Diagnosis

Laboratory findings include leukopenia and increasing thrombocytopenia, proteinuria, and hematuria, and evidence of coagulation. Diagnostic tests have been developed. Viremia is a constant feature in Lassa cases, and the virus can be isolated and identified in cell culture, using procedures that take a week or more to run. By this time, the patient, if indeed a Lassa patient, may be in dire straits. A rapid diagnostic test is sorely needed. Progress has been made in survey methodology. Serum specimens from suspected patients, taken a few weeks after illness, and those taken in samplings of populations, can be examined for the presence of antibody to Lassa, using a special test plate developed in U.S. Army laboratories. "Spots" of inactivated antigens are made on a test plate, called colloquially a CRELMplate. A drop of serum from an individual is placed on each of the "spots" of, respectively, Congo-Crimean fever, Rift Valley fever, and Ebola, Lassa, and Marburg inactivated viruses, and incubated. A fluorescein-tagged anti-human globulin is then added to each drop. Development of fluorescence in one of the "spots" after incubation indicates presence of human antibody, coupled to the signaled antigen. This method has led to greater knowledge of several deadly diseases in Africa, and is a major step toward understanding the geographic location of these diseases.

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