Viral hemorrhagic fevers

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at February 24, 2016
StartDiseasesViral hemorrhagic fevers

Viral hemorrhagic fevers affect people around the world on a continual basis. These types of fevers usually affect various organs and while not always life-threatening, they sometimes are. Ebola virus disease, for example, is one such viral hemorrhagic fever that can cause death. Anyone who suspects that they have a VHF should visit a clinic or doctor right away.


Definition & Facts

Viral hemorrhagic fevers are groups of illnesses caused by several different families of viruses including bunyavirus, flavivirus (e.g. yellow fever virus and dengue fever virus), filovirus (e.g. Ebola virus), and arenavirus (e.g. Lassa virus).

Viral hemorrhagic fevers can be spread through contact with animals that carry them. This is the case with yellow fever and dengue fever which are spread by mosquitoes. VHFs can also be spread through contact with the bodily fluids of an infected person as in the case of Ebola virus disease. Lassa fever is spread through both human-to-human transmission as well as by contact with rats.

The most serious VHF's are typically found in some West African countries while some mild forms of virus hemorrhagic fevers are found in some parts of South America and Asia.

Symptoms & Complaints

Symptoms include extreme weakness, chills, and joint aches accompanied by a high grade fever, as well as extreme fatigue. A person infected with VHF may suffer from bleeding ears, bleeding from the mouth, bleeding eyes, or significant life-threatening internal bleeding. Severe symptoms may include:

The above mentioned complaints will typically happen as the disease progresses. It is important for anyone who feels sick with a high fever and fatigue especially after traveling to areas with high rates of infection to get diagnosed as soon as possible.

Someone who has traveled to infected countries may notice symptoms between 2 to 21 days. While it is typically from around the eighth to tenth day, symptoms can show up as early as the day after infection. Because VHF progresses quickly, people who fear infection should visit medical personnel as soon as they begin to feel feverish and overly tired.


The most common cause of viral hemorrhagic fevers is through animal contagion. Rodents are the most common vectors or carriers of viruses that cause VHF's and these illnesses are typically spread in countries with a lack of rodent control. Mosquitoes and bats are also known to be carriers of underlying viruses.

In some instances, viral hemorrhagic fevers are spread from person to person. A person who comes into contact with blood, semen, feces, saliva, urine, or even breast milk from an infected person is at high risk for contagion.

Even coming into contact with a deceased person's body can cause infection. Many health workers that come in contact with dangerous VHF illnesses can become infected if the utmost care and use of protective wear is not used. People who attend burial rituals of someone who died from a life-threatening VHF are opening themselves up to possible contamination.

Diagnosis & Tests

While most of the symptoms that are first felt when a person has VHF are quite normal in other sicknesses, a tell-tale sign would be a recent trip to another country where contagion is evident. A high fever that just doesn't get better and extreme fatigue or definite reasons to visit a doctor and get medical tests.

People who recognize these symptoms should communicate if they have traveled with the details of when and where. Knowing where someone has been to can be a clear signal of whether the disease is VHF or something else. Doctors will usually want to know details of what was done on the trip, whether a person worked with sick people, had sexual relations, or visited highly infectious locations.

If tests are required, extreme precautions will need to be taken due to the nature of some of these highly infectious diseases. Blood tests may look for antigens and antibodies that relate to the specific viruses in question. Blood cultures may also isolate the viruses.

Treatment & Therapy

At the moment there are not many antiviral drugs for VHF. There are a few that can help in some cases, such as ribavirin for Lassa fever, but in most cases close monitoring of an infected person is the best way to ensure survival. Because VHF often affects people's organs, medical personnel must ensure that fluids are controlled and do what they can to maintain the stability of the patient. Ebola and dengue fever are both treated through supportive care and close monitoring.

Many complications can occur from VHF infections and the care and quick response of the medical staff can go far in the recovery from any type of VHF. From controlling blood pressure to stopping other infections that appear from a weakened immune system, the most important part of treatment for a serious diagnosis of VHF is a highly responsive and dedicated medical staff.

Sometimes when there is organ failure, doctors may need to perform surgery to save the patient's life. Kidney failure often requires waste to be drained and a patient with sepsis will need fluids, electrolytes, and antibiotics. Prompt treatment of a diagnosed person is extremely important in saving their life. Recovery often depends on the individual's immune system strength, as well as experienced and skilled medical care.

Prevention & Prophylaxis

A first step in the prevention of VHF's is to not travel to destinations that are known to be homes to the viruses. If it is necessary for travel to infected areas, precautions should be taken, including proper hygiene, taking care of food consumption, and avoiding contact with a potentially infected person. Viral hemorrhagic fevers are highly contagious and exercising wisdom and caution while visiting countries with outbreaks is one of the most important ways to prevent infection.

There are a few vaccines for some VHF illnesses such as yellow fever and clinical trials exist for an Ebola virus vaccine. People who plan to travel to countries that are known to have outbreaks of this type of viral hemorrhagic fever should speak to their doctor about vaccinations and precautions to take. Medical personnel who work with infected people must wear protective wear when treating and providing therapy to someone with a dangerous VHF to prevent further spread of the disease.