1D61.2 Lassa fever

International Classification of Diseases for Mortality and Morbidity Statistics, 11th Revision, v2025-01


A disease endemic in some areas of sub-Saharan Western Africa caused by infection with Lassa virus. Infection is mild or asymptomatic in most cases but can cause severe illness or death. When it is symptomatic, the onset of the disease is usually gradual, starting with fever, general weakness headache and malaise. After a few days, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough and abdominal pain may follow. As the disease progresses, in severe cases facial swelling, fluid in the lung cavity, bleeding from the mouth, nose, vagina or gastrointestinal tract and low blood pressure may develop. Shock, seizures, tremor, disorientation, and coma may be seen in the later stages. Among hospitalized patients, approximately 15% die of Lassa fever disease. In fatal cases, death usually occurs within 14 days of symptom onset. During pregnancy, Lassa fever can cause high maternal and foetal mortality, especially late in pregnancy. In the third trimester, fetal death and maternal death rates can exceed 80% and 30% respectively. Prolonged convalescence in some patients has been documented leading sometimes to sequelae. Sudden hearing loss has been reported with varying incidence and up to 25% of recovered patients, both during acute disease and after recovery. In most circumstances hearing loss is reported to be permanent. Other sequelae including neurological signs, visual impairment, joint pain, transient hair loss and psychological disorders have been reported to a lesser extent. The incubation period of Lassa fever ranges from 2–21 days. Transmission occurs either through exposure to food or household items that are contaminated with urine or faeces of infected Mastomys rat, or directly via contact with infected rats. Although to a much less extent, Lassa virus may also spread between humans through direct contact with blood, urine, faeces or other bodily secretions of a person infected with Lassa fever. Person-to-person transmission may occur primarily in health-care settings, where the virus may also be spread by contaminated medical equipment, such as re-used needles. Diagnosis occurs by identification of Lassa virus in blood samples by molecular or serologic methods.

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