Lujo virus: origins, reservoirs, transmission and guidelines
Source: gov.uk (2025-07-10)

Lujo virus infection can lead to an acute viral haemorrhagic fever (VHF).

Background

Lujo virus is a member of the arenavirus family which was first identified in 2008 (https://pmc.ncbi.nlm.nih.gov/articles/PMC2866397/) after an individual became infected in Zambia and then sought medical care in South Africa. Lujo virus is likely zoonotic (can be transmitted from animals to humans), although its specific animal reservoir has not yet been identified. Other arenaviruses are typically spread by infected rodents which excrete the virus in their urine and droppings.

Lujo virus is designated as a high consequence infectious disease (HCID) (https://www.gov.uk/guidance/high-consequence-infectious-diseases-hcid) in the UK.

Epidemiology

There has been a single documented outbreak of Lujo virus. Information about the disease is therefore limited. In 2008, an individual in Zambia became infected from an unknown source. They then travelled to South Africa and were admitted to hospital. Unfortunately, 4 healthcare workers caring for the index case were subsequently infected. Four of the five confirmed cases in this outbreak were fatal.

Transmission

Humans most likely become infected by Lujo virus through mucosal exposure, inhalation of aerosolised excretions or secretions, or by direct contact of broken skin with infectious material from infected rodents. Human-to-human transmission may occur via direct contact with the blood, tissues or body fluids from an infected patient. Nosocomial transmission was documented in the single reported outbreak.

Symptoms

To date, data on the clinical features of Lujo infection in humans are extremely limited. The incubation period for Lujo virus is not known but in cases with an identifiable exposure, symptoms have developed 7 to 13 days later. The onset of the clinical disease appears similar to other arenaviruses (for example, Lassa fever). Initial symptoms include:
- fatigue
- fever
- chills and shivering
- joint pain
- muscle aches and pain
As the disease increases in severity symptoms include:
- rash
- face and neck swelling
- sore throat
- diarrhoea
Cardiovascular and neurologic signs and symptoms occurred rapidly in the 4 fatal cases.

Diagnosis

In the UK, clinicians who suspect that a patient may have Lujo virus infection should seek urgent advice from the UK Health Security Agency’s Imported Fever Service (https://www.gov.uk/guidance/imported-fever-service-ifs) (IFS), on xx-xxxx-xxxx. The IFS operates 24/7 and provides advice on risk assessment, immediate management and infection control. The IFS will also coordinate urgent testing for any suspected cases.

See also VHF sample testing advice (https://www.gov.uk/government/publications/viral-haemorrhagic-fever-sample-testing-advice)

Treatment

As Lujo virus disease is a HCID, patients with confirmed infection should be transferred to an appropriate facility under the HCID Network.

There are currently no specific antivirals to treat Lujo virus infection.

Treatment is therefore supportive and includes:
- balancing fluids and electrolytes
- replacing blood components
- maintaining oxygen status and blood pressure
- organ support as needed
Guidelines

The UK has guidelines for managing viral haemorrhagic fevers (https://www.gov.uk/government/publications/viral-haemorrhagic-fever-algorithm-and-guidance-on-management-of-patients/risk-assessment-and-immediate-management-of-viral-haemorrhagic-fevers-contact-high-consequence-infectious-diseases-in-acute-hospitals), including Lujo virus.

The guidelines provide advice on risk assessment, testing and management of suspected cases presenting to healthcare services within the UK.

Prevention and control

There are currently no licensed vaccines for Lujo virus. Avoiding contact with infected humans can help prevent infection. This includes avoiding contact with blood and other bodily fluids of those who are infected, as well as avoiding contact with contaminated items like bedding and medical equipment. In healthcare settings, infection control measures include:
- special barrier nursing procedures
- VHF isolation precautions to isolate infected patients
- wearing protective clothing for contact with the patient
In the UK, confirmed cases will be notified immediately to the HCID Network to arrange urgent transport to a High Level Isolation Unit.

Cases in the UK

There have been no reported cases of Lujo virus in the UK. There has only been one documented outbreak in 2008, with cases reported from Zambia and South Africa (https://pmc.ncbi.nlm.nih.gov/articles/PMC2866397/).