World Health Organization Country Office for Liberia, Avenue Mamba, PO Box 316, Monrovia, Montserrado, Liberia.
World Health Organization Country Office for Liberia, Avenue Mamba, PO Box 316, Monrovia, Montserrado, Liberia.
Int J Infect Dis. 2018 Jan;66:65-73. doi: 10.1016/j.ijid.2017.11.007. Epub 2017 Nov 11.
Lassa fever (LF), a priority emerging pathogen likely to cause major epidemics, is endemic in much of West Africa and is difficult to distinguish from other viral hemorrhagic fevers, including Ebola virus disease (EVD). Definitive diagnosis requires laboratory confirmation, which is not widely available in affected settings. The public health action to contain a LF outbreak and the challenges encountered in an EVD-affected setting are reported herein.
In February 2016, a rapid response team was deployed in Liberia in response to a cluster of LF cases. Active case finding, case investigation, contact tracing, laboratory testing, environmental investigation, risk communication, and community awareness raising were undertaken.
From January to June 2016, 53 suspected LF cases were reported through the Integrated Disease Surveillance and Response system (IDSR). Fourteen cases (26%) were confirmed for LF, 14 (26%) did not have a sample tested, and 25 (47%) were classified as not a case following laboratory analysis. The case fatality rate in the confirmed cases was 29%. One case of international exportation was reported from Sweden. Difficulties were identified in timely specimen collection, packaging, and transportation (in confirmed cases, the time from sample collection to sample result ranged from 2 to 64 days) and a lack of response interventions for early cases.
The delay in response to this outbreak could have been related to a number of challenges in this EVD-affected setting: a need to strengthen the IDSR system, develop preparedness plans, train rapid response teams, and build laboratory capacity. Prioritizing these actions will aid in the timely response to future outbreaks.
拉沙热（LF）是一种可能引发重大疫情的优先新兴病原体，在西非大部分地区流行，难以与其他病毒性出血热（包括埃博拉病毒病[EVD]）区分开来。明确诊断需要实验室确认，但在受影响的环境中，这种确认并不广泛。本文报告了为控制 LF 疫情而采取的公共卫生行动，以及在 EVD 疫区所面临的挑战。
2016 年 2 月，为应对一组 LF 病例，利比里亚迅速部署了一个快速反应小组。开展了主动病例发现、病例调查、接触者追踪、实验室检测、环境调查、风险沟通和社区意识提升工作。
2016 年 1 月至 6 月，通过综合疾病监测和应对系统（IDSR）报告了 53 例疑似 LF 病例。经实验室分析确认了 14 例（26%）为 LF，14 例（26%）未进行样本检测，25 例（47%）被归类为非病例。确诊病例的病死率为 29%。从瑞典报告了 1 例国际输出病例。在及时采集、包装和运输标本方面存在困难（在确诊病例中，从采集样本到获得样本结果的时间范围为 2 至 64 天），而且对早期病例缺乏应对干预措施。
在这个 EVD 疫区，对这次疫情的反应延迟可能与许多挑战有关：需要加强 IDSR 系统，制定备灾计划，培训快速反应小组，以及建立实验室能力。优先考虑这些行动将有助于及时应对未来的疫情。
