Haemorrhagic fever

Overview

Haemorrhagic fever is an umbrella term for a number of viral, tropical infectious diseases. Severe disease progression is typified by internal and external bleeding (haemorrhages), and death can occur due to multiple organ failure. Depending on the virus, the disease can also have a mild course, with flu-like symptoms. Preventive measures include, among other things, the yellow fever vaccination, good hygiene practices and protection against mosquitoes.

Possible diseases (list is not exhaustive)

• Lassa fever
• Dengue fever
• Yellow fever
• Ebola fever

Symptoms

• Incubation period: average 1 week

Mild progression

• Flu-like symptoms
  • Exhaustion
  • Fever (high)
  • Headaches and sore throat
  • Swollen neck lymph nodes
  • Joint and muscle pain
  • Skin rash
  • Nausea, vomiting
  • Burning eyes (conjunctivitis)

Severe progression

• Oedema (collection of fluid)
• Encephalitis/meningitis
  • Cramps
  • Loss of hearing
• Kidney and liver damage
• Pneumonia
• Haemorrhage (bleeding), coagulation disorders
  • Heavy external and internal bleeding
  • Red dots on skin (petechiae)
  • Vomiting of blood, blood in stools and urine
  • Nosebleeds
  • Sometimes circulatory collapse
• Disorientation, possibly leading to coma
• Can cause death (multiple organ failure/circulatory shock)

Causes and treatment

Causes

• Pathogens:
  • Different types of viruses (see below for diseases)
  • Found in (sub-)tropical areas
  • Europe: introduced by returning travellers

Means of transmission (depending on the virus)

• From animals to humans
  • Consumption of infected meat, contaminated water
  • Contact with animal excretions (e.g. rodents, cats)
  • Mosquito/tick bite, bat, etc.
• Human-to-human transmission
  • Contact with blood and other bodily fluids
  • Sexual intercourse
  • Rarely: droplet infection (sneezing, coughing)

Possible diseases (list is not exhaustive)

• Lassa fever
• Dengue fever
• Yellow fever
• Ebola fever
• Chikungunya fever
• Hanta fever

Further treatment by your doctor / in hospital

Possible tests

• Physical examination
• Identification of pathogen
  • Blood test
  • Analysis of other bodily fluids, if necessary
  • Done in high-security laboratories

Possible therapies

• Usually, the cause can't be treated
• Isolation (risk of contagion)
• Treatment of symptoms
  • Medication to reduce fever/pain
  • Coagulation control
  • Replacement of lost fluids
• Intensive care treatment
  • Monitoring
  • Organ replacement therapy (artificial respiration, blood purification, etc.)

What can I do myself?

• Medical advice for travellers (at least 3 months before travelling)
  • Recommendations/information
  • Vaccination (yellow fever), if necessary
• Generally, the safer sex rules apply:
  • Always use a condom or femidom during sexual intercourse outside a committed partnership
  • Don't get sperm or blood (including menstrual blood) in your mouth, and don’t swallow
• Insect repellent and suitable clothing
  • Mosquito spay (suitable for the tropics)
  • Mosquito net (suitable for the tropics)
  • Clothing suitable for the tropics (light colours, long sleeves, long trousers)
  • Don't let water stand uncovered (breeding ground)
• Avoid contact with animals
  • Don't eat wild animals killed as food (“bushmeat”)
• General hygiene measures
  • Food hygiene
  • Hand hygiene
  • Avoid contact with infected people
• For fever: no acetylsalicylic acid preparations (increased risk of bleeding)

When to see a doctor?

If following symptoms occur during or up to three weeks after returning from a trip to the (sub)tropics (general suspicion of a tropical disease)

• Fever
• Feeling ill
• Bleeding (skin, mucous membranes)
• Vomiting of blood, blood in stools and urine
• Headaches/joint pain/muscle pain
• New skin rash, yellow skin

Further information

Ostschweizer Infostelle für Reisemedizin (Eastern Switzerland Information Centre for Travel Medicine)
www.osir.ch

Swiss Tropical and Public Health Institute (Schweizerisches Tropen- und Public Health-Institut)
www.swisstph.ch

FDFA (travel links)
www.eda.admin.ch

Synonyms

haemorrhagic fever, viral haemorrhagic fever, VHF, haemorrhagic syndrome, hemorrhagic fever