American deaths from Lassa fever, an Ebola-like virus, have been reported in Iowa

An Iowa person who recently returned to the United States from West Africa has died after contracting Lassa fever, a virus that can cause an Ebola-like illness in some patients. State health officials reported the case Monday.

“I want to reassure Iowans that the risk of transmission in our state is incredibly low. We continue to investigate and monitor this situation and implement the necessary public health protocols,” Robert Kruse, medical director of the Iowa Department of Health and Human Services, said in a statement on the department’s website.

The unnamed person was described as a middle-aged individual from eastern Iowa. The statement said the person was being cared for by University of Iowa Health Care. It did not indicate how long he or she had been in care or whether the person had sought care elsewhere before being admitted to the hospital.

This is important because, although person-to-person spread of Lassa virus is rare, transmission in healthcare settings can occur, especially if healthcare workers do not realize they are dealing with a patient who has the disease and do not take adequate medication . precautionary measures.

Although there have been previous cases of Lassa fever imported into the United States, they are not common. The statement said there have been eight imported cases in the past 55 years, including the new one.

There was a case in May 2015 in a New Jersey resident who had traveled to Liberia, and another case in a New Jersey resident in 2004. Both people died. Minnesota reported a case in 2014; that person recovered.

Lassa fever is endemic to a number of countries in West Africa, including Nigeria, Ghana, Guinea, Sierra Leone and Liberia. In these countries, the virus causes several hundred thousand infections and approximately 5,000 deaths every year.

The main source of the virus is a rodent called the multi-nipple rat. People contract the virus by handling or eating infected rodents, or by having the rodents in their home. Food or household items contaminated with urine or feces from infected rodents can transmit the disease.

Although severe Lassa fever causes symptoms like those of an Ebola infection, it does not cause large chains of human cases, as can happen during Ebola outbreaks, said Armand Sprecher, an expert on viral hemorrhagic fever working for Doctors Without Borders works.

“You don’t see a lot of human-to-human transmission,” Sprecher told STAT. “Most people get it from the source, the reservoir.”

The World Health Organization says about eight in 10 people who contract the virus have no or only mild symptoms, including headache, fatigue and low-grade fever.

In those who develop severe illness, symptoms can include bleeding, difficulty breathing, vomiting and shock, according to the Centers for Disease Control and Prevention. The WHO suggests that about 15% of people who develop severe Lassa disease die from the condition.

The death rate may be much higher in some places, says Robert Garry, a professor at Tulane Medical School in New Orleans who has studied Lassa fever for the past several decades. In Sierra Leone, where Garry has research projects, the death rate among severe cases could be as high as 70%, he said. Good supportive care – for example, replacing fluids – can increase the chances of survival, he said.

He agreed that most cases are people infected from an animal source, but said person-to-person transmission can occur, especially in hospitals. “It’s happening in West Africa, even in places where they are very aware of the possibility (of Lassa cases). So yes, if you didn’t expect such a disease to show up in your hospital, it could happen.”

That said, Garry said he doesn’t expect to see transmission here. “There is very little chance that this will spread outside the hospital environment. But they have to do the case contacts (investigations) and all that to make sure.”

Of the diseases that cause viral hemorrhagic fever — things like Ebola and Marburg fever — Lassa is probably the one most imported into non-endemic countries, Garry said.