6, A total of 1, cases were reported; were laboratory-confirmed cases, among which deaths were recorded case-fatality rate Among all confirmed cases, 37 occurred in healthcare workers. The secondary attack rate among 5, contacts was 0. Most Fatal outcomes were significantly associated with being elderly; no administration of ribavirin; and the presence of a cough, hemorrhaging, and unconsciousness. The findings in this study should lead to further LF research and provide guidance to those preparing to respond to future outbreaks. Lassa fever LF is a febrile infectious disease caused by Lassa virus. The disease was first described in Nigeria in 1. Rodents, particularly Mastomys natalensisare considered the natural hosts of the virus 2. The disease is mainly spread to humans through contamination with the urine or feces of infected rats 34. Human-to-human transmission can occur through contact with the body fluids of infected persons; therefore, healthcare workers HCWs are at high risk for infection when the standard precautions for infection prevention and control are inadequate 56. The incubation period of the disease is 3—21 days. The clinical manifestation of the disease is nonspecific and includes fever, fatigue, hemorrhaging, gastrointestinal symptoms vomiting, diarrhea, and stomachacherespiratory symptoms cough, chest pain, and dyspneaand neurologic symptoms disorientation, seizures, and unconsciousness 3. In Nigeria, laboratory-confirmed LF patients are treated in isolation units, according to national guidelines, to prevent community and nosocomial human-to-human infections 9. Isolation units are also located in tertiary-care centers in other states. Ribavirin has been shown to reduce the CFR for LF 11 ; Nigeria national guidelines recommend that parenteral ribavirin be administered over a day period for patients with confirmed LF 9.

Lassa Fever

Lassa fever is an acute, viral disease carried by a type of rat that is common in West Africa. It can be life-threatening. It is a hemorrhagic virus, which means it can cause bleeding, although 8 out of every 10 people with the virus have no symptoms. If it affects the liver, kidneys, or spleen, it can be fatal. The disease is endemic to a number of West African countries. Rough estimates suggest there are betweenandcases of Lassa fever each year in West Africa, and approximately 5, deaths due to the disease. In some areas of Liberia and Sierra Leone, 10 to 16 percent of all hospital admissions are due to Lassa fever, indicating a serious and widespread impact in those areas. Ina person returning from Liberia to the U. International travel has increased the risk of diseases spreading from one country to another. Lassa fever was first discovered in Nigeria, when two missionary nurses became ill with the virus in Its name is derived from the village of Lassa, where it was first documented. Lassa fever is a viral infection carried by the multimammate rat Mastomys natalensis M. This is one of the most common rodents in equatorial Africa, found across much of sub-Saharan Africa. However, the Mastomys rat is common in neighboring countries, so these areas are also at risk. Once a Mastomys rat is infected with the virus, it can excrete the virus in its feces and urine, potentially for the rest of its life. As a result, the virus can spread easily, especially as the rats breed rapidly and can inhabit human homes. The most common method of transmission is by consuming or inhaling rat urine or feces. It can also be spread through cuts and open sores. The rats live in and around human habitation, and they often come into contact with foodstuffs. Sometimes people eat the rats, and the disease can be spread during their preparation. Person-to-person contact is possible via blood, tissue, secretions or excretions, but not through touch. Sharing needles may spread the virus, and there are some reports of sexual transmission. Lassa fever can also be passed between patients and staff at poorly equipped hospitals where sterilization and protective clothing is not standard. Symptoms generally appear within 6 to 21 days after infection occurs. An estimated 80 percent of infections do not produce significant symptoms, although there may be a general malaise, headacheand a slight fever. In around 1 percent of all cases, Lassa fever is fatal, and around 15 to 20 percent of all hospitalizations for the disease will end in death. One of the most common complications of Lassa fever is hearing loss, which occurs in around 1 in 3 infections. This hearing loss varies in degree and is not necessarily related to the severity of the symptoms. Deafness caused by Lassa fever can be permanent and total. It is particularly dangerous for women in the third trimester of pregnancy. Spontaneous loss of pregnancy occurs in around 95 percent of pregnancies. Clinically, the disease can resemble other viral hemorrhagic fevers, including the Ebola virus, malariaand typhoid. The only definitive tests for Lassa fever are laboratory-based, and the handling of specimens can be hazardous. Only specialized institutions can conduct these tests. Reverse transcription-polymerase chain reaction RT-PCR can also be used in the early stages of the disease. Rehydration and treatment of symptoms can improve the chances of survival if there is an early diagnosis. Prescribed early, the antiviral drug ribavirin has proven useful in fighting Lassa virus, but how it works remains unclear. However, access to ribavirin in the areas worst affected by the Lassa virus is limited. Additionally, ribavirin may be toxic and teratogenic, meaning it can cause mutations. For this reason, it is not a perfect solution.

