Clinical insights from the management of China’s first Lassa fever case on precise diagnosis and treatment of infectious diseases_West China Medical Journal

Authors：

CUI Kunping ¹ , CAI Lin ² ,  ZONG Zhiyong ¹

1. Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

ZONG Zhiyong, Email: zongzhiy@scu.edu.cn

Keywords：

Lassa fever; precise diagnosis; next-generation sequencing; infectious disease intensive care unit

DOI：

10.7507/1002-0179.202601047

Video：

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Based on the management of the first imported case of Lassa fever in China, this article summarizes key experiences in precise etiological diagnosis, multidisciplinary collaboration, and development of infectious disease critical care system. It focuses on the application value of next-generation sequencing in the identification of emerging pathogens, highlights the importance of critical thinking and a global epidemiological perspective among infectious disease physicians, and explores feasible approaches to establishing an infectious disease intensive care unit to create an integrated “precision diagnosis-critical care” model. The aim is to provide practical insights for improving the early recognition of imported infectious diseases and strengthening critical care system capacity in China.

Citation： CUI Kunping, CAI Lin, ZONG Zhiyong. Clinical insights from the management of China’s first Lassa fever case on precise diagnosis and treatment of infectious diseases. West China Medical Journal, 2026, 41(3): 368-374. doi: 10.7507/1002-0179.202601047 Copy

