Viral haemorrhagic fevers

Viral haemorrhagic fevers (VHFs) are a group of diseases caused by a number of different viruses. Examples of VHFs that have been involved in human-to-human transmission include:

• Lassa fever
• Lujo haemorrhagic fever
• Crimean-Congo haemorrhagic fever
• Marburg virus disease
• Ebola virus disease (EVD). EVD is covered in detail in the Ebola virus disease factsheet

Signs and Symptoms

VHFs cause acute illness and can be fatal (causing death). The seriousness of illness can be different for people.

Symptoms can include fever, muscle aches and pains, fatigue (extreme tiredness), headache, sore throat, conjunctivitis (irritated or red eyes) , flushing of the skin, diarrhoea and vomiting.

Acute illness with a VHF can lead to life-threatening internal and external bleeding and shock.

Global Situation

Lassa fever cases occur frequently in several West African countries. Outbreaks occurred in Nigeria and Guinea in 2022 with many cases, including 40 deaths (in Nigeria).

Two fatal cases of Marburg virus disease occurred in 2022 in Ghana. Large outbreaks have occurred in Angola and Democratic Republic of Congo previously.

Lujo haemorrhagic fever has only been identified in one small outbreak (5 cases) in Zambia and South Africa in 2008. This outbreak resulted in 4 deaths.

Crimean-Congo Haemorrhagic Fever (CCHF) cases occur in Africa, the Balkans, the Middle East and some Asian countries. The most recently reported outbreak was in Iraq of 212 cases reported in 2022.

There have been no human or animal cases of VHF in Australia.

Diagnosis

VHF is diagnosed with a blood test.

Other tests may be done to look for VHF, including a urine test or a throat swab.

Treatment

Prompt treatment is key for survival. It is important for people who may have been exposed to VHF to seek immediate medical attention if they have signs and symptoms of VHF, or if they become unwell.

Treatment for VHF may include medicines and intensive medical care in hospital.

Transmission

VHFs spread through contact with the blood or body fluids of an infected person or animal (alive or dead). The exception to this is CCHF, which is usually transmitted by infected ticks.

Body fluids are blood, urine (wee), saliva, faeces (poo), vomit, semen, breastmilk.

VHFs can be spread through sexual contact, including after the case has recovered.

People at risk

• People who are living in, or travelling to and from, VHF affected countries, particularly within Africa. The risk of infection is low unless there has been direct exposure to the bodily fluids of an infected person or animal (alive or dead).
• People caring for ill relatives with VHF.
• People taking part in traditional burial ceremonies in affected areas of Africa.
• Healthcare workers, particularly those in resource poor settings.

If you believe you have been in contact with a person infected with VHF, contact your local public health unit or call 13 HEALTH (13 43 25 84).

Seek immediate medical attention if you become ill or feel unwell while travelling in VHF-affected countries. Do not wait until you arrive back in Australia to see a doctor. Instead, you should see a doctor or go to the local emergency department in that country to work out why you are ill.

Seek immediate medical attention if you have recently returned from a VHF-affected country and become ill or feel unwell.

It is important that you ring ahead to your GP or the hospital. Mention your symptoms and which countries you have visited.

In Queensland, before seeing a doctor or going to the hospital, you should call 13 HEALTH (13 43 25 84) for advice.

Prevention

Visit Smartraveller prior to travel.

You can reduce the chance of being exposed to VHF when travelling to affected countries:

• Avoid direct exposure to the body fluids of an infected person or animal (alive or dead).
• Practice careful personal hygiene. This includes regular hand washing.

There are 2 vaccines that may be used to prevent Ebola virus disease. These vaccines are only available for restricted use.

If you are travelling to affected areas to work or volunteer in a public health or healthcare setting you should seek advice before you travel (in Queensland, you can call 13 HEALTH 13 43 25 84). You must be fully informed about infection control procedures and recommendations.

Help and assistance

For advice on current outbreaks visit Smartraveller or the World Health Organization.

Other helpful resources

U.S. Centres for Disease Control and Prevention. Lujo Hemorrhagic Fever (LUHF).

World Health Organization Factsheets: Ebola virus disease, Marburg virus disease, Crimean-Congo Haemorrhagic Fever, Lassa fever.