Burden of Lassa fever disease in pregnant women and children and options for prevention.

Journal: Vaccine

Volume: 43

Issue: Pt 1

Year of Publication: 

Affiliated Institutions:  Department of Infectious Diseases, Rainbow Children's Hospital, Bangalore, India. African Leadership in Vaccinology Expertise (Wits-Alive), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland. Epidemiology Department, Ricardo Gutierrez Children Hospital, University of Buenos Aires, Argentina. Faculty of Medicine and Institute for Life Sciences, University of Southampton and NIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK. Kaurna Country, Women's and Children's Health Network and Adelaide Medical School, The University of Adelaide, Adelaide, , SA, Australia. School of Pharmacy, University of Washington, Seattle, WA and School of Public Health, University of Washington, Seattle, WA, USA. Coalition for Epidemic Preparedness and Innovation, London, UK. Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA. Department of Physiological Science, Clinical Pharmacology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique. Centers for Disease Control and Prevention, Atlanta, GA, USA. Centre for Global Health, Charite Universitätsmedizin, Berlin, Germany. Departments of Pediatrics and Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX , USA. Electronic address: florm@bcm.edu.

Abstract summary 

Lassa fever is a serious epidemic viral disease in West Africa affecting an estimated 2 million people annually with about 5000-10,000 deaths, although supporting data is sparse. Lassa fever significantly affects neonates, children, and pregnant women, however, comprehensive data on its impact in these populations are lacking. We reviewed the available literature on Lassa fever to assess its prevalence and impact in these populations and implications for vaccine development. Clinical features in children were similar to those observed in adults, with complications such as bleeding. Altered mental status, anasarca (swollen baby syndrome), bleeding, and poor urine output were risk factors for death. The case fatality rate (CFR) in 16 paediatric studies ranged from 6 % to 63 % and was 66.7 % and 75.0 % in two neonatal studies. In a systematic review of studies on pregnant women the CFR was 33.73 %. The adverse foetal outcomes included miscarriage, stillbirth, and intrauterine death associated with maternal death. Since Lassa fever significantly affects neonates, children, and pregnant women, developing a safe and effective, single-dose vaccine for these high-risk populations is vital. Currently, there are four clinical trials assessing Lassa virus vaccines. Only one of these trials is enrolling children aged ≥18 months, and exclude pregnant and breast-feeding women. It is essential that pregnant and breast-feeding women and young children are included in clinical trials that incorporate robust safety surveillance and risk mitigation measures. In our review, potential approaches to address the specific gaps in the areas of diagnosis, management, and prevention of Lassa fever in these specific populations, such as disease surveillance systems and vaccine development, were identified. A comprehensive strategy with investment focused on addressing specific knowledge gaps will be essential in protecting the health of these specific populations in Lassa virus endemic regions.

Authors & Co-authors:  Chaudhary Manu M Cutland Clare L CL Bonet Mercedes M Gentile Angela A Jones Christine E CE Marshall Helen S HS Stergachis Andy A Voss Gerald G Darko Delese Mimi DM Sevene Esperanca E Hyde Terri T Fairlie Lee L Kampmann Beate B Everett Darcie D Munoz Flor M FM

Study Outcome 

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Statistics
Citations : 
Authors :  15
Identifiers
Doi : 10.1016/j.vaccine.2024.126479
SSN : 1873-2518
Study Population
Women
Mesh Terms
Other Terms
Infants;Lassa fever;Lassa vaccine;Maternal immunization;Pediatrics;Pregnancy
Study Design
Case Study
Study Approach
Systemic Review
Country of Study
Publication Country
Netherlands