ViralHemorrhagicFever

Information about ViralHemorrhagicFever

Published on August 11, 2014

Author: johngeorge22

Source: authorstream.com

Content

Viral Hemorrhagic Fever: Viral Hemorrhagic Fever What is Viral Hemorrhagic Fever?: Center for Food Security and Public Health Iowa State University - 2004 What is Viral Hemorrhagic Fever? Severe multisystem syndrome   Damage to overall vascular system Symptoms often accompanied by hemorrhage Rarely life threatening in itself Includes conjunctivitis, petechia, echymosis Overview: Center for Food Security and Public Health Iowa State University - 2004 Overview Organism History Epidemiology Transmission Disease in Humans Disease in Animals Prevention and Control The Organisms: The Organisms Viral Hemorrhagic Fever: Center for Food Security and Public Health Iowa State University - 2004 Viral Hemorrhagic Fever Viruses of four distinct families Arenaviruses Filoviruses Bunyaviruses Flaviviruses RNA viruses Enveloped in lipid coating Survival dependent on an animal or insect host, for the natural reservoir Classification: Center for Food Security and Public Health Iowa State University - 2004 Classification Arenaviridae Bunyaviridae Filoviridae Flaviviridae Junin Crimean- Congo H.F. Ebola Kyasanur Forest Disease Machupo Hantavirus Marburg Omsk H.F. Sabia Rift Valley fever Yellow Fever Guanarito Dengue Lassa Arenaviridae: Arenaviridae Junin virus Machupo virus Guanarito virus Lassa virus Sabia virus Arenaviridae History: Center for Food Security and Public Health Iowa State University - 2004 Arenaviridae History First isolated in 1933 1958: Junin virus - Argentina First to cause hemorrhagic fever Argentine hemorrhagic fever 1963: Machupo virus – Bolivia Bolivian hemorrhagic fever 1969: Lassa virus – Nigeria Lassa fever Arenaviridae Transmission: Center for Food Security and Public Health Iowa State University - 2004 Arenaviridae Transmission Virus transmission and amplification occurs in rodents Shed virus through urine, feces, and other excreta Human infection Contact with excreta Contaminated materials Aerosol transmission Person-to-person transmission Arenaviridae Epidemiology: Center for Food Security and Public Health Iowa State University - 2004 Arenaviridae Epidemiology Africa Lassa South America Junin, Machupo, Guanarito, and Sabia Contact with rodent excreta Case fatality: 5 – 35% Explosive nosicomial outbreaks with Lassa and Machupo Arenaviridae in Humans: Center for Food Security and Public Health Iowa State University - 2004 Arenaviridae in Humans Incubation period 10–14 days Fever and malaise 2–4 days Hemorrhagic stage Hemorrhage, leukopenia, thrombocytopenia Neurologic signs Bunyaviridae: Bunyaviridae Rift Valley Fever virus Crimean-Congo Hemorrhagic Fever virus Hantavirus Bunyaviridae History: Center for Food Security and Public Health Iowa State University - 2004 Bunyaviridae History 1930: Rift Valley Fever – Egypt Epizootic in sheep 1940s: CCHF - Crimean peninsula Hemorrhagic fever in agricultural workers 1951: Hantavirus – Korea Hemorrhagic fever in UN troops 5 genera with over 350 viruses Bunyaviridae Transmission: Center for Food Security and Public Health Iowa State University - 2004 Bunyaviridae Transmission Arthropod vector Exception – Hantaviruses RVF – Aedes mosquito CCHF – Ixodid tick Hantavirus – Rodents Less common Aerosol Exposure to infected animal tissue Bunyaviridae Epidemiology: Center for Food Security and Public Health Iowa State University - 2004 Bunyaviridae Epidemiology RVF - Africa and Arabian Peninsula 1% case fatality rate CCHF - Africa, Eastern Europe, Asia 30% case fatality rate Hantavirus - North and South America, Eastern Europe, and Eastern Asia 1-50% case fatality rate Bunyaviridae Humans: Center for Food Security and Public Health Iowa State University - 2004 Bunyaviridae Humans RVF Incubation period – 2-5 days 0.5% - Hemorrhagic Fever CCHF Incubation period – 3-7 days Hemorrhagic Fever - 3–6 days following clinical