Viral Hemorrhagic Fevers

Signs and Symptoms

VHFs are severe fever illnesses that can feature flushing of the face and chest, skin hemorrhages, bleeding, edema, hypotension, and shock. Malaise, muscle pain, headache, vomiting, and diarrhea may occur in any of the hemorrhagic fevers.

Diagnosis

Definitive diagnosis rests on specific virologic techniques. Any outbreaks of a hemorrhagic fever syndrome should suggest the diagnosis of a viral hemorrhagic fever.

Treatment

Intensive supportive care may be required. Antiviral therapy with ribavirin (broad-spectrum antiviral drug) may be useful in several of these infections.

Preventative Measures

The only licensed VHF vaccine is yellow fever vaccine. Prophylactic ribavirin may be effective for Lassa fever, Rift Valley fever, CCHF, and possibly HFRS.

Isolation and Decontamination

Contact isolation, with the addition of a surgical mask and eye protection for those coming within three feet of the patient, is indicated for suspected or proven Lassa fever, CCHF, and infections.

Respiratory protection should be upgraded to airborne isolation, including the use of a fit-tested HEPA filtered respirator, a battery powered air purifying respirator, or a positive pressure supplied air respirator, if patients with the above conditions have prominent cough, vomiting, diarrhea, or hemorrhage. Decontamination is accomplished with hypochlorite (household bleach) or carbolic acid disinfectants.