Lujo virus
Lujo virus is a bisegmented RNA virus—a member of the family Arenaviridae—and a known cause of viral hemorrhagic fever in humans. Its name was suggested by the Special Pathogens Unit of the National Institute for Communicable Diseases of the National Health Laboratory Service by using the first two letters of the names of the cities involved in the 2008 outbreak of the disease, Lusaka and Johannesburg. It is the second pathogenic Arenavirus to be described from the African continent—the first being Lassa virus—and since 2012 has been classed as a "Select Agent" under U.S. law.
History
Only five cases of this virus have ever been reported; all five were identified in September and October 2008, and four were fatal. Those infections that proved fatal caused death within 10–13 days of showing symptoms. All four patients in whom infection proved fatal first showed signs of improvement and then went into respiratory distress, displayed neurological problems, and had circulatory issues that resulted in collapse. The discovery of this novel virus was described following a highly fatal nosocomial outbreak of VHF in Johannesburg. The identification of this virus was the first new arenavirus discovered in over 40 years.The first case was a female travel agent who lived on the outskirts of Lusaka. She developed a fever, which progressed over time. She was evacuated to Johannesburg for medical treatment. Almost two weeks later, the paramedic who nursed the patient on the flight to South Africa also fell ill and was brought to Johannesburg for medical treatment. At this time, the connection between these two patients was recognized by the attending physician in the Johannesburg hospital. Together with the NICD-NHLS the clinical syndrome of VHF was recognized and specimens from the second patient were submitted for laboratory confirmation. In addition, a cleaner and a nurse that had contact with the first patient also fell ill. A second nurse was infected through contact with the paramedic. The outbreak had a high case fatality rate with 4 of 5 identified cases resulting in death.
The Special Pathogens Unit of the NICD-NHLS, together with colleagues from the Special Pathogens Unit of the U.S. Centers for Disease Control and Prevention, identified the etiological agent of the outbreak as an Old World arenavirus using molecular and serological tests. Sequencing and phylogenetic investigation of partial genome sequencing indicated that this virus was not Lassavirus and likely a previously unreported arenavirus. This was corroborated by full genome sequencing that was conducted by the NICD-NHLS, CDC and collaborators from Columbia University in New York.