signs Hantavirus Incubation period – 7–21 days HPS and HFRS Bunyaviridae Animals: Center for Food Security and Public Health Iowa State University - 2004 Bunyaviridae Animals RVF Abortion – 100% Mortality rate >90% in young 5-60% in older animals CCHF Unapparent infection in livestock Hantaviruses Unapparent infection in rodents Filoviridae: Filoviridae Marburg virus Ebola virus Filoviridae History: Center for Food Security and Public Health Iowa State University - 2004 Filoviridae History 1967: Marburg virus European laboratory workers 1976: Ebola virus Ebola Zaire Ebola Sudan 1989 and 1992: Ebola Reston USA and Italy Imported macaques from Philippines 1994: Ebola Côte d'Ivoire Filoviridae Transmission : Center for Food Security and Public Health Iowa State University - 2004 Filoviridae Transmission Reservoir is UNKNOWN Bats implicated with Marburg Intimate contact Nosicomial transmission Reuse of needles and syringes Exposure to infectious tissues, excretions, and hospital wastes Aerosol transmission Primates Filoviridae Epidemiology: Center for Food Security and Public Health Iowa State University - 2004 Filoviridae Epidemiology Marburg – Africa Case fatality – 23-33% Ebola - Sudan, Zaire and Côte d'Ivoire – Africa Case fatality – 53-88% Ebola – Reston – Philippines Pattern of disease is UNKOWN Filoviridae Humans: Center for Food Security and Public Health Iowa State University - 2004 Filoviridae Humans Most severe hemorrhagic fever Incubation period: 4–10 days Abrupt onset Fever, chills, malaise, and myalgia Hemorrhage and DIC Death around day 7–11 Painful recovery Filoviridae Animals: Center for Food Security and Public Health Iowa State University - 2004 Filoviridae Animals Hemorrhagic fever Same clinical course as humans Ebola Reston High primate mortality - ~82% Flaviviridae: Flaviviridae Dengue virus Yellow Fever virus Omsk Hemorrhagic Fever virus Kyassnur Forest Disease virus Flaviviridae History: Center for Food Security and Public Health Iowa State University - 2004 Flaviviridae History 1648 : Yellow Fever described 17 th –20 th century Yellow Fever and Dengue outbreaks 1927: Yellow Fever virus isolated 1943: Dengue virus isolated 1947 Omsk Hemorrhagic Fever virus isolated 1957: Kyasanur Forest virus isolated Flaviviridae Transmission: Center for Food Security and Public Health Iowa State University - 2004 Flaviviridae Transmission Arthropod vector Yellow Fever and Dengue viruses Aedes aegypti Sylvatic cycle Urban cycle Kasanur Forest Virus Ixodid tick Omsk Hemorrhagic Fever virus Muskrat urine, feces, or blood Flaviviridae Epidemiology: Center for Food Security and Public Health Iowa State University - 2004 Flaviviridae Epidemiology Yellow Fever Virus – Africa and Americas Case fatality rate – varies Dengue Virus – Asia, Africa, Australia, and Americas Case fatality rate – 1-10% Kyasanur Forest virus – India Case fatality rate – 3–5% Omsk Hemorrhagic Fever virus – Europe Case fatlity rate – 0.5–3% Flaviviridae Humans: Center for Food Security and Public Health Iowa State University - 2004 Flaviviridae Humans Yellow Fever Incubation period – 3–6 days Short remission Dengue Hemorrhagic Fever Incubation period – 2–5 days Infection with different serotype Kyasanur Forest Disease Omsk Hemorrhagic Fever Lasting sequela Flaviviridae Animals: Center for Food Security and Public Health Iowa State University - 2004 Flaviviridae Animals Yellow Fever virus Non-human primates – varying clinical signs Dengue virus Non-human primates – No symptoms Kyasanur Forest Disease Virus Livestock – No symptoms Omsk Hemorrhagic Fever Virus Rodents – No symptoms Disease in Humans: Disease in Humans Clinical Symptoms: Center for Food Security and Public Health Iowa State University - 2004 Clinical Symptoms Differ slightly depending on virus Initial symptoms Marked fever Fatigue Dizziness Muscle aches Exhaustion Clinical Symptoms: Center for Food Security and Public Health Iowa State University - 2004 Clinical