Viral Hemorrhagic Fever

Abstract

New guidelines are presented for the initial management of suspected and confirmed cases of viral hemorrhagic fever. Lassa, Ebola, Marburg, and Crimean-Congo hemorrhagic fever are the only hemorrhagic fevers with documented person-to-person transmission. Health professionals caring for patients, missionaries, and Peace Corps volunteers, ail serving in Africa, would be the likeliest travelers entering the United States to have been exposed to these diseases. The communicability of these viruses in the hospital setting may differ, but the consequences of such transmission may be severe as case-fatality rates in hospital outbreaks have been high. Because these viruses have nonspecific symptoms that may resemble those of other diseases, appropriate barrier techniques designed to prevent transmission may not be implemented until late in the course of the illness. Specific isolation techniques are discussed, including the use of a mobile laboratory.