Emergency Preparedness

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

VIRAL HEMORRHAGIC FEVER (VHF) – OVERVIEW

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 the local health department [ insert telephone number ] immediately.

Naturally Occurring VHF The viral hemorrhagic fevers are a diverse group of naturally occurring illnesses caused by viruses from four different families: Arenaviridae, Bunyaviridae, Filoviridae, and Flaviviridae . ? The arenaviruses include Argentine (Junin virus), Bolivian (Machupo virus), Brazilian (Sabia virus) and Venezuelan (Guanarito virus) and Lassa (Lassa) hemorrhagic viruses. These viruses are transmitted from rodent reservoirs to humans by inhalation of dust contaminated with rodent feces. ? The bunyaviruses include Rift Valley fever (Phlebovirus), Crimean-Congo fever (Nairovirus), and Hantaviruses (hantavirus renal syndrome [HFRS] andhantavirus pulmonary syndrome [HPS]). These viruses are transmitted to humans from a variety of reservoirs including mosquito and domestic animal slaughter (RiftValley fever), ticks and domestic animal slaughter (Crimean-Congo fever) and rodents (Hantavirus). ? The filoviruses include Marburg and Ebola viruses. Their natural reservoir is unknown. ? The flaviviruses include yellow fever and dengue fever. Both viruses are mosquito- borne. Each of these viral families share a number of common features: ? They are all RNA viruses covered or enveloped in a fatty (lipid) coating. ? Their survival is dependent of an animal or insect host, called a natural reservoir. ? The viruses are geographically restricted to the areas where their host species live. ? Humans are not the natural reservoir for any of these viruses. Humansare infected when they are exposed to infected hosts. However, after accidental transmission from the host, humans can transmit some of these viruses to other humans. ? Human cases or outbreaks of hemorrhagic fevers occur sporadically and irregularly and outbreaks cannot be predicted. ? With a few noteworthy exceptions, there is no cure or established drug treatment for VHF.

1