Ribavirin for Lassa Fever Postexposure Prophylaxis

Medically reviewed by Drugs. Last updated on Oct 16, Ribavirin not effective alone for treatment of chronic HCV infection; do not use ribavirin monotherapy for this indication. Principal toxicity of oral ribavirin is hemolytic anemia which may result in worsening of cardiac disease and has resulted in fatal and nonfatal MI. Contraindicated in pregnant women and male partners of pregnant women. Aerosolized ribavirin ribavirin for nasal and oral inhalation should be used in patients requiring mechanical ventilator assistance only if clinicians and support staff are familiar with this mode of administration and the specific ventilator being used. Initiation of aerosolized ribavirin in infants has resulted in sudden deterioration of respiratory function. Ribavirin for nasal and oral inhalation is not indicated in adults. Antiviral agent; nucleoside derivative. Treatment of chronic HCV infection in adults and pediatric patients with compensated liver disease. Used in conjunction with other drugs in multiple-drug regimens for treatment of chronic HCV infection; do not use alone. Has been used in conjunction with peginterferon alfa peginterferon alfa-2a, peginterferon alfa-2b. Usually used in multiple-drug regimens that include one or more HCV direct-acting antivirals DAAs with or without peginterferon alfa. Safety and efficacy of oral ribavirin in conjunction with peginterferon alfa not established for treatment of chronic HCV infection in patients with decompensated liver disease, HBV coinfection, or liver or other organ transplants. Most appropriate multiple-drug regimen depends on specific HCV genotype and patient population involved. Treatment of chronic HCV infection is complex and rapidly evolving; consult a specialist to obtain the most up-to-date information. To allow for spontaneous resolution, some experts suggest delaying initiation of treatment of acute HCV infection especially in asymptomatic individuals for 8—12 weeks after acute onset of hepatitis, unless HCV RNA levels are high and not declining. Consult a specialist to obtain the most up-to-date information regarding treatment of acute HCV infection. Chronic HEV infection reported almost exclusively among immunocompromised individuals, including solid organ transplant recipients, patients receiving cancer chemotherapy, and HIV patients. Ribavirin nasal and oral inhalation used for treatment of severe lower respiratory tract infections i. Manufacturer states consider use only in infants and small children with severe RSV lower respiratory tract infections; use in mechanically ventilated patients only if clinicians and support staff are familiar with the mode of administration and specific ventilator being used. AAP states ribavirin nasal and oral inhalation therapy may be considered for selected patients with documented life-threatening RSV infection, but routine use not recommended. Inactive against and not used for treatment of infections caused by Filoviridae including Ebola hemorrhagic fever and Marburg hemorrhagic fever. Information on diagnosis and management of viral hemorrhagic fevers is available from Special Pathogens Branch of CDC at [Web] or at Safety and efficacy not established; only limited experience to date. Generally has been used in critically ill patients with severe adenovirus infections e. Has been used for preemptive therapy in immunocompromised patients who were asymptomatic but had clinical cultures positive for adenovirus. Has been used in conjunction with an interferon e. Administer orally or by nasal and oral inhalation. Administer ribavirin capsules, tablets, and oral solution with food. Do not open, crush, or break capsules.

