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Lassa fever

Lassa mammarenavirus · Arenaviridae

Strains

  • Lineage I (Nigeria)
  • Lineage II (Nigeria)
  • Lineage III (Nigeria)
  • Lineage IV (Sierra Leone, Guinea, Liberia)
  • Lineage V (Mali, Ivory Coast)
  • Lineage VI (Togo)
  • Lineage VII (Benin)

Transmission

  • Contact with urine, faeces, or saliva of infected multimammate rats (Mastomys natalensis)
  • Handling or consuming infected multimammate rats
  • Direct contact with blood or body fluids of an infected person
  • Healthcare-associated exposure without adequate PPE
  • Sexual transmission during convalescence — virus persists in semen up to ~3 months
Incubation
6-21 days
Mortality rate
~1% overall (most cases mild/asymptomatic); 15-25% in hospitalised patients; foetal mortality approaches 80% in third-trimester pregnancy
Vaccine
No

Treatment

Ribavirin is effective when started early — ideally within 6 days of fever onset — together with supportive care (IV fluids, electrolyte correction, treatment of secondary infections). Sensorineural hearing loss affects 25-30% of patients and may be permanent.

Vaccine status

No WHO-approved Lassa fever vaccine as of 2026. Multiple candidates (e.g. INO-4500, MV-LASV, rVSV- and measles-vectored vaccines) are in clinical development, several under CEPI funding.

Endemic regions

  • Nigeria — highest reported burden, thousands of cases annually (NCDC), peak transmission January-April
  • Sierra Leone — highly endemic
  • Liberia — highly endemic
  • Guinea — highly endemic
  • Mali, Ivory Coast, Benin, Togo — sporadic cases
  • Europe and North America — occasional imported cases among returning travellers

Frequently asked questions

Sources

Last update Jun 9, 2026 · ⚠ Not medical advice.