Viral Haemorrhagic Fevers

Question 1

What are distinct about the VHFs?

Answer 1

RNA viruses, fast mutating
Filoviruses, arena viruses, bunyaviridae

Question 2

What is common to the VHFs?

Answer 2

-Non specific febrile illness progressing to shock/MOF/haemorrhage
-zoonoses

Question 3

What is Ebola?

Answer 3

Filo virus

Question 4

Natural host for ebola?

Answer 4

Fruit bat

Question 5

Transmission of ebola?

Answer 5

Contact with bodily fluids from infected patient e.g tears, blood, diarrhoea, vomit, sweat, semen

Question 6

Incubation period for Ebola?

Answer 6

2-21 days

Question 7

Major symptoms of ebola?

Answer 7

Fever, rash, vomiting and diarrhoea with blood

Question 8

Diagnosis of EBOLA?

Answer 8

PCR

Question 9

Classic bloods in a patient with Ebola?

Answer 9

AKI
Deranged LFTs
Hyponatraemia
Amylase high

Question 10

Stages of Ebola management?

Answer 10

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)

Question 11

Treatment of Ebola?

Answer 11

Monoclonal antibodies
Only for Ebola Zaire

Question 12

Which viral haemorrhagic fever more likely to occur in east africa? Who gets it?

Answer 12

Marburg virus
Miners/cavers
(Fruit bat is natural host)

Question 13

What type of virus is Lassa? Incubation period?

Answer 13

Sand like virus, arenavirus
2-21 days

Question 14

Reservoir for Lassa? How is it transmitted?

Answer 14

Mastomys natalensis - rodent.
Contact with contaminated faeces/water, person to person spread of body fluids

Question 15

Where is Lassa?

Answer 15

West Africa - Nigeria and Ghana

Question 16

Lassa feature that differentiates it from a filovirus

Answer 16

Proteinuria
Swelling of face
Sore throat
Deranged LFTs

Question 17

Complication of Lassa?

Answer 17

Sensorineural hearing loss

Question 18

What proportion of patients are asymptomatic with Lassa?

Answer 18

80%

Question 19

What type of virus is hantavirus?

Answer 19

Hantaviridae virus

Question 20

Hanta spread by? Where do you catch it?

Answer 20

Rodents
Forrests,camping

Question 21

presentation of hantavirus in old world? Where?

Answer 21

Haemorrhagic fever with renal syndrome
- AKI - proteinuria, haematuria
- capillary leak, thrombocytopenia
Eastern Europe

Question 22

Hantavirus in new world?

Answer 22

Short flu like illness
Pulmonary oedema and shock

Question 23

Andes virus presentation?

Answer 23

-long incubation period up to 40 days
-Flu like symptoms
-Severe symptoms - acute resp compromise, pulmonary oedema, hypotension
-High case fatality rate!!!

Question 24

Returning from Afghanistan, which viral haemorrhagic fever?

Answer 24

Crimean congo haemorrhagic fever

Question 25

What type of virus is CCHF? Transmitted by?

Answer 25

Bunyavirus
Ticks

Question 26

Clinical features of CCHF?

Answer 26

Very short incubation period
Short illness and much more haemorrhagic***
Returning from Eastern Europe/Turkey but wide spectrum

Question 27

Key feature of hx in CCHF?

Answer 27

Cattle slaughtering/tick exposure

Question 28

Incubation period for Lassa?

Answer 28

2-21 days