CBRNE - Viral Hemorrhagic Fevers Follow-up

Updated: Mar 16, 2017
  • Author: David C Pigott, MD, RDMS, FACEP; Chief Editor: Zygmunt F Dembek, PhD, MPH, MS, LHD  more...
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Follow-up

Further Inpatient Care

Notification of local and state public health departments and the Centers for Disease Control and Prevention (CDC) may provide resources for further epidemiologic investigation into the source of the infection.

Appropriate barrier precautions should remain in place throughout the hospital course because of the highly pathogenic nature of viral hemorrhagic fever infection and because various causes of viral hemorrhagic fever often are clinically indistinguishable.

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Deterrence/Prevention

Because fruit bats have been shown to be natural reservoirs for Ebola and Marburg, [28] specific prevention measures should include avoidance of bats, their excreta and areas with concentrated bat populations within endemic areas. Studies have suggested that contact with fruit bats may be responsible for some cases of filovirus infection. [29, 30]

Efforts are under way in West Africa to educate people in high-risk areas about ways to decrease rodent populations, thereby reducing transmission of Lassa fever.

Strict barrier precautions in the treatment of patients with known or suspected viral hemorrhagic fever infection reduce nosocomial transmission.

Proposed guidelines for the use of ribavirin for Lassa fever postexposure prophylaxis recommend the use of oral ribavirin exclusively for definitive, high-risk exposures, such as the following [31] :

  • Contaminated needlestick injury
  • Mucous membrane or nonintact skin exposure with contaminated blood or body fluids
  • Participation in emergency resuscitative procedures (eg, intubation, suctioning)
  • Prolonged close contact in an enclosed space with infected patients without appropriate personal protective equipment
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Complications

Complications from viral hemorrhagic fever (VHF) infection include the following:

  • Retinitis
  • Orchitis
  • Encephalitis
  • Hepatitis
  • Transverse myelitis
  • Uveitis

In patients who recover from Lassa fever infection, deafness is the most common complication. Spontaneous abortion also is common.

Renal insufficiency is associated with HFRS infection. Post-Ebola syndrome can affect multiple organ systems, including the musculoskeletal system, central nervous system, and eyes. [16]

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Patient Education

For patient education resources, see the First Aid and Injuries Center, as well as Biological Warfare and Personal Protective Equipment.

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