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Case Reports
. 2017 Sep 1;65(5):855-859.
doi: 10.1093/cid/cix406.

Favipiravir and Ribavirin Treatment of Epidemiologically Linked Cases of Lassa Fever

Vanessa N Raabe  1 , Gerrit Kann  2 , Bruce S Ribner  1 , Andres Morales  3 , Jay B Varkey  1 , Aneesh K Mehta  1 , G Marshall Lyon  1 , Sharon Vanairsdale  4 , Kelly Faber  5 , Stephan Becker  6 , Markus Eickmann  6 , Thomas Strecker  6 , Shelley Brown  7 , Ketan Patel  7 , Philipp De Leuw  2 , Gundolf Schuettfort  2 , Christoph Stephan  2 , Holger Rabenau  8 , John D Klena  7 , Pierre E Rollin  7 , Anita McElroy  7 , Ute Ströher  7 , Stuart Nichol  7 , Colleen S Kraft  1   9 , Timo Wolf  2 ; Emory Serious Communicable Diseases Unit
Collaborators, Affiliations
Case Reports

Favipiravir and Ribavirin Treatment of Epidemiologically Linked Cases of Lassa Fever

Vanessa N Raabe et al. Clin Infect Dis. .

Abstract

Two patients with Lassa fever are described who are the first human cases treated with a combination of ribavirin and favipiravir. Both patients survived but developed transaminitis and had prolonged detectable virus RNA in blood and semen, suggesting that the possibility of sexual transmission of Lassa virus should be considered.

Keywords: Lassa; Togo; favipiravir; ribavirin.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1
Figure 1
Patient E (A) and patient F (B): Symbols represent different samples taken from different body fluids. Filled symbols represent body fluid samples from which a viral isolate was recovered. Positive culture results and positive qualitative polymerase chain reaction (PCR) results are indicated by cycle threshold values ranging from 10 to 15. Symbols below the red bar indicate body fluid samples testing negative by PCR. The presence of immunoglobulin G, immunoglobulin M, duration of treatment, duration of symptoms, and duration of clinical examination findings are indicated by the bars underneath. Abbreviations: A. Fib, atrial fibrillation; Dim. Hearing, diminished hearing; IgG, immunoglobulin G; IgM, immunoglobulin M; LAD, painful lymphadenopathy; PCR, polymerase chain reaction.
Figure 2
Figure 2
A, White blood cell (WBC) count, hemoglobin (HgB), and platelet (Plt) counts for patient E (triangles) and patient F (circles). B, Aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, lactate dehydrogenase, and creatinine values for patient E (triangles) and patient F (circles).
See this image and copyright information in PMC

Comment in

  • Discharge Criteria for Patient With Lassa Fever Infection.
    Nicastri E, Vairo F, Ippolito G. Nicastri E, et al. Clin Infect Dis. 2018 Feb 1;66(4):638. doi: 10.1093/cid/cix864. Clin Infect Dis. 2018. PMID: 29186289 No abstract available.
  • Reply to Nicastri et al.
    Raabe V, O'Neal JP, Drenzek C, Kraft CS. Raabe V, et al. Clin Infect Dis. 2018 Feb 1;66(4):638-639. doi: 10.1093/cid/cix865. Clin Infect Dis. 2018. PMID: 29186318 No abstract available.

References

    1. Centers for Disease Control and Prevention. Lassa fever. Available at: https://www.cdc.gov/vhf/lassa/. Accessed 18 March 2017.
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    1. McCormick JB, King IJ, Webb PA, et al. Lassa fever. Effective therapy with ribavirin. N Engl J Med. 1986;314:20–6. - PubMed
    1. Safronetz D, Rosenke K, Westover JB, et al. The broad-spectrum antiviral favipiravir protects guinea pigs from lethal Lassa virus infection post-disease onset. Sci Rep. 2015;5:14775. - PMC - PubMed

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