Viral haemorrhagic fever (VHF)

Viral haemorrhagic fever (VHF)

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Pathology is a group of viral infections which share similar clinical presentation, have a high potential for transmission in nosocomial settings, and carry a high mortality rate. Viral haemorrhagic fever (VHF) should be considered in all travelers who develop fever within 3 weeks of visiting an endemic area.


The most common forms of VHF are Lassa fever, Crimean-Congo haemorrhagic fever, Ebola and Marburg. In Ebola, the infectious agent is typically transmitted from an animal vector, most commonly a bat.


VHF is characterized by fever, malaise, vomiting and mucosal and gastrointestinal (GI) bleeding.


Physical signs of VHF include petechiae, oedema, hypotension, flushing, and conjunctival injection.


A blood film should be performed to exclude malaria, along with a full blood count (FBC), urea and electrolytes (U&E) and clotting tests.


Conservative treatment includes isolation of the patient, transfer to a tertiary infectious diseases unit and the notification of the appropriate authorities.


Complications of VHF may include shock, circulatory collapse, death, retinitis, orchitis, deafness, hepatitis, transverse myelitis, renal failure and uveitis.


The prognosis for VHF is extremely poor, as mortality rates are very high.

Risk Assessment for VHF

  • Any fever and clinical features
  • Travel history � Onset < 3 weeks from geographical exposure
  • Exposure to a sick person with unexplained fever +/- bleeding within the last 3 years
  • Exposure to animal reservoir such as rodents, monkeys, bats or livestock

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