Emergency Preparedness

Kern Medical Bioterrorism Response Guide Section 2-C-2 – Viral Hemorrhagic Fever

VIRAL HEMORRHAGIC FEVER (VHF): RECOMMENDATIONS FOR ISOLATION

Any suspected case of viral hemorrhagic fever MUST BE TREATED AS A PUBLIC HEALTH EMERGENCY and reported to the infection control practitioner [ insert telephone number ] and local health department [ insert telephone number ] immediately.

Introduction The term viral hemorrhagic fever (VHF) refers to a group of diseases caused by several distinct families of viruses. The Centers for Disease Control and Prevention (CDC) has issued isolation recommendations that apply to four viruses that cause VHF: Lassa, Marburg, Ebola, and Congo-Crimean hemorrhagic fever. Health Canada has issued recommendations that also apply Junin, Sabia and Machupo viruses, found in South America. Blood, body secretions and excretions, semen, and tissue specimens from infected patients contain the virus responsible for VHF. Evidence suggests that the risk of person- to-person transmission increase as the patient’s condition deteriorates. Persons at highest risk for secondary transmission are those who are in closest contact with the blood and body fluids of the infected person toward the end of the incubation period and into the acute phase of the illness. Such persons include those with prolonged or close physical contact with infected persons such as family members, those providing direct medical and nursing care, and laboratory workers handling the patient’s specimens. Healthcare workers in Africa are at great risk of acquiring VHF due to inappropriate barriers to protect them from exposure to blood and body fluids. The risks associated with various body fluids have not been well defined as most health care workers in Africa who acquire the infection have had multiple unprotected contacts with multiple Healthcare workers (HCW) should follow facility specific procedures related to reducing the risk of occupational exposure to blood and other potentially infectious materials as required by the California Occupational Safety and Health Administration’s (CAL-OSHA) Bloodborne Pathogens Standard. Extreme vigilance is required to prevent needle sticks or other sharp injuries. Parenteral exposure has been associated with a high risk of transmission, a short incubation period and severe disease. Wheneve r possible, needleless intravenous systems, safety syringes and phlebotomy equipment should be used. If an exposure occurs, wash the skin with copious amounts of antimicrobial soap (not bleach) and water and flush the mucous membranes of the eyes, nose, a nd mouth body fluids over a relatively short period. OSHA Bloodborne Pathogens Standard

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