Viral Hemorrhagic Fever (VHF)

What is Viral Hemorrhagic Fever(VHF)?

Viral hemorrhagic fever is an illness caused by several different viruses. The virus enters the body usually through cuts or scratches on the skin, through a bite, or through moist body surfaces such as the eyes, nose, or mouth (mucous membranes). The virus attacks the body’s disease-fighting (immune) system and prevents it from fighting the infection. A VHF can damage the blood vessels and can create problems with how the blood clots, causing the body to bleed. The kidneys and liver can also become badly damaged.

The most well-known VHF is Ebola. Others include yellow fever, Lassa fever, and Marburg. Some VHFs are mild, but others can be very serious.

What are the causes of VHF?

The viruses that cause VHFs infect animals or insects (hosts) before they infect humans. Humans can get sick if they get bitten by an infected animal or insect. In some cases, they can also get sick if they come into contact with the fluid or body of an infected host or with a person who has been infected.

Hosts of these viruses include rodents, bats, ticks, mosquitoes, and flies. The hosts of some viruses are known, while the hosts of others are not. For example:

• Rodents in North and South America carry hantavirus.
• Monkeys carry the Marburg virus.
• Mosquitoes carry the yellow fever virus.

What increases the risk of VHF?

You are more likely to develop a VHF if:

• You live in an area that is heavily populated by hosts, like rodents or mosquitoes.
• You travel to remote areas, especially to areas where there is an outbreak of a VHF.
• You have been around a person who has a VHF.

What are the signs or symptoms?

The symptoms of a VHF depend on the illness. VHFs often cause these symptoms:

• Fever.
• Headache, back ache, or bone and muscle aches.
• Tiredness (fatigue) and exhaustion.
• Muscle aches.
• Sore throat.
• Dizziness.
• Red, itchy eyes (conjunctivitis).
• Vomiting, diarrhea, or stomach pain.
• Rash.

As the illness gets worse, symptoms can include:

• Bleeding from the ears, eyes, mouth, or other body openings (orifices).
• Blood in various bodily fluids and internal organs.
• Bruising.
• Confusion (delirium).
• Loss of consciousness.
• Seizures.

How is this diagnosed?

A VHF may be diagnosed based on your symptoms and a physical exam. Blood tests are also done.

How is this treated?

Treatment for many VHFs involves supportive care as the body fights the infection. Many of the diseases have no cure. Vaccines for these infections are in various stages of development. Treatments may include:

• Antiviral medicines. These may need to be taken by mouth or through an IV.
• IV fluids.
• Blood transfusion.
• Medicines for fever or vomiting.
• Antibiotic medicine. These may be prescribed if there is a secondary infection.

If you are at the hospital, safety measures (contact precautions) will be taken to prevent the infection from spreading to others. You will be separated (isolated) from other patients in the hospital, and health care workers will wear protective clothing, gloves, masks, goggles, and boots to cover their whole body. Depending on the type of VHF you have, you may be kept in the hospital until you are no longer infectious.

Follow these instructions at home:

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic or antiviral medicine, take it as told by your health care provider. Do not stop taking the medicine even if you start to feel better.
• Drink enough fluids to keep your urine clear or pale yellow.
• Keep all follow-up visits as directed by your health care provider. This is important.

Preventing the spread of infection

• You and people around you should wash hands often with soap and water. If soap and water are not available, use hand sanitizer.
• Some viruses may stay in semen and breast milk for a longer time. For this reason your health care provider may recommend that you:
  • Do not have sex for 3 months after treatment, or for as long as told by your health care provider.
  • Use a condom, even after you recover, and use it correctly every time you have sex.
  • Do not breastfeed your child, if breastfeeding, until you have two negative breast milk tests.

How is this prevented?

• Avoid travel to high-risk areas and to areas with an active VHF outbreak.
• Avoid contact with dead animals.
• Use insect repellent. The best insect repellents have:
  • DEET, picaridin, oil of lemon eucalyptus (OLE), or IR3535 in them.
  • Higher amounts of an active ingredient in them.
• Get rid of standing water, where mosquitoes may reproduce. Standing water is often found in items such as buckets, bowls, animal food dishes, and flowerpots.
• Avoid contact with people who might have a VHF.
• Get vaccinated as recommended by your health care provider.

Contact a health care provider if:

• You feel weak, tired, dizzy, or achy, and these symptoms do not improve after a few days.

Get help right away if:

• You have a fever.
• You suspect that someone else has a VHF. Your health care provider will report it to your local department of public health.
• You notice blood in your vomit, stools, urine, or other bodily fluids.
• You have a yellow tint to your skin or eyes (jaundice).
• You bleed from your eyes, mouth, or ears.
• You notice bruising without an injury.
• You have seizures.
• You have confusion.
• You feel lightheaded or faint.

If you or someone else shows signs of VHF, call your local emergency services. Do not go directly to a hospital or a health care provider’s office. Tell emergency services about your symptoms and that you suspect VHF infection. This information will help health care workers prepare for your visit so you can be diagnosed quickly and other people can be protected from catching the infection.

Summary

• VHFs usually affects the immune system and blood vessels. They usually cause internal bleeding (hemorrhage) and other symptoms.
• The most well-known VHF is Ebola. Others include yellow fever, Lassa fever, and Marburg.
• There is no specific treatment for many VHFs. Depending on the type of VHF you have, you may be kept in the hospital until you are no longer infectious.