Mystery of Zambian hemorrhagic fever solved -- it's Lujo (and yes, it's new)
Scott McPherson
in influenza and infectious diseases
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A few months ago, I blogged on the appearance of a mysterious new fever that behaved much like Ebola.In that blog, titled (and linked here) called Do we have another species jump in Africa?, I speculated (as did the rest of the world) that we had ourselves another new, species-jumping virus.
DINGDINGDING! Yes, it's new. It's name is the Lujo virus. Yes, as suspected, it is an arenavirus, which is normally carried and spread by rodents.
Now here's the problem: It is an aggressive little sucker, and has an incubation period equivalent to influenza. From my blog of October, 2008:
The index case -- Patient Zero of this new and so-far unknown variant -- is a Zambian who was hospitalized in Johannesburg, South Africa. Two persons who were in the hospital for treatment unassociated with the index patient's disease(nosocomial) also develped symptoms and died. A fourth patient -- a nurse treating the second, NOT the index patient -- is in isolation and is being treated with ribavirin, which helps against lassa fever but is experimental when dealing with this new virus.
Here's a chilling paragraph from the proMED report:
"Arenaviruses cause chronic infection in wild rodents (multimammate mice) with excretion of virus in urine, which can contaminate human food or house dust. Arenaviruses have been found in southern African rodents in the past, but there has been no previous association with human disease. The virus associated with the present outbreak may prove to be a new member of the group." (bold mine)
So we have a new and previously undiagnosed form of arenavirus which has apparently jumped the species barrier from animals (rodents) to humans. Isn't that just lovely? And the virus is highly contagious to boot, as evidenced by the rapid spread to other patients in the hospital -- and the infection of the nurse who was attending one of the follow-on cases.
Now here's the press account, from the AP and found at MSNBC.com:
New killer virus found in Africa
Scientists discover disease that causes Ebola-like bleeding The Associated Press updated 8:17 p.m. ET, Thurs., May 28, 2009
ATLANTA - Scientists have identified a lethal new virus in Africa that causes bleeding like the dreaded Ebola virus.
The so-called "Lujo" virus infected five people in Zambia and South Africa last fall. Four of them died, but a fifth survived, perhaps helped by a medicine recommended by the scientists.
It's not clear how the first person became infected, but the bug comes from a family of viruses found in rodents, said Dr. Ian Lipkin, a Columbia University epidemiologist involved in the discovery.
"This one is really, really aggressive," he said of the virus.
A paper on the virus by Lipkin and his collaborators was published online Thursday on in PLoS Pathogens.
The outbreak started in September, when a female travel agent who lives on the outskirts of Lusaka, Zambia, became ill with a fever-like illness that quickly grew much worse.
She was airlifted to Johannesburg, South Africa, where she died.
A paramedic in Lusaka who treated her also became sick, was transported to Johannesburg and died. The three others infected were health care workers in Johannesburg.
Investigators believe the virus spread from person to person through contact with infected body fluids.
"It's not a kind of virus like the flu that can spread widely," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, which helped fund the research.
The name given to the virus — "Lujo" — stems from Lusaka and Johannesburg, the cities where it was first identified.
Investigators in Africa thought the illness might be Ebola, because some of the patients had bleeding in the gums and around needle injection sites, said Stuart Nichol, chief of the molecular biology lab in the CDC's Special Pathogens Branch. Other symptoms include include fever, shock, coma and organ failure.
Samples of blood and liver from the victims were sent to the United States, where they were tested at Columbia University in New York and at CDC in Atlanta. Tests determined it belonged to the arenavirus family, and that it is distantly related to Lassa fever, another disease found in Africa.
The drug ribavirin, which is given to Lassa victims, was given to the fifth Lujo virus patient — a Johannesburg nurse. It's not clear if the medicine made a difference or if she just had a milder case of the disease, but she fully recovered, Nichol said.
The research is a startling example of how quickly scientists can now identify new viruses, Fauci said. Using genetic sequencing techniques, the virus was identified in a matter of a few days — a process that used to take weeks or longer.
Along with Fauci's institute, the National Heart, Lung, and Blood Institute and Google also helped fund the research.
© 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
URL: http://www.msnbc.msn.com/id/30989694/
The link to the study, published in the journal Public Library of Science Pathogens, is at:
http://www.plospathogens.org/article/info:doi/10.1371/journal.ppat.1000455
But wait, there's more! In my December post, I make reference to a woman who died on a Virgin flight from Johannesburg, South Africa, to London in May of 2006. The initial speculation was that she died of Ebola, but we never had a follow-up news story. I strongly urge health authorities to retest her samples to determine if she died of Lujo. that would give us a glimpse of how old this "new" virus really might be.
Now this virus does not travel as influenza does -- it is not "airborne," as they say. It can currently only be transmitted via contact with bodily fluids. The good news within the bad news is that the virus does seem to be sensitive to the antiviral ribavirin, which is used to treat Lujo's distant viral cousin, Lassa Fever. And it is still a rare virus.
So my question of last October -- Do we have another species jump in Africa? -- is answered. The answer is Yes. And it could be a doozy.
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