TABLE 20.11.
Epidemiology and Clinical Characteristics of Viral Hemorrhagic Fevers
| Disease | Clinical Syndrome | Geographic Distribution | Vector |
|---|---|---|---|
| Yellow fever | Ranges from mild febrile illnesses to severe hepatitis and renal failure (with albuminuria); biphasic course of illness may be noted | Tropical South America and sub-Saharan Africa | Aedes aegypti mosquito |
| Haemagogus mosquito (urban Americas) | |||
| Dengue | Classic dengue: fever, severe myalgia/arthralgia, and morbilliform rash | Tropical and subtropical regions of the Americas, Africa, Asia, and Australia | Aedes aegypti mosquito |
| Dengue hemorrhagic fever: shock and DIC | |||
| Lassa fever | Fever, severe headache, lumbar pain, chest pain, and thrombocytopenia; possible encephalitis, pneumonitis, and myocarditis | Sub-Saharan Africa | None (high potential for person-to-person transmission) |
| Argentine hemorrhagic fever (Junin virus) | Insidious onset of fever, myalgia, headache, conjunctivitis, epigastric pain, nausea, and vomiting; possible shock | Argentina (especially Buenos Aires province) | None |
| Bolivian hemorrhagic fever (Machupo virus) | Similar to Argentine hemorrhagic fever | Bolivia (Department of Beni) | None |
| Marburg virus | Abrupt onset of fever, headache, conjunctivitis, myalgia, nausea, and vomiting; severe hemorrhagic complications and shock are common | Laboratory outbreaks involved with handling infected monkey tissues/cells | None (high potential for person-to-person transmission) |
| Ebola virus | Similar to Marburg virus; in West African outbreak, hemorrhagic complications are uncommon; large volume diarrhea common | Large outbreak in West Africa beginning in early 2014; isolated outbreaks in rural sub-Saharan Africa | None (high potential for person-to-person transmission) |
| Crimean-Congo hemorrhagic fever | Abrupt onset of fever, headache, arthralgia, myalgia, conjunctivitis, and abdominal pain; purpura and ecchymoses are common | Africa, Middle East, and Eastern Europe | Hyalomma species (ticks) (potential for nosocomial transmission) |
| Hemorrhagic fever with renal syndrome (hantavirus) | Abrupt onset of fever, headache, lethargy, abdominal pain associated with oliguria and acute renal failure; petechiae are common | Balkans, former Soviet Union, Korea, and China | None |
DIC, Disseminated intravascular coagulopathy.