Learning Objectives
1
Identify major VHF agents and their reservoirs
2
Recognize clinical presentation and disease progression
3
Implement enhanced infection control measures
4
Understand PPE requirements including trained observer for doffing
VHF Overview
Video: Understanding Viral Hemorrhagic Fevers
| Virus | Family | Reservoir | Mortality |
|---|---|---|---|
| Ebola | Filovirus | Bats (suspected) | 50-90% |
| Marburg | Filovirus | Bats | 24-88% |
| Lassa | Arenavirus | Rodents | 1-15% |
| Crimean-Congo HF | Bunyavirus | Ticks | 10-40% |
Clinical Presentation
Early Phase (Days 1-3)
- • Sudden onset high fever
- • Severe headache, myalgia
- • Sore throat, chest pain
Progression (Days 4-7)
- • Nausea, vomiting, diarrhea
- • Maculopapular rash
- • Conjunctival injection
Hemorrhagic Phase (Days 7+)
- • Bleeding from multiple sites
- • Shock, multi-organ failure
- • Death typically 7-16 days
Enhanced PPE Requirements
VHF PPE REQUIREMENTS
- Fluid-impermeable gown/suit
- Double gloves with extended cuffs
- N95 respirator or PAPR
- Full face shield
- Impermeable apron
- Boot covers
CRITICAL REQUIREMENT
Trained observer REQUIRED for PPE doffing (removal)
Improper doffing is the highest-risk moment for self-contamination
Treatment
Treatment for most VHFs is primarily SUPPORTIVE CARE:
- Aggressive fluid resuscitation
- Blood products for coagulopathy
- Vasopressors for shock
- Renal replacement therapy
- Antibiotics for secondary infections
- Ribavirin may help Lassa fever
Key Takeaways
VHFs cause vascular damage, bleeding, and multi-organ failure
Ebola transmitted through direct contact - NOT airborne
Trained observer REQUIRED for PPE doffing
Treatment is primarily supportive care