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INTRODUCTION

Viral hemorrhagic fevers (VHFs) are a diverse group of diseases and include dozens of viruses (Table 302-1). The diseases they cause are either endemic or episodic, with both annual cycles and longer secular trends. Some are associated with high lethality and potential for person-to-person transmission. The challenges for clinicians evaluating suspect cases are to exclude more likely conditions that are potentially life-threatening and treatable (especially malaria and typhoid fever); narrow the differential diagnosis based on the travel history; institute appropriate precautions for the diseases in the narrowed differential that are associated with person-to-person transmission; and seek expert guidance for diagnostic confirmation and treatment guidelines.

TABLE 302-1FEATURES OF VIRAL HEMORRHAGIC FEVERS

PATHOGENESIS AND EPIDEMIOLOGY

The etiologic agents of this syndrome are lipid-enveloped ribonucleic acid (RNA) viruses and include dozens of members from 4 families of viruses: arenaviruses, filoviruses, bunyaviruses, and flaviviruses. All are zoonotic infections and reside in animal reservoirs or insect vectors as opposed to ...

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