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Hemorrhagic Fevers, Emergency Medicine

Fraser C. Mackay and Ben Osborne Reviewed 06/2017



Hemorrhagic fever describes a multisystem syndrome of vasocapillary permeability and/or organ dysfunction. Viral hemorrhagic fever (VHF) is caused by a distinct group of viruses, but...


Signs and Symptoms

  • Most common (>50%) symptoms:

    • Acute febrile illness

    • Malaise

    • Headache

    • Nausea/vomiting

    • Flushing

    • Diarrhea (nonbloody)

    • Abdominal pain

    • Myalgias

  • Less common (<30%) symptoms:

    • Gingival ...



  • Increasing globalization has increased frequency of imported cases of rare diseases.

  • Early detection of VHF, natural, or biologic attack is key to control an outbreak. Report to C...



Admission Criteria

Suspected cases of VHF, particularly those with suspected multisystem involvement/compromise 
  • Isolation precautions

  • ICU for signs of shock or multiorgan system fai...

Pearls and Pitfalls

  • EXTREME caution with volume resuscitation

  • Hemoconcentration and pulmonary involvement are RED FLAGS

  • Consider hemorrhagic viruses in your differential diagnosis when caring for a sick...

Additional Reading

  • Jeffs  B. A clinical guide to viral hemorrhagic fevers: Ebola, Marburg and Lassa. Trop Doct.  2006;36:1–4.

  • Mahanty  S, Bray  M. Pathogenesis of filoviral haemorrhagic fevers. La...



  • 065.4 Mosquito-borne hemorrhagic fever

  • 065.9 Arthropod-borne hemorrhagic fever, unspecified

  • 078.89 Other specified diseases due to viruses

  • 065.0 Crimean hemorrhagic fever [CHF Congo virus]

  • 060.9...

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