What you need to know about . . . Viral Hemorrhagic Fevers and Bioterrorism What are viral hemorrhagic fevers? How are viral hemorrhagic fevers Viral hemorrhagic fevers (VHFs) are a spread? group of illnesses caused by several distinct In nature, viruses causing hemorrhagic fever families of viruses. In general the term typically are passed from mice, rats, fleas “viral hemorrhagic fever” describes severe and ticks to humans. People can be infected problems affecting several organ systems when they come in contact with urine, fecal in the body. Typically, the entire system of ma�er, saliva or other body fluids from blood vessels is damaged, and the body has infected rodents. Fleas and ticks transmit the problems regulating itself. Symptoms o�en viruses when they bite a person or when a include bleeding, but the bleeding itself is person crushes a tick. Hosts for some viruses rarely life-threatening. VHFs are caused by such as Ebola and Marburg are not known. viruses of four families: Some viruses such as Ebola, Marburg and Lassa can be spread from person to person • Arenavirus including Lassa fever and by direct contact with infected blood or Argentine, Bolivian, Brazilian and organs or indirectly through contact with Venezuelan hemorrhagic fevers; objects such as syringes or needles that are • Filovirus including Ebola and Marburg; contaminated with infected body fluids. • Bunyavirus including Hantavirus and Ri� Valley Fever; What are the symptoms? • Flavivirus including yellow fever and Symptoms vary with the different virus dengue fever. families, but first signs o�en include sudden fever, weakness, muscle pain, tiredness, Can viral hemorrhagic fevers be used headache and sore throat. Patients with as bioterrorism threats? severe cases of VHF o�en show signs of Viral hemorrhagic fever viruses can be bleeding under the skin, in internal organs or very infectious, and outbreaks of VHF from the mouth, eyes or ears. Very ill patients can result in high death rates. Ebola and may also have a nervous system breakdown, Marburg viruses are the most likely of viral delirium and seizures and may go into shock hemorrhagic fevers to be used as biological and a coma. Some types of VHF are linked weapons. A�empts have been made to use to kidney failure. Percentage of death among these viruses as weapons by aerosolizing cases depends on the virus family but can be infected body fluids or rodent excrement. as high as 90 percent with Ebola.

Fact Sheet Series How soon do symptoms appear? had casual contact with a VHF patient, take Symptoms begin anywhere from 2 to 21 your temperature twice a day for up to three days a�er infection, depending on the weeks a�er contact. If any symptoms appear, specific virus. tell your doctor about your exposure to VHF.

How are viral hemorrhagic fevers What is the public health system treated? doing about the possibility of an There is no treatment or cure for viral hemor- outbreak? Local, state and federal public health agencies rhagic fevers. Supportive care includes main- are actively working with local health care taining a patient’s fluids, watching oxygen providers, hospitals, emergency response levels and blood pressure, and treating any teams, laboratories, veterinarians and others infection. Ribavirin, an anti-viral drug, has to prepare for infectious disease outbreaks been helpful in treating some people with and biological disasters of all types, including Lassa fever. viral hemorrhagic fevers. If bioterrorism is suspected, the Department of State Health Is there a vaccine? Services notifies the CDC, FBI and other Currently there is a vaccine only for yellow appropriate authorities. fever and Argentine hemorrhagic fever. No other vaccines have been developed to Where can I get more information? prevent VHFs. Contact your local health department. Information about viral hemorrhagic fevers How can I protect myself? can be found on the Department of State Avoid close physical contact with infected Health Services Web site and the CDC Web people and their body fluids. Infected people site at: may be isolated, and those who care for www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/vhf.htm them wear protective clothing. If you have

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Publication #19-12071 Rev 08/04