The following agents can all cause viral hemmorhagic fever (VHF)
- Arenaviradae (Lassa, Junin, Machupo, Guanarito, and Sabia),
- Filoviradae (Marburg and Ebola),
- Bunyaviradae (Congo-Crimean hemmorhagic fever virus and hantaviruses)
- Flaviradae (yellow fever and Dengue)
- Highly infectious after aerosolization.
- Infectious dose can be as low as 1-10 organisms.
- Risk of person-to-person transmission depends on virus.
- Incubation period is 4 – 21 days, depending on virus.
Clinical presentation would vary by viral agent; however, dominant clinical features of all are a consequence of microvascular damage and changes in vascular permeability.
- Fever, myalgia, and prostration may evolve to shock, generalized mucous membrane hemmorhage, and neurologic, hematopoietic, or pulmonary involvement.
- Viral isolation should be handled in a Biosafety Level 3 or 4 facility and may take 3 – 10 days.
- ELISA or reverse transcriptase PCR available for most VHF viruses.
- Isolation room with contact precautions.
- Ribavirin (30 mg/kg IV x 1, then 15 mg/kg IV q 6 h x 4 days, 7.5 mg/kg IV q 8 x 6 days) may be helpful for Congo-Crimean hemorrhagic fever or arenaviruses.
- Licensed vaccine available only for yellow fever.