ACH Outbreaks

Viral Hemorrhagic Fevers (VHFs)

About

Viral Hemorrhagic Fevers (VHFs) are a group of diseases that are caused by several distinct families of viruses. They have been identified in many areas of the world including some parts of Africa, Asia, and South America. Anyone can get a viral hemorrhagic fever, but most people can be infected when living or visiting areas where there are infected rodents, bats or arthropods. VHFs can be spread through blood, stool or urine of infected animals, or insect bites. Certain VHFs (Ebola, Marburg, Lassa fever, Lujo, Crimean-Congo hemorrhagic fever, Junin, Machupo, Chapare, Guanarito, and Sabia viruses) can spread from person-to-person through direct contact with the bodily fluids (i.e., blood or secretions) of an infected person or exposure to objects (such as needles) that have been contaminated with infected bodily fluids. Family members living with or taking care of an infected person or healthcare workers taking care of an ill person with VHF are examples of those most at risk. VHFs can cause mild illness or more life-threatening disease. Symptoms can vary but may include bleeding or hemorrhaging. People cannot transmit the disease before they have symptoms and remain infectious as long as their blood contains the virus. VHFs are not respiratory diseases like the flu or COVID-19, and not transmitted through the air. Although hantavirus, dengue, and yellow fever are classified as VHFs, they are not covered here.

For evaluation or questions about possible cases, contact:

Acute Communicable Disease Control Program
Mon-Fri 8am-5pm: 213-240-7941
After Hours: 213-974-1234 (ask for physician on call, AOD)

Common Symptoms and Treatment
Symptoms

VHF symptoms can appear anywhere from 2 to 21 days after exposure to the virus. Illness typically progresses from "dry" symptoms (fever, aches, fatigue) to "wet" symptoms (diarrhea, vomiting, and in some cases, bleeding). A person with a VHF is not contagious until the appearance of symptoms. Primary signs and symptoms of VHFs often include some or several of the following:

  • Fever (≥100.4°F/38.0°C)
  • Aches and pains, such as severe headache and muscle and/or joint pain
  • Weakness and fatigue
  • Cough/difficulty breathing
  • Sore throat
  • Loss of appetite
  • Gastrointestinal symptoms including abdominal pain, diarrhea, and vomiting
  • Chest pain
  • Encephalitis
  • Acute hearing loss
  • Unexplained hemorrhaging, bleeding or bruising
  • Red eyes, skin rash, and hiccups
Treatment
  • Healthcare providers should notify their health department and CDC to determine a patient's course of treatment.
  • FDA-approved therapeutics do not exist for most viral hemorrhagic fevers.
  • Supportive care is vital for patients with suspected or confirmed VHFs.
Transmission and Prevention
Transmission

VHFs can spread through contact with infected animals, infected insects or contact with the body or body fluids of an infected person depending on the type of VHF. In general VHF can spread by:

  • Contact with Animals
    • Handling infected animals, alive or dead.
    • Being bitten by infected mosquitoes or ticks.
    • Contact with urine, feces, or saliva from infected animals.
    • Inhaling airborne particles from infected animal urine or feces.
  • Human-Human
    • Close contact with infected people or their body fluids.
    • Sexual contact with an infected person.
    • Touching objects contaminated with infected body fluids.
Prevention
  • Avoid traveling to areas with active outbreaks.
  • Before travel, check the CDC Travel Health Notices site for recommendations.

Travelers visiting risk areas should:

  • Avoid physical contact with ill people and dead bodies.
  • Avoid contact with sick or dead animals.
  • Avoid contact with rodents, bats, primates and other animals that can carry VHFs.
  • Avoid handling, cooking, or eating raw or undercooked bushmeat or animal products.
  • Use insect repellents, bed nets, and protective clothing to avoid mosquito and tick bites.


Public Health has made reasonable efforts to provide accurate translation. However, no computerized translation is perfect and is not intended to replace traditional translation methods. If questions arise concerning the accuracy of the information, please refer to the English edition of the website, which is the official version.

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