Viral Haemorrhagic Fevers Flashcards
What are distinct about the VHFs?
RNA viruses, fast mutating
Filoviruses, arena viruses, bunyaviridae
What is common to the VHFs?
-Non specific febrile illness progressing to shock/MOF/haemorrhage
-zoonoses
What is Ebola?
Filo virus
Natural host for ebola?
Fruit bat
Transmission of ebola?
Contact with bodily fluids from infected patient e.g tears, blood, diarrhoea, vomit, sweat, semen
Incubation period for Ebola?
2-21 days
Major symptoms of ebola?
Fever, rash, vomiting and diarrhoea with blood
Diagnosis of EBOLA?
PCR
Classic bloods in a patient with Ebola?
AKI
Deranged LFTs
Hyponatraemia
Amylase high
Stages of Ebola management?
Stage 1: fever, myalgia - dry stage
Stage 2: wet stage - vomiting, diarrhoea, abdo pain (15% mortality)
Stage 3: characterised by haemorrhage and coma (50% mortality)
Treatment of Ebola?
Monoclonal antibodies
Only for Ebola Zaire
Which viral haemorrhagic fever more likely to occur in east africa? Who gets it?
Marburg virus
Miners/cavers
(Fruit bat is natural host)
What type of virus is Lassa? Incubation period?
Sand like virus, arenavirus
2-21 days
Reservoir for Lassa? How is it transmitted?
Mastomys natalensis - rodent.
Contact with contaminated faeces/water, person to person spread of body fluids
Where is Lassa?
West Africa - Nigeria and Ghana
Lassa feature that differentiates it from a filovirus
Proteinuria
Swelling of face
Sore throat
Deranged LFTs
Complication of Lassa?
Sensorineural hearing loss
What proportion of patients are asymptomatic with Lassa?
80%
What type of virus is hantavirus?
Hantaviridae virus
Hanta spread by? Where do you catch it?
Rodents
Forrests,camping
presentation of hantavirus in old world? Where?
Haemorrhagic fever with renal syndrome
- AKI - proteinuria, haematuria
- capillary leak, thrombocytopenia
Eastern Europe
Hantavirus in new world?
Short flu like illness
Pulmonary oedema and shock
Andes virus presentation?
-long incubation period up to 40 days
-Flu like symptoms
-Severe symptoms - acute resp compromise, pulmonary oedema, hypotension
-High case fatality rate!!!
Returning from Afghanistan, which viral haemorrhagic fever?
Crimean congo haemorrhagic fever
What type of virus is CCHF? Transmitted by?
Bunyavirus
Ticks
Clinical features of CCHF?
Very short incubation period
Short illness and much more haemorrhagic***
Returning from Eastern Europe/Turkey but wide spectrum
Key feature of hx in CCHF?
Cattle slaughtering/tick exposure
Incubation period for Lassa?
2-21 days
