Lassa fever — the road ahead

• Published in: Nature reviews. Microbiology Vol. 21; no. 2; pp. 87 - 96
• Main Author: Garry, Robert F.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-02-2023; Nature Publishing Group
• Subjects: 631/326/596/1961; 692/699/255/2514; Africa, Western - epidemiology; Biomedical and Life Sciences; Epidemiology; Fever; Hemorrhage; Hemorrhagic fever; Humans; Immunology; Infectious Diseases; Lassa fever; Lassa Fever - epidemiology; Lassa Fever - prevention & control; Lassa virus; Life Sciences; Medical Microbiology; Microbiology; Parasitology; Pathogenesis; Population density; Review; Review Article; Rodents; Viral Vaccines; Virology; Viruses; Africa, Western; West Africa
• ISSN: 1740-1526; 1740-1534
• DOI: 10.1038/s41579-022-00789-8

Lassa virus (LASV) is endemic in the rodent populations of Sierra Leone, Nigeria and other countries in West Africa. Spillover to humans occurs frequently and results in Lassa fever, a viral haemorrhagic fever (VHF) associated with a high case fatality rate. Despite advances, fundamental gaps in knowledge of the immunology, epidemiology, ecology and pathogenesis of Lassa fever persist. More frequent outbreaks, the potential for further geographic expansion of
Mastomys natalensis
and other rodent reservoirs, the ease of procurement and possible use and weaponization of LASV, the frequent importation of LASV to North America and Europe, and the emergence of novel LASV strains in densely populated West Africa have driven new initiatives to develop countermeasures for LASV. Although promising candidates are being evaluated, as yet there are no approved vaccines or therapeutics for human use. This Review discusses the virology of LASV, the clinical course of Lassa fever and the progress towards developing medical countermeasures.
Lassa fever is a viral haemorrhagic fever that spills over from its rodent reservoir. Continued viral evolution and increasing exposure make Lassa virus a high-risk pathogen. In this Review, Garry highlights new insights into the virology, disease presentation and potential countermeasures.