Neonatal Survival Despite Maternal Death from Lassa Fever inNigeria: Clinical Suspicion and a Novel Exposure Bundle in Resource-Limited Endemic Settings
Keywords:
Lassa fever, Maternal mortality, Neonate, Nigeria, Ribavarin, Viral haemorrhagic feverAbstract
Background: High maternal and perinatal mortality is still largely driven by Lassa fever (LF) across West Africa,
particularly when infection occurs in late pregnancy or the postpartum period. Neonatal survival after laboratoryconfirmed
maternal death is exceedingly uncommon, yet such cases offer critical insights into the maternal-neonatal
disease spectrum and opportunities to refine management strategies in resource-constrained endemic settings.
Case Presentation: We report a 3-week-old female neonate whose mother died from RT-PCR-confirmed LF following
postpartum deterioration. The neonate presented with fever, irritability, and a unilateral right-sided cervical swelling (8 ×
10 cm, firm, non-fluctuant). Prompt empirical intravenous ribavirin combined with broad supportive care led to complete
recovery, though RT-PCR result for Lassa virus was negative.
Discussion and Conclusion: This outcome tasks the entrenched assumptions of uniformly fatal neonatal disease after
severe maternal LF and death. The distinctive cervical swelling strengthened diagnostic suspicion in an endemic context.
Early clinical suspicion, systematic neonatal evaluation, and timely ribavirin therapy can meaningfully improve survival.
Strengthened maternal-neonatal surveillance, decentralized diagnostics, and standardised exposure protocols are highly
important to reduce preventable mortality in LF-endemic regions.
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