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General Information:
- 5 families of RNA viruses
- Arenaviradae – Lassa fever
- Bunyaviradae – Crimean – Congo hemorrhagic fever (CCHF)
- Hantavirus - Hemorrhagic Fever with Renal Syndrome (HFRS)
- Flaviviruses – Yellow fever, Dengue
- 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