High risk

This category includes the following types of febrile patients.

1. They have been in an endemic area during the 3 weeks before illness and satisfy at least one of the following conditions:

a. they have lived or stayed for more than 4 h in a house where there were ill feverish persons known or strongly suspected to have a viral hemorrhagic fever;

b. they have taken part in nursing or caring for ill feverish patients known or strongly suspected to have a viral hemorrhagic fever, or have had contact with the body fluids, tissue, or dead body of such a patient;

c. they are a laboratory, health, or other worker who has, or has been likely to have, come into contact with the body fluids, tissues, or body of a human or animal known or strongly suspected to have a viral hemorrhagic fever;

d. they were previously categorized as moderate risk, but have developed organ failure and/or hemorrhage.

2. They have not been in an endemic area but during the 3 weeks before illness they have done at least one of the following:

a. they have cared for a patient or animal known or strongly suspected to have a viral hemorrhagic fever, or have come into contact with the body fluids, tissues, or dead body of such a patient or animal;

b. they have handled clinical specimens, tissues, or laboratory cultures known or strongly suspected to contain the agent of a viral hemorrhagic fever.

Such patients should be admitted to an HSIDU. United States guidelines

The United States recommendations on management of patients with suspected viral hemorrhagic fever (Centers..^ apply to patients who, within 3 weeks before onset of fever, have traveled in the specific local area of a country where viral hemorrhagic fever has recently occurred, had direct contact with blood, other body fluids, secretions, or excretions of a person or animal with viral hemorrhagic fever, or worked in a laboratory or animal facility that handles hemorrhagic fever viruses. The likelihood of acquiring viral hemorrhagic fever is considered extremely low in persons who do not meet any of these criteria.

Expert advice is available from:

Special Pathogens Branch

Division of Viral Diseases

National Center for Infectious Diseases

Centers for Disease Control and Prevention

1600 Clifton Road NE

Atlanta

GA 30333

USA Telephone: +1 404 639 1511 (from 4:30 p.m to 8 a.m. +1 404 639 2688) Principles of management Lassa fever

Intensive supportive therapy is applied plus ribavirin 30 mg/kg intravenously as a loading dose, followed by 16 mg/kg intravenously every 6 h for 4 days, and then 8 mg/kg intravenously every 8 h for 6 days. Prophylactic use (ribavirin 500 mg orally every 6 h for 7 days) may prevent or delay disease in exposed contacts.

Ebola virus and Marburg virus

No specific therapy is currently regarded as effective for either of these infections and management depends upon intensive supportive measures. Crimean/Congo hemorrhagic fever

Therapy depends upon intensive supportive treatment. However, early ribavirin therapy can reduce the duration of feverish illness and the severity of hemorrhagic manifestations.

Therapy depends upon intensive supportive treatment. However, early ribavirin therapy can reduce the duration of feverish illness and the severity of hemorrhagic manifestations.

Introduction History Examination Regional.. assessment

Oardioyascular.system Respiratory. .system Renal.system GiastroMe,sti,n,a,!...s,yst,em Hematological. system

Metabolic .systems..(hepatic,, . .p.a.n.creas,, .. e.n.doc.rine)

Infection

Chapter References

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