Bichat guidelines for the clinical management of haemorrhagic fever viruses and bioterrorism-related haemorrhagic fever viruses

Abstract

Haemorrhagic fever viruses (HFVs) are a diverse group of viruses that cause a clinical disease associated with fever and bleeding disorder. HFVs that are associated with a potential biological threat are Ebola and Marburg viruses (Filoviridae), Lassa fever and New World arenaviruses (Machupo, Junin, Guanarito and Sabia viruses) (Arenaviridae), Rift Valley fever (Bunyaviridae) and yellow fever, Omsk haemorrhagic fever, and Kyanasur Forest disease (Flaviviridae). In terms of biological warfare concerning dengue, Crimean-Congo haemorrhagic fever and Hantaviruses, there is not sufficient knowledge to include them as a major biological threat. Dengue virus is the only one of these that cannot be transmitted via aerosol. Crimean-Congo haemorrhagic fever and the agents of haemorrhagic fever with renal syndrome appear difficult to weaponise. Ribavirin is recommended for the treatment and the prophylaxis of the arenaviruses and the bunyaviruses, but is not effective for the other families. All patients must be isolated and receive intensive supportive therapy.

Immunotherapy with CpG Oligonucleotides and Antibodies to TNF-α Rescues Neonatal Mice from Lethal Arenavirus-Induced Meningoencephalitis

“…However, virus has been also isolated from cerebrospinal fluid and neurological signs, including depression, ataxia, tremors, convulsions, paresis, and muscle atrophy, have been described during acute infection and in convalescent patients (27)(28)(29). The mechanism by which arenaviruses cause neurological symptoms is not well understood but could be secondary to coagulation disorders or to direct or Ab-mediated neurotoxicity, or, as suggested by the animal models, could result from the cytokine cascade elicited by the virus.…”

A Complex Adenovirus-Vectored Vaccine against Rift Valley Fever Virus Protects Mice against Lethal Infection in the Presence of Preexisting Vector Immunity

“…Human infection with RVFV occurs most commonly through contact with infected animals but can also result from mosquito bites during periods when the virus is circulating at high densities in these hosts. Accidental infection of scientists in a laboratory setting, however, indicates that the virus is fully capable of aerosol transmission (15,39), and this has also been demonstrated with animal models (5,7).…”

An Outbreak of Plasmodium falciparum Malaria in U.S. Marines Deployed to Liberia

“…some Marines were infected, or co-infected, with Lassa virus after exposure to rat excreta and as a safety measure, they were initially cared for with contact and droplet isolation precautions. [12][13][14] Upon admission, each Marine answered a standard outbreak questionnaire (not anonymous) to obtain data on symptoms and adherence to personal protection measures and chemoprophylaxis. Clinical data, which included physical examination findings and admission laboratory results, were recorded.…”