Presence of Lassa Virus RNA in Cerebrospinal Fluid Indicating Neuroinvasive Lassa Fever in Pediatric Patients From Edo State, Nigeria
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Neurological complications of Lassa fever (LF) are associated with fatal outcome. In this study, we aimed to provide further evidence of Lassa virus (LASV) infection of the central nervous system (CNS) by assessing LASV in cerebrospinal fluid (CSF). METHODS: We retrospectively screened the database of the LF diagnostic unit at Irrua Specialist Teaching Hospital in Nigeria for patients with suspected or confirmed LF who underwent lumbar puncture as part of their routine clinical management due to CNS symptoms and had CSF samples tested by LASV reverse-transcription polymerase chain reaction (RT-PCR). RESULTS: RT-PCR results for CSF were available for 153 patients, all children. LF was confirmed in 49 of 153 (32%) patients, of whom 42 (86%) were LASV RNA positive in CSF. Of the 42 patients, 33 (79%) were LASV RNA positive in CSF and plasma, whereas 9 (21%) patients were positive in CSF only. The CSF-positive LF patients had a median age of 10.5 years. Sample pairs of CSF and plasma taken within a day of each other on admission were available for 26 patients, of whom 23 (88%) had higher LASV RNA concentration in CSF compared to plasma (cycle threshold, 28.2 vs 36.7, respectively; P < .00001). CONCLUSIONS: LASV is frequently detected in CSF of pediatric LF patients with neurological symptoms. The virus load in CSF is usually higher than in plasma, indicating a neuroinvasive infection with active virus replication in CNS. Our findings have implications for clinical management of LF patients and drug development for LF.
Authors: Hannah Caroline Sophie Müller, Cyril Oshomah Erameh, Joseph Okoeguale, Sheila Ojor Ileli, Imonifome Frank Onyeke, Adewale Elijah Adetunji, Lilian Omoyemen Akerele, Rita Esumeh, Ebo Benevolence Ohomoime, Mette Hinrichs, Jonas Müller, Ujiagbe Moses Aiterebhe, Christiana Ngozi Ekuma, Chukwuemeka Ogbuinya Ugadu, Ifeanyi Henry Onyerikam, Juliet Oemhenze Idialu-Eigbobo, Matthew Apeleokha, Ehisuan Ehiaghe, Osahogie Isaac Edeawe, Kelly Ohis Iraoyah, Chris Hoffmann, Donatus Adomeh, Thomas Olokor, Ikponmwosa Odia, Danny Asogun, Sylvanus Okogbenin, Ephraim Ogbaini-Emovon, Reuben Eifediyi, Stephan Günther, Meike Pahlmann, Michael Ramharter, Lisa Oestereich, Till Omansen, George Akpede
Language: English
Topic: Viral Infections and Vectors
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,763
Awards: G5215369446, G5733700260
OpenAlex ID: W4416735729