Viral hemorrhagic fever

Thank you for visiting nature. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser or turn off compatibility mode in Internet Explorer. In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. A Nature Research Journal. Ribavirin is a broad spectrum antiviral which inhibits Lassa virus LASV replication in vitro but exhibits a minor effect on viremia in vivo. However, ribavirin significantly improves the disease outcome when administered in combination with sub-optimal doses of favipiravir, a strong antiviral drug. The mechanisms explaining these conflicting findings have not been determined, so far. Here, we used an interdisciplinary approach combining mathematical models and experimental data in LASV-infected mice that were treated with ribavirin alone or in combination with the drug favipiravir to explore different putative mechanisms of action for ribavirin. Instead, the modeled viral kinetics suggest that the main mode of action of ribavirin is to protect infected cells from dying, possibly reducing the inflammatory response. There is currently no vaccine available against LASV in humans, and the sole treatment relying on the drug ribavirin is only effective if administered early in infection, i. However, ribavirin significantly improves clinical outcome, i. The improved clinical outcome caused by the addition of ribavirin to antivirals has been also observed in several other viral infections, including HCV 891011Junin and Pichinde virus 12 ; Crimean Congo hemorraghic fever virus 13and Rift Valley fever virus However, the mechanisms by which ribavirin improves responsiveness when given in combination despite its low efficacy during mono-therapy remain poorly understood. Numerous modes of action MOA for ribavirin have been proposed reviewed in ref. In addition, ribavirin has been characterized as a mutagen for HCV and hepatitis E virus HEVdriving the virus to its error catastrophe 161920212223 and thereby limiting its specific transmission. Although there has been evidence supporting each of these hypotheses, the preeminent mode of action is still unresolved and might vary dependent on the type of viral pathogen studied. In this study, we investigate to which extent the proposed various non mutually-exclusive roles of ribavirin affect the infection of LASV in mice. We evaluate the ability of these models to describe experimental data on viral load and cell damage marker kinetics of LASV infected mice which were treated with mono-therapy of ribavirin or favipiravir, or with a combination of both drugs using sub-optimal doses 7. Our analysis suggests that ribavirin mainly protects infected cells from dying, while having no effect on viral production or transmission. While all placebo treated animals develop high viral titers and high levels of aspartate aminotransferase ASTa marker for cell damage, there is a large variation in virus load VL and AST levels across different regimes of the mono- and combi-therapies Fig. Favipiravir reduces viremia in a dose-dependent manner, i. Animals were treated with PBS left columnsingle doses of favipiravir or ribavirin middle columnsand with three types of combination therapies right column. Error bars represent the standard deviation. The dark and light gray areas depict the treatment period between 4—11, and 4—15 days post infection p. Parts of this figure are adapted from ref. During combination-treatment, the time course of VL Fig. Interestingly, the reduction in AST levels seems to be larger than that observed during mono-therapy Fig. Taken together, the data suggest that ribavirin has little effect on viremia but seems to rather affect AST dynamics. Although there is large evidence for ribavirin in decreasing viral production in vitro 24252627our data do not indicate a substantial effect of ribavirin on viral load during LASV infection in vivoyet suggest that ribavirin clearly improves disease outcome during combination therapy. As the precise antiviral effect of ribavirin for LASV infection is unknown, we independently investigate four mechanisms of action using mathematical models describing viral and AST dynamics during LASV infection with and without treatment. The mathematical models follow the concentration of uninfected target cells, productively infected cells, and free infectious virions, as well as the levels of AST for a detailed description of the model and the corresponding equations see Materials and Methods. The different drug mechanisms are incorporated into the model by modifying the model parameters characterizing the hypothesized mode of action. Schematic representation of possible drug effects on viremia and AST dynamics.

7 Things You May Not Know About Lassa Fever Virus

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