Some VHFs have a wide geographic distribution (for example, Crimean Congo haemorrhagic fever which occurs in Europe, the Middle East, Asia and Africa), whereas others are localised (for example, Venezuelan haemorrhagic fever).
Most VHFs are very uncommon, even in the geographical areas where they occur.
Dengue haemorrhagic fever is the only viral haemorrhagic fever known to occur in Australia.
Viral haemorrhagic fevers disease is a notifiable condition1
How viral haemorrhagic fevers is spread
Many viral haemorrhagic fever viruses cycle naturally amongst wild animals, such as bats, rodents (for example rats and mice), shrews, moles and monkeys, with spread between animals either directly or by biting insects. The viruses only make occasional breakthroughs into the human population.
Infection in humans can occur through:
contact with infected rodent droppings or urine - Lassa fever, Venezuelan haemorrhagic fever
bite from or crushing of an infected tick - Alkhurma haemorrhagic fever, Crimean Congo haemorrhagic fever
bite from an infected mosquito - Rift Valley fever.
Some viral haemorrhagic fevers have been shown to be transmitted from person to person via contact with blood or body fluids from an infected person (living or deceased) or contact with an area contaminated with blood or body fluids of an infected person. These are:
Andes virus (one of the causes of Hantavirus pulmonary syndrome)
Lassa fever can be transmitted by breathing in infectious airborne droplets.
Signs and symptoms of viral haemorrhagic fevers
Initial symptoms are flu-like and may include:
fever and chills
joint and muscle pains
diarrhoea, nausea and vomiting
loss of appetite
Some people recover from this initial stage of illness whereas others go on to develop bleeding problems, multi-organ failure and death. Bleeding problems may include bleeding from the nose or gums, vomiting or coughing blood, bruising, and internal bleeding.
Many people infected with Lassa fever have mild or no symptoms.
The death rate of VHF depends on the cause. For Lassa fever it is around 1-15% in hospitalised people, whereas it is 50-90% in outbreaks of Ebola virus disease.
Diagnosis of viral haemorrhagic fevers
Cases are diagnosed with a blood test, either PCR or serology or both, depending on the virus.
Testing is done in a public health laboratory with special biosafety features, and appropriate safety procedures are followed during the collection and transport of specimens.
(time between becoming infected and developing symptoms)
The incubation period depends on the type of virus.
Crimean Congo haemorrhagic fever – usually 1 to 3 days but up to 12 days
Ebola virus disease –2 to 21 days, most commonly 8 to 10 days
Lassa fever – 1 to 3 weeks
Marburg virus disease – probably 2 to 21 days
Omsk haemorrhagic fever – 3 to 8 days.
(time during which an infected person can infect others)
Community person to person spread only occurs with some VHFs.
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