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Viral Haemorrhagic Fevers (VHF)
Related Subjects: |Fever in a traveller |Malaria Falciparum |Malaria Non Falciparum |Viral Haemorrhagic Fevers (VHF) |Lassa fever |Dengue |Marburg virus disease |AIDS HIV |Yellow fever |Ebola Virus |Leptospirosis | Crimean-Congo haemorrhagic fever |African Trypanosomiasis (Sleeping sickness) |American Trypanosomiasis (Chagas Disease) |Incubation Periods |Notifiable Diseases UK
🦠 Viral Haemorrhagic Fevers (VHF) are rare but life-threatening infections. Always think malaria first in a febrile returning traveller. VHF is a High Consequence Infectious Disease (HCID) - strict infection control is essential.
📍 When to Suspect VHF
- Travel to an endemic area in the last 21 days (West/Central Africa, parts of Asia for CCHF).
- Close contact with a confirmed or suspected VHF case / animal reservoir.
- Worked in a lab with potential VHF exposure.
🧾 Clinical Features
- Early: Fever, myalgia, headache, fatigue.
- Progressive: Diarrhoea, abdominal pain, conjunctival injection, bleeding (skin, GI, mucosa).
- Severe: Shock, CNS involvement, seizures, coma.
💡 Exam pearl: the commonest diagnosis in “suspected VHF” is malaria, not VHF.
🔍 Investigations (UK guidance)
- Do NOT send samples to routine labs ❌.
- Discuss immediately with:
- On-call Infectious Diseases physician
- Consultant microbiologist
- UK Imported Fever Service
- Perform malaria rapid test safely (PPE, side room).
- Confirmatory VHF testing only at Rare & Imported Pathogens Laboratory (RIPL).
🧤 Infection Control
- Isolate in a negative-pressure side room.
- Staff must use full PPE: FFP3 respirator, gown, gloves, face/eye protection.
- Strict contact & droplet precautions.
💊 Management
- Supportive care: ABC, fluids, organ support.
- Antivirals (specialist use only):
- Ribavirin → for Lassa fever, CCHF (variable benefit).
- Monoclonal antibodies / Remdesivir → for Ebola or Marburg in specialist centres.
- Public health: urgent notification to UKHSA Health Protection Team.
⚠️ Red Flags for Re-assessment
- Nosebleeds, bloody diarrhoea
- Rising AST, falling platelets
- Shock or increasing O₂ requirement
- Rapid neurological decline
🎯 Key Exam Tips
- Always rule out malaria first.
- VHF = rare, deadly, HCID → don’t send samples locally.
- Remember the 21-day risk window.
- Follow HCID protocols immediately.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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