Viral Haemorrhaghic Fevers (VHF)

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Viral  Haemorrhagic  Fever  (VHF)  is  a  general  term  for  a  severe  illness  caused  by  viruses  and  sometimes  associated  with  bleeding.  Their  distribution  is  dependent  on  the  ecology  of  reservoir  hosts  with  a  potential  to  cause  life-threatening  illness  in  humans.  Diagnosis  and  management  is  challenging  due  to  the  non-specificity  of  early  symptoms,  limited  laboratory  facilities  in  endemic  areas,  severity  of  disease,  lack  of  effective  therapy,  strict  infection  control  requirements  and  propensity to cause epidemics with secondary cases in healthcare workers. 

Primary  transmission  is  from  animal  to  human,  through  contact  with  an  infected  animal  or  its  product.

Secondary transmission is from person to person through: 

• Contact  with  a  sick  person  or  direct  contact  with  the  blood  and/or  secretions  or  with  objects,  such  as  needles  that  have  been  contaminated  with  infected  secretions  of  an  infected person. 
• Breast feeding
• Sexual contact   

Public Health Control measures  

• Maintain  strict  viral  haemorrhagic  disease  (VHD)  infection  prevention  and  control  (IPC) practices throughout the outbreak. 
• Mobilize  the  community  for  early  detection  and  care  and  conduct  community  education about how the disease is transmitted and how to implement IPC in the home care setting  and during funerals and burials. Consider social distancing strategies. 
• Conduct contact follow-up and active searches for additional cases that may not come to the health care setting. 
• Establish an isolation ward or treatment centre to handle additional cases that may come to the health centre and ensure strict IPC measures to avoid transmission in health care  settings. 
• Suspected cases should be isolated and treated for more common conditions with similar  symptoms,  which  might  include  malaria,  typhoid,  louse  borne  typhus,  relapsing  fever  or  leptospirosis. Ensure a barrier is instituted between suspected and confirmed cases. 
• Provide psychosocial support for the family, community and staff. 
• Consider quarantine for high risk contacts with home support during the incubation period and ensure daily follow up of their movements. 
• There are promising vaccine candidates under development for some VHDs that might be useful to be used in the event of outbreak in a ring vaccination approach and for health  care workers. 
• Treat  conservatively  the  symptoms  which  might  be  presented;  severe  cases  require  intensive  support  care;  if  dehydrated  ensure  fluid  replacement  with  fluids  that  contain  electrolytes.