Viral Hemorrhagic Fever - Types, Causes, Risk Factors, Diagnosis, Treatment and Prevention

What Is a Viral Hemorrhagic Fever?

Viral hemorrhagic fever is a multisystem syndrome caused by several families of viruses. Of which, few can be mild illnesses, and few can have fatal complications. It damages the body's vascular system and causes hemorrhagic or bleeding complications. When the viruses enter the body, they impair the walls of small blood vessels, thereby interfering with their clotting ability.

What Are the Types of Viral Hemorrhagic Fevers?

• Lassa.

• Ebola.

• Marburg.

• Yellow fever.

• Dengue.

What Causes Viral Hemorrhagic Fever?

Viral hemorrhagic fever is caused by RNA viruses, namely

• Filovirus.

• Arenavirus.

• Flavivirus.

• Bunyavirus.

How Does the Transmission of Viral Hemorrhagic Fevers Occur?

The viruses that cause viral hemorrhagic fevers are transmitted to humans from infected vectors or reservoir hosts.

1. The reservoir hosts include rodents. When humans come in contact with saliva, urine, feces, or any body fluids of infected rodents, the virus is transmitted, and disease occurs.

2. The infected hosts transmit the disease. When infected hosts like mosquitoes or ticks bite a healthy human being, the virus enters the person's bloodstream.

3. In some cases, these vectors transmit the virus to animals, from whom human beings can pick up the virus.

4. In addition, human-to-human transmission of the virus can also happen. A few examples of such transmission are Crimean-Congo hemorrhagic fever, Marburg, Ebola, etc. Close contact, contact with the body fluids, or contact with items infected by the body fluids of the affected individual is responsible for this type of transmission.

What Increases the Risk of Developing Viral Hemorrhagic Fever?

The following factors increase the risk of developing viral hemorrhagic fever:

• Residing or traveling to areas where this viral hemorrhagic fever occurs.

• Coming in contact with infected people.

• Unprotected sex with affected individuals.

• Animal slaughtering or consuming infected animal meats.

• Coming in contact with the blood and body fluids of the affected individual.

• Working in buildings with a rodent infestation.

Where Are Viral Hemorrhagic Fevers Common?

Viral hemorrhagic fevers are seen in most parts of the world. However, its incidence is significantly less in the United States. Africa, Asia, and South America are the most common areas where viral hemorrhagic fevers occur. But with traveling becoming so common, the spread of this virus has also become prevalent in many areas.

How Is Viral Hemorrhagic Fevers Manifested?

Early Signs:

• Fatigue.

• Fever.

• Nausea and vomiting.

• Pain in the muscles, joints, and bone.

• Dizziness.

• Diarrhea.

• Weakness.

• Exhaustion.

Severe and Life-threatening Signs:

• Vascular complications like bleeding. Bleeding occurs in the internal organs, eyes, ears, and mouth.

• Renal failure.

• Delirium.

• Seizures.

• Liver failure.

• Lung failure.

• Failure of the nervous system.

• Shock.

• Coma.

How Can We Diagnose Viral Hemorrhagic Fevers?

Diagnosis of viral hemorrhagic fevers includes the following:

• Physical examination.

• Travel history.

• Complete blood count.

• Coagulation profile.

• Liver function test.

• Reverse transcriptase-polymerase chain reaction (RT-PCR) test.

Culture test to isolate the virus.

How Is Viral Hemorrhagic Fevers Treated?

The first and foremost step in treating viral hemorrhagic fevers is to isolate the person with suspected symptoms and travel history to prevent the spread. Treatment mainly aims at providing supportive care as there is no specific treatment modality available.

Each virus requires different treatments, including

• Ebola Virus and Marburg Virus:

It involves supportive care by treating the symptoms present.

• Lassa Virus:

It is shown in clinical outcomes that Ribavirin has a good prognosis when given at the early stages of the disease. LASV-specific monoclonal antibodies and Favipiravir are under study.

• Dengue Fever:

It also does not have any specific treatment method. Providing supportive care is only the recommended treatment.

• Crimean-Congo Hemorrhagic Fever:

Laboratory studies have suggested Ribavirin is effective. However, the recommended choice is supportive care

What Are the Complications of Viral Hemorrhagic Fevers?

• Multiorgan failure.

• Death.

What Is the Differential Diagnosis of Viral Hemorrhagic Fevers?

• Typhoid fever.

• Malaria.

• Chikungunya fever.

• HIV/AIDS.

• Systemic lupus erythematosus.

• Leptospirosis.

How Can We Prevent Viral Hemorrhagic Fevers?

Vaccination:

• An essential method of preventing viral hemorrhagic fevers is to get the available vaccination. Vaccinations are not available for all hemorrhagic fevers.

• Ebola virus vaccine is available and is approved by the Food and Drug Administration (FDA) of the United States.

• Vaccine for yellow fever is also available for everyone. Infants below nine months, immunocompromised individuals, and pregnant women should not get the vaccine in their first trimester.

• A vaccine is available for dengue fever in Southeast Asia and Latin America; however, this vaccine is recommended in individuals with previous dengue infection by the World Health Organization (WHO).

Protection Against Mosquitoes and Ticks:

While traveling to areas with viral hemorrhagic fever or if you are living in such places, do the following to avoid mosquitoes and ticks:

• Wear long pants and long-sleeved shirts.

• Choose light color clothing.

• If possible, use clothes coated with Permethrin. However, Permethrins should not be applied to the skin directly.

• Avoid going out in the evening, when the mosquitoes will be very active.

• Use insect repellents made of 20 % to 25 % of DEET to both your skin and clothes.

• Use bed nets or mosquito coils.

Protection Against Rodents:

• Regularly and adequately dispose of the garbage.

• Use tightfitting screens on your windows and doors.

• Keep your trash in containers that are rodent-proof and also clean them adequately.

• Do cover your pet food and store them in rodent-proof containers.

• Trim your lawn closely.

• Place the brick stacks, woodpiles, or other dumped materials at a distance of 100 feet from your living area.

Conclusion:

Viral hemorrhagic fevers are commonly seen in tropical areas. There is no specific treatment available. and vaccines are available only for a few fevers. Therefore, preventing the disease in the first place is essential. Do follow adequate preventive measures to avoid one.