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Viral hemorrhagic fevers

Lassa, Marburg, Ebola, Crimean-Congo Hemorrhagic Fever (CCHF) and other emerging viruses

Infectious Disease

Viral hemorrhagic fevers are a group of illnesses caused by several viruses. These viruses affect multiple organs in the body by damaging the vascular (blood vessel) system. The bleeding or hemorrhaging caused by the virus is not usually life threatening but damage to organ systems in the body can range from mild to deadly. The viruses responsible for this type of illness include Lassa, Marburg, Ebola and Crimean-Congo hemorrhagic fever (CCHF).

How can you get it?

These emerging viral hemorrhagic fevers are presumed to be animal borne (zoonotic) and can be transmitted to humans through contact. Infected humans can spread the virus to each other through contact with contaminated objects or blood. The risk of acquiring these diseases is typically restricted to the geographic regions where the virus is found. Given global travel, rare cases have been reported outside of the host region. These rare cases are probably the greatest form of the occupational threat to fire fighters.

For Ebola, the disease is spread through contact with the body fluids of an infected sick or dead person, it does not spread through the air. An infected individual is only contagious once they begin showing symptoms of the disease.

LassaAssociated with Multimammate rodentsFound in West Africa
MarburgTransmitted by Egyptian fruit batFound in Africa
EbolaTransmitted by unknown animal but likely batsFound in Africa
CCHFTick-borne virusFound in Africa, Asia, Europe

Symptoms

The time to develop symptoms varies by virus but is between 2 to 21 days after exposure, but on average symptoms appear 8 to 10 days after exposure.
The signs and symptoms of viral hemorrhagic fever vary depending on the virus but include:

  • Initial Flu-like symptoms
    • Fever
    • Fatigue
    • Muscle aches
    • Headache
    • Loss of appetite
  • Gastrointestinal Symptoms
    • Nausea and/or vomiting
    • Abdominal pain
    • Diarrhea
  • Delirium
  • Unexplained bleeding or hemorrhage  
  • System shock
  • Organ failure
  • The most common complication of Lassa fever is deafness

Prevention

No vaccine currently exists to prevent Lassa, Marburg, Ebola or CCHF.
Focus prevention on avoiding contact with the host species and stopping further transmission from person to person.

  • Avoid close physical contact with infected individuals and their body fluids.
  • Using Contact and Airborne Precautions until transmission pattern of the particular infection is determined; then Contact and Droplet Precautions
    • Hand hygiene
    • Barrier protection against blood and body fluids (single gloves and fluid-resistant or impermeable gown, face/eye protection with masks, goggles or face shields)
    • Appropriate waste handling.
    • Use N95 or higher respirators. IAFF recommends P100 respirators for all patients with respiratory symptoms such as cough.

What should you do if you are exposed to the disease or get the disease?

You should see a doctor immediately if you have been exposed to the disease. There is no specific treatment for these viral infections, but hospitals can provide supportive care.

Intravenous fluid and electrolytes may be beneficial in addition to medication that treats certain symptoms such as blood pressure, reducing vomiting and reducing diarrhea.

For Ebola, there are two FDA-approved treatments currently available for only the Orthoebolavirus zairense species of Ebola. The two treatments are Inmazeb™ and Ebanga™.

Additional Resources for Ebola

Ebola information:

EMS information: