Viral Hemorrhagic Fever

By | June 10, 2022

Viral haemorrhagic fever is a collective term for viral diseases associated with high fever and internal bleeding. Four different groups of viruses are responsible for these diseases, but they are related to each other. At present, a viral hemorrhagic fever that has broken out cannot be treated causally.

What is Viral Hemorrhagic Fever?

Viral hemorrhagic fever refers to a group of virus-related infectious diseases, the main symptom of which is a combination of high fever and severe internal bleeding. Strictly speaking, this group of diseases includes very serious, highly contagious and life-threatening infections. In a broader sense, milder forms of the disease are also included in which the transmission path is not direct but via vectors. For cretinism explanation, please visit

There are four groups of pathogens that can cause viral hemorrhagic fever. These include the families of the Arenaviridae, the Bunyaviridae, the Filoviridae and the Flaviviridae. These virus families are partly related to each other. All corresponding pathogens are RNA viruses. Among other things, the Arenaviridae are responsible for triggering Lassa fever and other hemorrhagic fevers.

Most carriers are rodents. Bunyaviridae, in turn, are mainly transmitted by insects such as mosquitoes, gnats, sand flies or others. They trigger various forms of Hanta fever as well as Rift Valley fever (RVF) or Crimean-Congo fever (CCHF). The Filoviridae cause Ebola or Marburg fever. Yellow fever, dengue fever, West Nile fever, Kyasanur forest fever or Omsk fever (OHF) are caused by the Flaviviridae family.


All causative agents of viral hemorrhagic fever were originally transmitted from animals to humans. These are so-called zoonoses. Carriers of these viruses are mainly monkeys, rodents, bats and also pets. The animals themselves do not fall ill with hemorrhagic fever because their immune systems are adapted to these viruses. However, humans are false hosts and come into contact with the pathogens for the first time.

This results in violent defense reactions that can lead to high fever and destruction of the blood vessels. However, there are also infections that are silent. Insects such as mosquitoes or ticks can often be used as transmitters from animals to humans. But eating infected animals often leads to an infection. The disease can also be triggered by contact with infected animal feces or urine.

This is especially true for Lassa fever. Some hemorrhagic fevers can also be transmitted directly from person to person. This occurs, among other things, via droplet infection, stool, urine, vomit, sweat or even blood contacts. The higher the viral load of a patient, the higher the infectivity.

The high level of infectivity means, among other things, that many new infections occur in hospitals. Therefore, the highest hygiene and safety measures are required. Infected people must be strictly isolated to prevent the disease from spreading.

Symptoms, Ailments & Signs

Although the diseases and pathogens are different, all infections have high fever, internal bleeding and kidney and liver dysfunction with edema in common. The bleeding is caused by so-called capillary leakage (destruction of capillary blood vessels). Bruises appear all the time. Stool and urine are often bloody.

It can lead to circulatory collapse, shock, convulsions or even paralysis. The prognosis of the disease worsens due to heavy bleeding and inflammatory diseases of the meninges or the brain. If the patient survives the disease, they often suffer from neurological sequelae such as hearing loss.

However, not all infections lead to hemorrhagic fever. There are even patients who are asymptomatic. Different courses of the disease are also possible within a specific infection. However, diseases such as Ebola or Marburg fever almost always show the symptoms of a hemorrhagic fever. Up to 90 percent of those affected do not survive these infections.

Diagnosis & course of disease

The investigation of a viral haemorrhagic fever must be carried out under high security conditions to avoid transmission of the pathogens. The virus can be diagnosed in the blood, urine, or saliva . First, differential diagnoses against malaria and bacterial infections must be made. By clearly identifying the virus, the corresponding disease can be diagnosed.


Depending on the type and severity of the disease, viral hemorrhagic fever can cause various complications. What the various diseases and pathogens have in common is high fever, kidney and liver dysfunction and internal bleeding. If internal bleeding is not stopped immediately, the loss of blood can cause anemia with deficiency symptoms and the risk of shock.

If the course is severe, the fever can have life-threatening consequences, for example cardiac arrhythmia and circulatory failure. Cramps and symptoms of paralysis cannot be ruled out in the event of a severe course. If an inflammatory disease of the meninges occurs, this can result in blood poisoning. This can result in septic shock and acute circulatory failure.

Organ failure, brain abscesses and neurological damage can also occur. A viral hemorrhagic fever is usually associated with sequelae such as hearing loss and neurological deficits. Treatment is usually uneventful.

However, antipyretic drugs can cause side effects and lead to circulatory problems, for example. If an infusion is placed to regulate the fluid and nutrient balance, inflammation sometimes occurs at the injection site. In individual cases, the patient reacts allergically to the materials and substances used.

When should you go to the doctor?

Persistent or increasing fever is basically a complaint that needs to be clarified by a doctor. A greatly increased body temperature can be understood as a warning signal from the organism. Since there is a risk of infection in a large number of cases, precautions must be taken to ensure that people in the immediate vicinity are not affected. If there is a feeling of inner weakness, inner dryness and heat development, the affected person needs immediate medical help. In case of a circulatory collapse, a state of shock or severe convulsions, a hospital must be visited. In acute cases, an emergency service must be alerted immediately. Until his arrival, first aid measures must be taken to ensure the survival of the victim.

Hearing or vision disorders as well as a lack of concentration and attention are warning signals from the organism. If there is disorientation, there is an acute need for action. Mobility restrictions, pain, signs of paralysis and muscle problems must be examined and treated. Changes in the skin’s appearance and the development of bruises are other complaints that need to be discussed during a doctor’s visit. Sudden bleeding when going to the toilet, loss of appetite and signs of confusion require medical attention. Since the person affected is in a life-threatening situation with viral hemorrhagic fever, it is necessary for the people present to react as quickly as possible.

Treatment & Therapy

A causal treatment of viral hemorrhagic fever is not yet possible. Only symptomatic therapy can be carried out. This therapy consists of antipyretic measures, extensive intensive medical care and regulation of the glucose, water and electrolyte balance.

It is also important to protect hospital staff from infection. Safety measures and patient isolation are mandatory during treatment. The antiviral agent ribavirin is also effective against hantavirus and adenoviruses. However, this only applies to the initial stage of the respective infection. The other viruses do not respond to the active ingredient.


Prevention of a viral hemorrhagic fever consists above all in measures to protect against transmitting insects. The consumption of raw meat in infected areas should also be avoided. Furthermore, the basic hygiene rules must be observed. Physical contact with sick people must be avoided at all costs.

Medical staff in particular must protect themselves from infection by wearing protective clothing and respiratory masks. According to the Infection Protection Act (IfSG) in Germany, there is a general obligation to report suspected hemorrhagic fever in order to take appropriate quarantine measures. Isolation of affected patients is mandatory. There is already a vaccine against yellow fever. To prevent other diseases with viral hemorrhagic fever, intensive research is currently being carried out on vaccines.

Viral haemorrhagic fevers (AF) include tropical diseases such as Ebola, yellow fever, dengue fever or Marburg fever. They are associated with internal and external bleeding. The prognosis is different for each fever. Some are benign and usually heal without consequences, others are considered life-threatening. With Ebola, the mortality rate can be as high as 90 percent. Every viral hemorrhagic fever must be treated medically, and the diseases in Germany are notifiable. Follow-up care is necessary to stabilize the patient’s condition and avoid consequential damage.


In the case of viral hemorrhagic fevers, the patient’s vital functions must be closely monitored. These measures have priority in the treatment. Appropriate medication can help against pain, and transfusions are necessary if there is a high level of blood loss. Antipyretics are also given.

Even after the treatment has been completed, a doctor (ideally a tropical medicine specialist) continues to provide follow-up care. It is only stopped when the patient is no longer infectious. If the symptoms worsen or the fever breaks out again unexpectedly, treatment and follow-up are restarted. If the patient was treated successfully and is no longer considered contagious, the doctor ends the therapy. If damage to the internal organs remains, the follow-up care is long-term and can last for years.

You can do that yourself

Viral hemorrhagic fever requires immediate medical attention. If the symptoms occur during a trip to the risk areas, the trip must be canceled. If possible, a German doctor who can treat the disease accordingly should be consulted.

Symptomatic therapy is supported by rest, a change in diet and observation of the symptoms. First of all, it is important to drink plenty of fluids to prevent dehydration. The diet consists of bland foods such as rusks or chicken broth. Irritating foods and stimulants such as alcohol or nicotine must be avoided at all costs. Rest and bed rest are also important. The fever can be brought down with leg wraps, ice packs, and other well-known home remedies. Cooling applications should be avoided if you have chills or a high fever.

Sick infants or small children must also not be treated independently. Staying in a children’s hospital is necessary for effective treatment of viral hemorrhagic fever. If the body temperature continues to rise, the doctor must be informed. If the course is positive, it is important to slowly cure the fever. In addition, regular visits to the doctor are indicated.

Viral Hemorrhagic Fever