Febrele

hemoragice

Clasificarea febrelor hemoragice

Transmise de cpue
FH Crimea-Congo
FH de Omsc
FH de Kiasanur
Transmise de nari
Febra galben
Febra Denghe
Febra Cicungunia
Febra vii Rift

De contact
FH cu sindrom renal
Febra Lassa
Febra Marburg
Febra Ebola
Febra de Argentina
Febra de Bolivia
Febra de Brazilia
Febra de Venesuela

Four distinct viral families:

Filoviridae
Ebola
Marburg
Arenaviridae
Lassa fever
New world hemorrhagic fever
Bolivian hemorrhagic fever (Machupo)
Argentine hemorrhagic fever (Junin virus)
Venezuelan hemorrhagic fever (Guanarito
virus)
Brazilian hemorrhagic fever (Sabia virus)
Bunyaviridae
Crimean-Congo hemorrhagic fever
Rift Valley fever
Hantavirus
Flaviviridae
Dengue
Yellow fever
Omsk hemorrhagic fever
Kyasanur Forest disease

Cpuele vectori de transmitere a

febrelor hemoragice

Animals:
Numerous wild and domestic animals, such as cattle,
goats, sheep, and hares, serve as amplifying hosts
Filoviridae:
Same clinical course as that of humans
High primate mortality rate: ~ 82%
Bunyaviridae:
CCHF- unapparent infection in livestock
RVF- 100% abortion rate and mortality rate of > 90% in
young animals and 5-60% in older animals
Hantavirus unapparent infection in rodents
Flaviviridae:
Non-human primates varying clinical signs (Yellow
fever); no clinical signs (Dengue)
Livestock no symptoms (Kyasanur Forest Disease)
Rodents no symptoms

Humans:
Clinical signs and symptoms vary by the type of VHF
Patients usually present with the following clinical signs and
symptoms:
Fever 38.3C of < 3 week duration
Fatigue
Dizziness
Muscle aches
Loss of strength
Exhaustion
At least two of the following:
Hemorrhagic or purple rash
Epistaxis
Hemoptysis
Blood in stools
Petechiae in nondependent areas
No predisposing factors for hemorrhage and no established
alternative diagnosis

Filoviridae:
Most severe hemorrhagic fevers with abrupt onset and death
around day 7 to 11; painful recovery
Incubation: 4 to 10 days
Case fatality: 23-33% (Marburg) and 53-88% (Ebola)

Incubation: 10 to 14 days
Case fatality: 5-35%

Arenaviridae:
Bunyaviridae:

Incubation: 3 to 7 days (CCHF); 2 to 5 days (RVF); 7 to 21 days

(Hantavirus)
Case fatality: 30% (CCHF); 1% (RVF); 1-50% (Hantavirus)
Flaviviridae

Incubation: 2 to 6 days
Case fatality: 1-10% (Dengue); 3-5% (Kyasanur Forest virus); 0.53% (Omsk hemorrhagic fever); varies (Yellow fever)

Febra hemoragic Crimea-Congo

Febra hemoragic Crimea-Congo

Febra hemoragic cu sindrom renal

Virusul Ebola
Virusul Marburg
Familia Filivirusuri

Febra hemoragic Ebola i Marburg

Manifestri clinice n FH Ebola i

Marburg
Debut brusc cu frison
Febr nalt
Cefalee intens
Mialgii
Dureri n abdomen
Diaree
Voma
Tus i dureri n torace
Sindrom hemoragic exprimat
Erupii hemoragice la 4-5 zi
Hepatomegalie
Afectarea renal
Letalitatea pn la 80%

Febra de Argentina i de Bolivia

Debut lent cu temperatura
subfebril
Cefalee, mialgii
Enantem hemoragic la 2-3 zi
Semne catarale
Hiperemia feii, conjunctivei
Perioada de stare cu sindrom
hemoragic exprimat
afectarea renal cu oligurie
encefalit
Letalitatea 10-20%

Massive cutaneous ecchymosis

Febra Lassa
Debut brusc
Sindrom de intoxicaie exprimat
Sindrom dispeptic cu grea,
vom, diaree
Limfadenopatie cervical
Sindrom hemoragic exprimat
Focare de necroz n orofaringe
Ulceraii cu depuneri fibrinoase
oc toxico-infecios
Insuficien pulmonar
Insuficien renal
Sfrit letal la 15-20%

Hantavirus sindrom febril

Diagnosticul de laborator

Msurile antiepidemice n focare