Figure 3

A comprehensive metabolic panel was obtained daily by Piccolo analysis. Fourteen metabolic indicators were measured in the serum of G-1180 daily after admission, through day 14 (with the exception of day 12), using a Piccolo comprehensive metabolic panel disk array (see additional file 1 figure S1 for Na⁺, Cl^-, Ca²⁺, K⁺, TCO ₂ , Alb and TP levels).A Two samples from G-1180 contacts -A and -B were also analyzed, along with Sierra Leonean and U.S. normal controls. Values were plotted alongside normal ranges for each metabolite, for reference (rose boxes). G-1180 presented with elevated TBil, and extremely high BUN:Cre ratios. Surprisingly, levels of Cre remained within normals levels throughout, in contrast to other report cases of Lassa hemorrhagic fever. The most dramatically elevated metabolic indicators were ALP, ALT, and AST, all indicative of severe liver implication in this case of Lassa fever. Patient G-1177, who succumbed to Lassa fever, presented with elevated TBil, but low BUN:Cre, mainly due to extremely high Cre levels. This patient also had highly elevated levels of ALP and ALT, but normal levels of AST. Metabolic indicators were assayed in normal Sierra Leonean and U.S. normals, along with two samples each from G-1180 contacts -A and -B. B Haemoglobin levels (Hb) were measured in G-1180 on days 8, 12, 19, and 22 post- onset of disease. Low levels of Hb prompted blood transfusions on days 9 and 14.