1.	Huang XA, Xiang R, Liao RH, et al. Babesia microti (Babesiidae, Piroplasmida) infection in a Chinese traveler returning from the United States of America. Infect Dis Poverty, 2025, 14(1): 45.
2.	王玉文, 牟峰, 宋薇, 等. 全球新發傳染病. 中國感染控制雜志, 2006, 5(2): 188-190, 171.
3.	Ogbu O, Ajuluchukwu E, Uneke CJ. Lassa fever in West African sub-region: an overview. J Vector Borne Dis, 2007, 44(1): 1-11.
4.	Idemyor V. Lassa virus infection in Nigeria: clinical perspective overview. J Natl Med Assoc, 2010, 102(12): 1243-1246.
5.	Wang Y, Wen X, Li D, et al. The first imported case of Lassa fever - China, 2024. China CDC Wkly, 2025, 7(12): 400-404.
6.	Li C, Luo F. The first imported case of Lassa fever in China: a case description. Quant Imaging Med Surg, 2025, 15(1): 1066-1072.
7.	Peng Y, Wang Y, Li S, et al. Infection prevention and control measures for emerging infectious disease: lessons learned from the first case of imported Lassa fever in China. Antimicrob Resist Infect Control, 2025, 14(1): 74.
8.	Gu W, Miller S, Chiu CY. Clinical metagenomic next-generation sequencing for pathogen detection. Annu Rev Pathol, 2019, 14: 319-338.
9.	Zhao Y, Zhang W, Zhang X. Application of metagenomic next-generation sequencing in the diagnosis of infectious diseases. Front Cell Infect Microbiol, 2024, 14: 1458316.
10.	Houlihan C, Behrens R. Lassa fever. BMJ, 2017, 358: j2986.
11.	Garry RF. Lassa fever - the road ahead. Nat Rev Microbiol, 2023, 21(2): 87-96.
12.	Senewiratne B, Senewiratne K. Reassessment of the Widal test in the diagnosis of typhoid. Gastroenterology, 1977, 73(2): 233-236.
13.	王樹坤, 儲從佳, 向正華, 等. 肥達凝集試驗在(副)傷寒診斷中的應用評價. 預防醫學情報雜志, 2002, 18(4): 303-304.
14.	Maskalyk J. Typhoid fever. CMAJ, 2003, 169(2): 132.
15.	Reyna RA, Littlefield KE, Shehu N, et al. The importance of Lassa fever and its disease management in West Africa. Viruses, 2024, 16(2): 266.
16.	Madalgi RK, Arakera SB, Kulkarni RD. Aptamer and aptasensor technology for diagnosis of infectious diseases: a mini review. Indian J Med Microbiol, 2024, 51: 100694.
17.	Carrillo-Bustamante P, Nguyen THT, Oestereich L, et al. Determining ribavirin’s mechanism of action against Lassa virus infection. Sci Rep, 2017, 7(1): 11693.
18.	McCormick JB, King IJ, Webb PA, et al. Lassa fever. Effective therapy with ribavirin. N Engl J Med, 1986, 314(1): 20-26.
19.	Duvignaud A, Etafo IC, Jaspard M, et al. Presentation and outcomes of Lassa fever in children in Nigeria: a prospective cohort study (LASCOPE). J Pediatric Infect Dis Soc, 2024, 13(10): 513-522.
20.	Shehu NY, Gomerep SS, Isa SE, et al. Lassa fever 2016 outbreak in Plateau State, Nigeria-the changing epidemiology and clinical presentation. Front Public Health, 2018, 6: 232.
21.	Bausch DG, Hadi CM, Khan SH, et al. Review of the literature and proposed guidelines for the use of oral ribavirin as postexposure prophylaxis for Lassa fever. Clin Infect Dis, 2010, 51(12): 1435-1441.
22.	Oestereich L, Rieger T, Lüdtke A, et al. Efficacy of favipiravir alone and in combination with ribavirin in a lethal, immunocompetent mouse model of Lassa fever. J Infect Dis, 2016, 213(6): 934-938.
23.	Moore KA, Ostrowsky JT, Mehr AJ, et al. Lassa fever research priorities: towards effective medical countermeasures by the end of the decade. Lancet Infect Dis, 2024, 24(11): e696-e706.
24.	Yalan Q, Jin T. Impact of establishing a respiratory high dependency unit for SCAP patients on the therapeutic effect, prognosis, and expenditure: a retrospective case-control study. Sci Rep, 2022, 12(1): 10703.
25.	Aiken LH, Sloane D, Griffiths P, et al. Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care. BMJ Qual Saf, 2017, 26(7): 559-568.
26.	Tipping CJ, Harrold M, Holland A, et al. The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review. Intensive Care Med, 2017, 43(2): 171-183.
27.	Idrees S, Mathews M, Hedden L, et al. The implementation of infection prevention and control procedures in primary care during the COVID-19 pandemic: a qualitative study of nursing roles. J Nurs Manag, 2025, 2025: 6634676.
28.	Walker DH, Wulff H, Lange JV, et al. Comparative pathology of Lassa virus infection in monkeys, guinea-pigs, and Mastomys natalensis. Bull World Health Organ, 1975, 52(4/5/6): 523-534.

