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Pediatric Lassa Fever: A Review of 33 Liberian Cases

Mark H. Monson^*,,, Andrew K. Cole, John D. Frame, Janet R. Serwint^*, Suzama Alexander^* AND Peter B. Jahrling^¶

^* Curran Lutheran Hospital, Box 1046, Monrovia, Liberia,
Michigan State University, East Lansing, Michigan 48824,
Lassa Fever Control Project, Liberian Institute of Biomedical Research, Box 31, Robertsfield, Liberia,
Columbia University School of Public Health, 630 West 168th Street, New York, New York 10032,
and^¶ United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland 21701

Thirty-three cases of pediatric Lassa fever were identified at Curran Lutheran Hospital and Phebe Hospital in Liberia between January 1980 and March 1984. All 18 fetal cases died and the case-fatality rate for 15 childhood cases was 27%. We identified four clinical presentations according to age, including a case of congenital Lassa fever, a condition not reported previously.

Two cases of Lassa fever were found serologically during a one-month survey of all pediatric admissions at Curran Lutheran Hospital, 2.4% of those children who had serum pairs collected. We also identified a "swollen baby syndrome" consisting of widespread edema, abdominal distention, and bleeding. This distinctive clinical presentation of Lassa fever ended in death in three of four cases and was present in three of the four childhood deaths in this series. Its absence seems to be a good prognostic indicator in children.

Accepted for publication September 16, 1986.