About Viral Hemorrhagic Fevers

Learn about viral hemorrhagic fevers (VHFs), how they spread, and how CDC is combatting them.

This content is for informational purposes only. Always consult a healthcare professional.

Source: National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) — Content from the Centers for Disease Control and Prevention (public domain).

At a glance * Viral hemorrhagic fevers (VHFs) are a group of diseases that are caused by several distinct families of viruses. * The term “viral hemorrhagic fever” refers to a condition where many of the body’s organ systems are affected, the overall cardiovascular system is damaged, and the body’s ability to function on its own is reduced. * In addition to VHFs, there are serious infectious diseases like Nipah and Hendra diseases that also require a specialized laboratory, are highly pathogenic, and have no, or limited, vaccine or treatment currently available. * VHFs, Nipah and Hendra disease can cause relatively mild illness or more life-threatening disease. Symptoms can vary but may include bleeding or hemorrhaging. Distribution of these viruses is determined by where the animals that naturally carry them live. image of arenaviridae virus Types Most VHFs fall into one of four families of virus: Arenaviruses Each arenavirus has one or a few closely related rodents that carry the virus without getting sick themselves. This is known as the reservoir, or source of the virus in nature. The reservoir can spread the virus to people through infected urine, saliva, or droppings, and can cause severe disease in people. People are infected with arenaviruses by: * Touching with rodent urine, droppings, or nesting materials from an infected rodent * Breathing in air contaminated by rodent urine, droppings or nesting materials. * Being bitten or scratched by an infected rodent. * Eating food contaminated by urine, droppings, or saliva from an infected rodent. * Contact with another person who has certain arenaviruses, such as Chapare, Lassa, Machupo, and Lujo viruses.

Bunyavirales order Viruses in the Bunyavirales order are spread by rodents or insects, such as mosquitos, ticks, or sand flies. They can produce mild to severe disease in animals and people. Many of these viruses cannot spread between people. However, person-to-person spread of Crimean-Congo hemorrhagic fever has occurred in healthcare settings where infection control was limited. Filoviruses Filoviruses can cause severe illness in people and nonhuman primates (such as monkeys and gorillas). The Egyptian rousette bat, Rousettus aegyptiacus, is a cave-dwelling bat, and the reservoir for Marburg virus. Bats infected with orthomarburgviruses do not show obvious signs of illness. It’s not known what animal carries ebolaviruses in nature but scientists suspect that bats are likely involved. Once filoviruses are introduced into the human population, they can spread between people through contact with an infected person’s body fluids. Caretakers and healthcare providers who do not use appropriate personal protective equipment (PPE) are at higher risk of infection. Flaviviruses Flaviviruses, are found throughout the world. These viruses, which are primarily spread by mosquitoes and ticks, can cause mild to severe disease or even death. They can also cause disease in animals, creating a large economic and social impact on people living in affected areas. Paramyxoviruses Paramyxoviruses can cause sudden onset of respiratory disease. While there are many viruses included within the Paramyxoviridae family, Hendra and Nipah viruses are considered more serious because they require a specialized lab (biosafety level 4 lab) and can cause serious disease, spread between animals and people , and have no vaccine or treatment currently available. Virus familyVirus nameHow long it takes for symptoms to startWhere it’s foundAnimal or insect that spreads it
FilovirusEbola virus
(EBOV)2-21 daysThe Democratic Republic of the Congo, Gabon, Guinea, Republic of the CongoLikely bats, (species unknown)
FilovirusSudan virus
(SUDV)2-21 daysSouth Sudan, Uganda
FilovirusBundibugyo virus
(BDBV)2-21 daysThe Democratic Republic of the Congo, Uganda
FilovirusTaï Forest virus
(TAFV)2-21 daysCote D’Ivoire
FilovirusMarburg virus
(MARV)2-21 daysAngola, The Democratic Republic of the Congo, Equatorial Guinea, Ghana, Guinea, Kenya, Tanzania, Uganda, ZimbabweEgyptian fruit bat (Rousettus aegyptiacus)
FilovirusRavn virus
(RAVN)2-21 daysThe Democratic Republic of the Congo, Kenya, UgandaEgyptian fruit bat (Rousettus aegyptiacus)
Arenavirus (order Bunyavirales)Lassa fever virus2-21 daysBenin, Burkina Faso, Cote D’Ivoire, Ghana, Guinea, Liberia, Mali, Nigeria, Sierra Leone, TogoMultimammate rat (Mastomys natalensis)
Arenavirus (order Bunyavirales)Lujo virus7-13 daysZambiaUnknown, likely rodents
Arenavirus (order Bunyavirales)Junin virus6-14 daysArgentinaDrylands vesper mouse (Calomys musculinus)
Arenavirus (order Bunyavirales)Chapare virus4-21 daysBoliviaSmall-eared pygmy rice rats (Oligoryzomys microtis)
Arenavirus (order Bunyavirales)Sabia virus6-21 daysBrazilUnknown, likely rodents
Arenavirus (order Bunyavirales)Machupo virus3-16 daysBoliviaLarge vesper mouse (Calomys callosus)
Arenavirus (order Bunyavirales)Guanarito virus3-19 daysVenezuelaShort-tailed Cane mouse (Zygodontomys brevicauda)
Hantavirus (Bunyavirales)Hantaviruses1-8 weeksOld World hantaviruses: Europe and Asia; New World hantaviruses: North, Central, and South AmericaEach hantavirus serotype has a specific rodent host species
Nairovirus (order Bunyavirales)Crimean-Congo Hemorrhagic Fever virus1-14 daysEastern and southern Europe, Central Asia, all of Africa, Middle EastIxodid (hard) ticks
Phenuvirus (Bunyavirales)Rift Valley Fever virus2-6 daysEastern and southern AfricaMosquitos
FlavivirusAlkhurma hemorrhagic fever virus2-4 daysSaudi Arabia and EgyptSoft ticks (Ornithodoros savignyi) and hard ticks (Hyalomma dromedary)
FlavivirusKyasanur Forest Disease virus3-8 daysKarnataka State, IndiaHard ticks (Hemaphysalis spinigera)
FlavivirusOmsk Hemorrhagic Fever virus3-8 daysWestern Siberia regions of Omsk, Novosibirsk, Kurgan and TyumenTicks (Dermacentor reticulatus , Dermacentor marginatus , Ixodes persulcatus)
FlavivirusSevere Dengue virus5-7 daysAfrica, the Americas, South and Southeast Asia, Western Pacific regionMosquitos (Aedes aegypti or Aedes. albopictus)
FlavivirusYellow Fever virus3-6 daysTropical and subtropical areas of Africa and South AmericaMosquitos (aedes aegypti)
ParamyxovirusesHendra virus9-16 daysAustraliaFlying fox bat (genus Pteropus)
ParamyxovirusesNipah virus5-14 daysBangladesh, IndiaFlying fox bat (genus Pteropus)
Prevention Prevention of VHFs and other HCIDs depends on the host reservoir and how the virus spreads. Prevention measures can target reservoir exclusion activities (for example, use of insect repellents, bed nets, and protective clothing and disinfection procedures while caring for a sick person) or by sealing up and setting traps in homes and other buildings when a rodent infestation is discovered.
⚠ Caution
Medical Disclaimer: This information is for educational purposes only. Always consult a healthcare professional for medical advice.