LASSA virus is an arenavirus of rodents widespread in rural areas of western Africa. Human infections are primarily due to to contact with the natural host, the multimammate rat Mastomys natalensis. In the early I970s nosocomial outbreaks involving expatriate medical staff in Nigeria, Liberia, and Sierra Leone led to concern over the possibility of man-to man transmission of the virus. Subsequently some western authorities introduced stringent requirements for containment of the patient to protect hospital and laborarory staff.
In eastern Sierra Leone in February, I985, a British midwife working in hospital A was admitted to a Lassa fever referral centre in hospital B. She became critically ill and required difficultics encountered in repatriating her for diagnosis and management unavailable in Sierra Leone are described, and experience with this case has implications for the medical care and safe handling of Lassa fever in both endemic and non- endemic areas.