Viral hemorrhagic fever

Viral hemorrhagic fevers (VHFs) are a diverse group of highly infectious diseases caused by several families of RNA viruses. These viruses wreak havoc on multiple organ systems, often leading to internal and external bleeding, and can range in severity from mild illness to fatal epidemics.

A Spectrum of Viruses, a Spectrum of Symptoms:

VHFs are not a single disease, but rather a collection of illnesses with distinct characteristics. Some of the more well-known VHFs include:

  • Ebola virus disease (EVD): Caused by Ebola viruses, EVD is infamous for its rapid onset and high mortality rate, reaching up to 90% in some outbreaks. Opens in a new windowclevelandclinic.orgEbola virus
  • Marburg virus disease: Similar to EVD, Marburg virus disease is a severe VHF with high mortality rates.Opens in a new window. Marburg virus
  • Lassa fever: Endemic in West Africa, Lassa fever is a relatively common VHF with a moderate mortality rate.Opens in a new window.frontiers in.orgLassa virus
  • Crimean-Congo hemorrhagic fever (CCHF): Ticks and livestock transmit CCHF, which can cause severe bleeding and organ failure.Opens in a new window. Researchgate.netCrimeanCongo hemorrhagic fever virus
  • Dengue fever: Dengue fever is the most common VHF, with millions of cases reported annually. While most cases are mild, severe dengue can be deadly. Opens in a new window. news-medical.get dengue fever virus

Despite their differences, VHFs share some common features:

  • Fever: A sudden onset of high fever is a hallmark of most VHFs.
  • Bleeding: Internal and/or external bleeding, ranging from petechiae (tiny red dots) to severe hemorrhaging, can occur.
  • Organ damage: VHFs can damage multiple organs, including the liver, kidneys, and lungs.
  • Shock: In severe cases, VHFs can lead to circulatory shock, a life-threatening condition.


The way VHFs spread varies depending on the virus. Some common transmission routes include:

  • Direct contact with infected bodily fluids: This includes blood, saliva, vomit, and feces.
  • Animal contact: Bites or contact with infected animals, such as bats, monkeys, and rodents, can transmit some VHFs.
  • Mosquitoes and ticks: These vectors can transmit viruses like dengue fever and CCHF.

Diagnosis and Treatment:

Early diagnosis and treatment are crucial for improving VHF outcomes. However, diagnosing VHFs can be challenging due to their diverse symptoms and the lack of specific tests for some viruses.

  • Blood tests: These can detect the presence of the virus or antibodies against it.
  • PCR tests: These tests can directly detect the viral genetic material.
  • Imaging tests: X-rays and CT scans can help assess organ damage.

There are no specific cures for most VHFs, and treatment typically focuses on supportive care, such as:

  • Fluid replacement to manage dehydration and shock
  • Blood transfusion to manage blood loss
  • Pain management
  • Oxygen therapy for respiratory distress

Prevention is Key:

Vaccines are available for some VHFs, such as yellow fever and dengue fever. However, for many VHFs, prevention relies on public health measures and individual behavior:

  • Avoiding contact with infected individuals and animals: This includes practicing good hygiene, wearing personal protective equipment (PPE) when caring for sick individuals, and avoiding contact with known animal reservoirs of the virus.
  • Vector control: Mosquito and tick control measures can help reduce transmission of VHFs spread by these vectors.
  • Community education: Raising awareness about VHFs and their transmission routes can help individuals take steps to protect themselves and their communities.

The Future of VHFs:

VHFs remain a significant global public health threat. Climate change, deforestation, and population growth are creating conditions that favor the emergence and spread of new VHFs. Additionally, the rapid evolution of some viruses makes developing effective vaccines and treatments challenging.

Investing in research and development, strengthening healthcare systems, and promoting international collaboration are crucial steps in preparing for future VHF outbreaks and protecting communities around the world.