**8.1 The individual**

The affected person should be admitted to a special center for the treatment of Lassa fever. Where this is not possible, the patient should be barrier-nursed. Health care providers and close associates of the patient should wear protective clothing, masks and gloves. Excrements from affected persons should be properly disposed.

#### **8.2 The community**

Table 1. Case fatality rates of common Diseases among Medical inpatients in ISTH, Irrua, Nigeria.

Legislation is needed to prevent widowhood rites, traditional autopsies, bush burning and unhygienic preparation of garri and other staple foods. Animal husbandry and fisheries should be encouraged in order to provide alternative sources of first-class proteins for rat eaters. Regular and sustainable environmental sanitation is needed to prevent rat breeding. The public should be made aware of the mode of contact of Lassa fever and its high casefatality rate using print and electronic media. Community involvement and participation is necessary to provide sustainable Lassa fever control. Food vendors should be educated on the need to prevent food contamination with Lassa fever virus. Grains, flours and left-over foods should be adequately covered to prevent contamination by rats. Rodenticides should be used for the destruction of rats in homes, and development of Lassa fever vaccine should be facilitated. Regular seminars should be held for health-care providers on early diagnosis and treatment of Lassa fever, while diagnostic kits should be made available in district hospitals. Affected people should be referred early to the special center in order to prevent or limit disability, while those with disabilities should be rehabilitated functionally, socially and psychologically so that they can be gainfully employed.

### **9. Prospects**

Though vaccines are not currently available for Lassa fever, there is evidence that they will be produced in the near future. Research done with non-human primates have revealed that survivors exhibit fewer lesions and a **lower** viral load than non-survivors.

**9** 

*Italy* 

**The Re-Emergence of an Old Disease:** 

*Laboratory of Virology, National Institute for Infectious Diseases "L. Spallanzani", Rome* 

Until recently, very few physicians in industrialized countries had heard the word "Chikungunya", and fewer knew how to spell it. Chikungunya, a viral infection transmitted by mosquitoes, derives its name from Makonde, a language spoken in south Tanzania, and means "that which bends up", referring to the posture of patients afflicted with severe joint paints characterizing this infection. Chikungunya virus (CHIKV) was first isolated in Tanzania in 1952 (Robinson, 1955) and has come to the world attention recently, when it caused a massive outbreak in the Indian Ocean region and India (Enserik, 2006). Since 1952, CHIKV has caused a number of epidemics, both in Africa and Southeast Asia, many of them having involved hundreds-of-thousands people. In 2005 the largest Chikungunya fever epidemic on record occurred. The most affected region was La Reunion Island, where CHIKV infected more than a third of the population and killed hundred of people. The 2005/2006 outbreak, started from Comoro Islands, rapidly spread to several countries in the Indian Ocean and India (Enserik, 2006; Mavalankar et al., 2007). Compared to earlier outbreaks, this episode was massive, occurred in highly medicalized areas such as La Reunion, and had very significant economic and social impact. More than 1000 imported CHIKV cases have been detected among European and American travellers returning from the affected areas since the beginning of the outbreak in the Indian Ocean region (Fusco et al., 2006; Taubiz et al., 2007), giving rise, in 2007, to the first autochthonous European outbreak in Italy (Charrel & de Lambellerie, 2008; Rezza et al., 2007). Since 2006, the Regional Office of the French Institute For Public Health Surveillance in the Indian Ocean has conducted epidemiological and biological surveillance for CHIKV infection. During the period December 2006-july 2009, no confirmed case was detected on Reunion Island and Mayotte, but new outbreak were reported in Madacascar. After few years of relative dormancy in Réunion Island, CHIKV transmission has restarted in 2009 and 2010, with one case imported in France (May 2010) (D'Ortenzio et al., 2010). This episode has refreshed the concerns about the

possibility of renewed autochthonous transmission in Mediterranean countries.

Meschi Silvia1, Selleri Marina1, Lalle Eleonora1, Castilletti Concetta1, Carletti Fabrizio2,

<sup>1</sup>*Laboratory of Virology, National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy* 

*2Laboratory of Microbiology and Infectious Disease Biorepository, National Institute for Infectious Diseases "L.* 

Di Caro Antonino2 and Capobianchi Maria Rosaria1

**1. Introduction** 

 \*

*Spallanzani", Rome, Italy*

**Chikungunya Fever** 

Bordi Licia et al.\*

Although all animals develop strong humoral responses, antibodies appear more rapidly in survivors and are directed against GP(1), GP(2), and NP. Activated T lymphocytes circulate in survivors, whereas T-cell activation is **low** and delayed in fatalities

A single injection of ML29 reassortant vaccine for **Lassa fever** induces **low**, transient viremia, and **low** or moderate levels of ML29 replication in tissues of common marmosets depending on the dose of the vaccination. The vaccination elicits specific immune responses and completely protects marmosets against fatal disease by induction of sterilizing cellmediated immunity. DNA array analysis of human peripheral blood mononuclear cells from healthy donors exposed to ML29 revealed that gene expression patterns in ML29 exposed PBMC and **control**, media-exposed PBMC, clustered together confirming safety profile of the ML29 in non-human primates. The ML29 reassortant is a promising vaccine candidate for **Lassa fever**.

#### **10. References**