Symptoms More severe Bleeding under skin Petechiae, echymoses, conjunctivitis Bleeding in internal organs Bleeding from orifices Blood loss rarely cause of death Diagnosis: Center for Food Security and Public Health Iowa State University - 2004 Diagnosis Specimens must be sent to CDC U.S. Army Medical Research Institute of Infectious Disease (USAMRIID) Serology PCR IHC Viral isolation Electron microscopy Treatment: Center for Food Security and Public Health Iowa State University - 2004 Treatment Supportive treatment Ribavirin Not approved by FDA Effective in some individuals Arenaviridae and Bunyaviridae only Convalescent-phase plasma Argentine HF, Bolivian HF and Ebola Strict isolation of affected patients is required Report to health authorities Prevention and Control: Prevention and Control Prevention and Control: Center for Food Security and Public Health Iowa State University - 2004 Prevention and Control Avoid contact with host species Rodents Control rodent populations Discourage rodents from entering or living in human populations Safe clean up of rodent nests and droppings Insects Use insect repellents Proper clothing and bed nets Window screens and other barriers to insects Prevention and Control: Center for Food Security and Public Health Iowa State University - 2004 Prevention and Control Vaccine available for Yellow fever Experimental vaccines under study Argentine HF, Rift Valley Fever, Hantavirus and Dengue HF If human case occurs Decrease person-to-person transmission Isolation of infected individuals Prevention and Control: Center for Food Security and Public Health Iowa State University - 2004 Prevention and Control Protective clothing Disposable gowns, gloves, masks and shoe covers, protective eyewear when splashing might occur, or if patient is disoriented or uncooperative WHO and CDC developed manual “Infection Control for Viral Hemorrhagic Fevers In the African Health Care Setting” PowerPoint Presentation: Center for Food Security and Public Health Iowa State University - 2004 Protective equipment worn by a nurse during Ebola outbreak in Zaire, 1995 Prevention and Control: Center for Food Security and Public Health Iowa State University - 2004 Prevention and Control Anyone suspected of having a VHF must use a chemical toilet Disinfect and dispose of instruments Use a 0.5% solution of sodium hypochlorite (1:10 dilution of bleach) VHF Agents as Biological Weapons: Center for Food Security and Public Health Iowa State University - 2004 VHF Agents as Biological Weapons Outbreak of undifferentiated febrile illness 2-21 days following attack Could include Rash, hemorrhagic diathesis and shock Diagnosis could be delayed Unfamiliarity Lack of diagnostic tests Ribavirin treatment may be beneficial VHF Agents as Biological Weapons: Center for Food Security and Public Health Iowa State University - 2004 VHF Agents as Biological Weapons Most are not stable in dry form Most have uncertain stability and effectiveness in aerosol form Arenaviruses have tested effectiveness in aerosol form Marburg and Ebola have high case fatality rates Rift Valley is the most stable VHF in liquid or frozen state VHFs do pose a threat as aerosolized agents Acknowledgments: Center for Food Security and Public Health Iowa State University - 2004 Acknowledgments Development of this presentation was funded by a grant from the Centers for Disease Control and Prevention to the Center for Food Security and Public Health at Iowa State University. Acknowledgments: Center for Food Security and Public Health Iowa State University - 2004 Acknowledgments Author: Co-authors: Jamie Snow, DVM, MPH Radford Davis, DVM, MPH Stacy Holzbauer, DVM

Related presentations


Other presentations created by johngeorge22

Dandruff
08. 08. 2014
0 views

Dandruff

ACUTE KIDNEY FAILURE
14. 08. 2014
0 views

ACUTE KIDNEY FAILURE

Gas And Gas Pain
26. 08. 2014
0 views

Gas And Gas Pain

Acute Liver Failure
22. 09. 2014
0 views

Acute Liver Failure