General Information:

• 5 families of RNA viruses

1. Arenaviradae – Lassa fever
2. Bunyaviradae – Crimean – Congo hemorrhagic fever (CCHF)
3. Hantavirus - Hemorrhagic Fever with Renal Syndrome (HFRS)
4. Flaviviruses – Yellow fever, Dengue
5. Filoviridae – Ebola, Marburg

• Vector transmission – humans, rodents, livestock, bush meat, mosquito, tick, contaminated feces
• Incubation of 2-14 days

Clinical Presentation:

• Mild – Mod: fever, fatigues, malaise, myalgia followed by coagulopathy (petechial rash)
• Severe: shock, coma, delirium, seizure, liver/renal failure

Diagnosis:

• Whole blood or serum can be sent to the CDC for testing (PCR, IgM/IgG, viral culture)
• Leukopenia/leukocytosis, proteinuria, thrombocytopenia, ­LFTs/PT/PTT, may see DIC

Treatment:

• Supportive
• Contact and airborne precautions
• Ribavirin – effective in patients with Lassa fever or HFRS (not approved by the FDA)
• Convalescent-phase plasma has been used with success in some patients with Argentine hemorrhagic fever
• FFP, high dose steroids has been reported to be successful in Crimean-Congo (CCHF)

Bottom Line:

• Immediate isolate patents with fever and signs of coagulopathy
• Supportive care primarily

University of Maryland Section of Global Emergency Health

Author: Veronica Pei

References

The CDC Yellow Book 2014 available at: http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/viral-hemorrhagic-fevers