1. Huang XA, Xiang R, Liao RH, et al. Babesia microti (Babesiidae, Piroplasmida) infection in a Chinese traveler returning from the United States of America. Infect Dis Poverty, 2025, 14(1): 45.
2. 王玉文, 牟峰, 宋薇, 等. 全球新發傳染病. 中國感染控制雜志, 2006, 5(2): 188-190, 171.
3. Ogbu O, Ajuluchukwu E, Uneke CJ. Lassa fever in West African sub-region: an overview. J Vector Borne Dis, 2007, 44(1): 1-11.
4. Idemyor V. Lassa virus infection in Nigeria: clinical perspective overview. J Natl Med Assoc, 2010, 102(12): 1243-1246.
5. Wang Y, Wen X, Li D, et al. The first imported case of Lassa fever - China, 2024. China CDC Wkly, 2025, 7(12): 400-404.
6. Li C, Luo F. The first imported case of Lassa fever in China: a case description. Quant Imaging Med Surg, 2025, 15(1): 1066-1072.
7. Peng Y, Wang Y, Li S, et al. Infection prevention and control measures for emerging infectious disease: lessons learned from the first case of imported Lassa fever in China. Antimicrob Resist Infect Control, 2025, 14(1): 74.
8. Gu W, Miller S, Chiu CY. Clinical metagenomic next-generation sequencing for pathogen detection. Annu Rev Pathol, 2019, 14: 319-338.
9. Zhao Y, Zhang W, Zhang X. Application of metagenomic next-generation sequencing in the diagnosis of infectious diseases. Front Cell Infect Microbiol, 2024, 14: 1458316.
10. Houlihan C, Behrens R. Lassa fever. BMJ, 2017, 358: j2986.
11. Garry RF. Lassa fever - the road ahead. Nat Rev Microbiol, 2023, 21(2): 87-96.
12. Senewiratne B, Senewiratne K. Reassessment of the Widal test in the diagnosis of typhoid. Gastroenterology, 1977, 73(2): 233-236.
13. 王樹坤, 儲從佳, 向正華, 等. 肥達凝集試驗在(副)傷寒診斷中的應用評價. 預防醫學情報雜志, 2002, 18(4): 303-304.
14. Maskalyk J. Typhoid fever. CMAJ, 2003, 169(2): 132.
15. Reyna RA, Littlefield KE, Shehu N, et al. The importance of Lassa fever and its disease management in West Africa. Viruses, 2024, 16(2): 266.
16. Madalgi RK, Arakera SB, Kulkarni RD. Aptamer and aptasensor technology for diagnosis of infectious diseases: a mini review. Indian J Med Microbiol, 2024, 51: 100694.
17. Carrillo-Bustamante P, Nguyen THT, Oestereich L, et al. Determining ribavirin’s mechanism of action against Lassa virus infection. Sci Rep, 2017, 7(1): 11693.
18. McCormick JB, King IJ, Webb PA, et al. Lassa fever. Effective therapy with ribavirin. N Engl J Med, 1986, 314(1): 20-26.
19. Duvignaud A, Etafo IC, Jaspard M, et al. Presentation and outcomes of Lassa fever in children in Nigeria: a prospective cohort study (LASCOPE). J Pediatric Infect Dis Soc, 2024, 13(10): 513-522.
20. Shehu NY, Gomerep SS, Isa SE, et al. Lassa fever 2016 outbreak in Plateau State, Nigeria-the changing epidemiology and clinical presentation. Front Public Health, 2018, 6: 232.
21. Bausch DG, Hadi CM, Khan SH, et al. Review of the literature and proposed guidelines for the use of oral ribavirin as postexposure prophylaxis for Lassa fever. Clin Infect Dis, 2010, 51(12): 1435-1441.
22. Oestereich L, Rieger T, Lüdtke A, et al. Efficacy of favipiravir alone and in combination with ribavirin in a lethal, immunocompetent mouse model of Lassa fever. J Infect Dis, 2016, 213(6): 934-938.
23. Moore KA, Ostrowsky JT, Mehr AJ, et al. Lassa fever research priorities: towards effective medical countermeasures by the end of the decade. Lancet Infect Dis, 2024, 24(11): e696-e706.
24. Yalan Q, Jin T. Impact of establishing a respiratory high dependency unit for SCAP patients on the therapeutic effect, prognosis, and expenditure: a retrospective case-control study. Sci Rep, 2022, 12(1): 10703.
25. Aiken LH, Sloane D, Griffiths P, et al. Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care. BMJ Qual Saf, 2017, 26(7): 559-568.
26. Tipping CJ, Harrold M, Holland A, et al. The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review. Intensive Care Med, 2017, 43(2): 171-183.
27. Idrees S, Mathews M, Hedden L, et al. The implementation of infection prevention and control procedures in primary care during the COVID-19 pandemic: a qualitative study of nursing roles. J Nurs Manag, 2025, 2025: 6634676.
28. Walker DH, Wulff H, Lange JV, et al. Comparative pathology of Lassa virus infection in monkeys, guinea-pigs, and Mastomys natalensis. Bull World Health Organ, 1975, 52(4/5/6): 523-534.

West China Medical Journal

Clinical insights from the management of China’s first Lassa fever case on precise diagnosis and treatment of infectious diseases

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