Lassa Fever: An Old World Arenavirus
ABSTRACT
A brief summary of lassa fever, its history, pathology and effects on the indigenous populations. Also, lassa fever in the context of newly emerging diseases. LASSA FEVER
On January 12, 1969, a missionary nun, working in the small town of
Lassa, Nigeria, began complaining of a backache. Thinking she had merely pulled a muscle, she ignored the pain and went on about her business. After a week, however, the nurse had a throat so sore and so filled with ulcers, she couldn't swallow. Thinking she was suffering from one of the many bacterial diseases endemic to the area, her sisters administered every antibiotic they had on store in the town's Church of the
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These viruses, long hidden in the deepest recesses of rain forests, are making their presence felt as much of the rain forest and other isolated areas become more and more accessible. Lassa fever is mostly on the rise as its main vector, the rodent Mastomys natalensis, is increasing in numbers due (indirectly) to an increase in poverty and scarcity of food.(Garrett, 1994) To be specific, when the endemic region has a scarcity of food, the villagers kill and eat the larger rat, Rattus ra ttus, which is a main competitor of the Mastomys natalensis, thereby allowing the smaller Mastomys to flourish. The disease mainly effects the areas of western Africa, from Senegal to, of course, Zaire, although it has been exported to the United States (about 115 cases). (Southern, 1996)
Lassa fever consists of two single strands of RNA enclosed within a spherical protein coat. The RNA exists as two strands designated L (for long) and S (for short). The S segment is the more abundant of the two as it codes for the major structural components such as the internal proteins and the glycoproteins, while the L segment codes for RNA polymerase and perhaps a few structural proteins. The protein coat has a number of T-shaped glycoproteins protruding from it, composed of GP (glycoprotein)2 which is the base and GP1 which is the T-bar. (Southern, 1996) This structure is what inserts itself into the receptors on the host cell. When the virus first gains entry into
The nurse was asked what was hurting and "she replied that she was having head pain and a server headache", the next question which was asked what time the incident happened, and "she replied to it that it had happened around 16:30 hours and has been sitting here to see if the pain would go away", the next question which was asked if she wanted to go to the hospital, "she replied that she wants to go", The EMS crew then told the nurse to get up and move over to the stretcher located along the side of her and,"she replied that she did not want to go by a stretcher and, but she would prefer to walk out to the
- Re-emerging diseases: Once controlled by preventative public health measures they are now on the rise
There was additional backup staff present (including a respiratory therapist) that could have been called upon for help, yet they never were. The charge nurse or nurse supervisor could have stepped in at this point to provide additional help. A lack of present nursing staff and support can lead to unfavorable patient outcomes, as is the case with Mr. B. Additionally, the staff on duty could have lacked training regarding protocols or their training could have been out of date.
It was almost midnight when I got the call from Dr. Seagraves. She told me to meet her in the physicians lounge at 7 am: we had a case. The next morning began like any other in the operating room. We met with the patient, I received permission to observe and then got suited up for case. The patient was an elderly African American woman, she called me handsome and smiled comfortably. When we made it into the OR I was asked to help lift the patient from bed to table, with a subtle warning of “watch out, it’s gooey.” Dr. Seagraves parted the patient’s gown, exposing a mass of raw tissue that somewhat resembled a leg. The patient had suffered a week’s worth of necrotizing fasciitis, more commonly known as flesh eating bacteria. The wound had a certain odor, a putrid smell you do not forget. Our hearts sank in unison as we realized what we were up against. We had to act fast. Dr. Seagraves began scrubbing the wounded tissue as the Anaestesiologist monitored the patient’s progress. I had observed Dr. Seagraves on multiple occasions and never did she express concern for the outcome. For the first time in our relationship I heard her mutter, “This is not good. This is not good at all.”
The nurse was clearly seeing that the Sarah was not capable of getting the help she
Empathy is absolutely necessary in this cruel world. What would we do without it? Scout learns to be empathetic throughout the book. She starts to show empathy towards characters such as Boo Radley, Tom Robinson and Mayella Ewell. Boo Radley scared Scout at the beginning of the book, but she learned there’s nothing to fear.
The most important element of a short story is Characterization as it drives the story as a whole. Characters involved in a story are responsible for creating different types of conflicts, struggles and tensions which in turn affects resolutions. Characterization is the core element that emphasizes the rest of the four elements as everything else eventually streams from character: plot, setting, theme and the point of view. There are no Conflicts without characters. A story only has meaning as the interaction among develops.
The district nursing team were now to be responsible for the wound care of an ulcer on the sole of her right foot on her impending discharge. She had previously attended the practice nurse and a podiatry service based within her local clinic. Due to a change in circumstances, she was now clearly housebound for the near future due to mobility issues. Prior to an arranged visit, the patient had called the nurse to advise her that she was pyrexial and was experiencing a pain in her right foot that was different from her normal neuropathic pain, which was often problematic. She was also finding it difficult to mobilise and was disinclined for diet but was taking oral fluids.
often left the nurses with feelings of inadequacy in meeting all of their patients' needs. In a
On one of the placement on the ward, the student nurse was assigned to assist a patient. Alfred is a 65 years old man and was admitted with diarrhoea and generally unwell to the hospital. In the process of his admission he was isolated in a side room to prevent and reduce any risk of spreading infection. Alfred was a barrier nursed because he had clostridium difficile. He was isolated to lessen the hazard of spread of infections to other patients, visitors, and
than there was before, we still find it difficult to prevent the disease and yet have a large
generations to come. Because this epidemic is a recent trend, it is hard to be sure on what may
Suddenly she felt a stinging, then numbing sensation run up her legs and was strapped into a wheelchair. She was rolled into a very dark and presumably vacant room.
In Sweden, where I live, the disease is not even seen as deadly anymore. Only approximately 6,500 Swedes are today infected
She held tightly, like she was holding on for dear life, and then she let go, she smiled and she moved on.