Hemorrhagic fever viruses

Abstract

This article reviews the epidemiology, pathophysiology, and clinical management of patients with suspected or confirmed viral hemorrhagic fever infection. The focus is on clinical management based on case series from naturally occuring outbreaks of viral hemorrhagic fever infection as well as imported cases of viral hemorrhagic fever encountered in industrialized nations. The potential risk of bioterrorism involving these agents is discussed as well as emergency department and critical care management of isolated cases or larger outbreaks. Important aspects of management, including recognition of infected patients, isolation and decontamination procedures, as well as available vaccines and therapies are emphasized.

Fig. 1

Viral hemorrhagic fever isolation precautions. This basic set of isolation precautions for patients with suspected or confirmed VHF infection was developed by the CDC and the World Health Organization for instruction of health care providers in Africa. (From Centers for Disease Control and Prevention and World Health Organization. Infection control for viral haemorrhagic fevers in the African health care setting. Atlanta (GA): Centers for Disease Control and Prevention; 1998. Figs. 7, 26; with permission.)

Fig. 2

The number of infected health care workers declined after barrier nursing practices were begun during the Ebola hemorrhagic fever outbreak at Kikwit, Democratic Republic of Congo, 1995. (From Centers for Disease Control and Prevention and World Health Organization. Infection control for viral haemorrhagic fevers in the African health care setting. Atlanta (GA): Centers for Disease Control and Prevention; 1998. Figs. 1, 3; with permission.)