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ViralHemorrhagicFever广州网站建立020WhatisViral

HemorrhagicFever?Severemultisystemsyndrome

DamagetooverallvascularsystemSymptomsoftenaccompaniedbyhemorrhageRarelylifethreateninginitselfIncludesconjunctivitis,petechia,echymosisCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004OverviewOrganismHistoryEpidemiologyTransmissionDiseaseinHumansDiseaseinAnimalsPreventionandControlCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004TheOrganismsViralHemorrhagicFeverVirusesoffourdistinctfamiliesArenavirusesFilovirusesBunyavirusesFlavivirusesRNAvirusesEnvelopedinlipidcoatingSurvivaldependentonananimalorinsecthost,forthenaturalreservoirCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004ClassificationArenaviridaeBunyaviridaeFiloviridaeFlaviviridaeJuninCrimean-CongoH.F.EbolaKyasanurForestDiseaseMachupoHantavirusMarburgOmskH.F.SabiaRiftValleyfeverYellowFeverGuanaritoDengueLassaCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004ArenaviridaeJuninvirusMachupovirusGuanaritovirusLassavirusSabiavirusArenaviridaeHistoryFirstisolatedin19331958:Juninvirus-ArgentinaFirsttocausehemorrhagicfeverArgentinehemorrhagicfever1963:Machupovirus–BoliviaBolivianhemorrhagicfever1969:Lassavirus–NigeriaLassafeverCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004ArenaviridaeTransmissionVirustransmissionandamplificationoccursinrodentsShedvirusthroughurine,feces,andotherexcretaHumaninfectionContactwithexcretaContaminatedmaterialsAerosoltransmissionPerson-to-persontransmissionCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004ArenaviridaeEpidemiologyAfricaLassaSouthAmericaJunin,Machupo,Guanarito,andSabiaContactwithrodentexcretaCasefatality:5–35%ExplosivenosicomialoutbreakswithLassaandMachupoCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004ArenaviridaeinHumansIncubationperiod10–14daysFeverandmalaise2–4daysHemorrhagicstageHemorrhage,leukopenia,thrombocytopeniaNeurologicsignsCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004BunyaviridaeRiftValleyFevervirusCrimean-CongoHemorrhagicFevervirusHantavirusBunyaviridaeHistory1930:RiftValleyFever–EgyptEpizooticinsheep1940s:CCHF-CrimeanpeninsulaHemorrhagicfeverinagriculturalworkers1951:Hantavirus–KoreaHemorrhagicfeverinUNtroops5generawithover350virusesCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004BunyaviridaeTransmissionArthropodvectorException–HantavirusesRVF–AedesmosquitoCCHF–IxodidtickHantavirus–RodentsLesscommonAerosolExposuretoinfectedanimaltissueCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004BunyaviridaeEpidemiologyRVF-AfricaandArabianPeninsula1%casefatalityrateCCHF-Africa,EasternEurope,Asia30%casefatalityrateHantavirus-NorthandSouthAmerica,EasternEurope,andEasternAsia1-50%casefatalityrateCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004BunyaviridaeHumansRVFIncubationperiod–2-5days0.5%-HemorrhagicFeverCCHFIncubationperiod–3-7daysHemorrhagicFever-3–6daysfollowingclinicalsignsHantavirusIncubationperiod–7–21daysHPSandHFRSCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004BunyaviridaeAnimalsRVFAbortion–100%Mortalityrate>90%inyoung5-60%inolderanimalsCCHFUnapparentinfectioninlivestockHantavirusesUnapparentinfectioninrodentsCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FiloviridaeMarburgvirusEbolavirusFiloviridaeHistory1967:MarburgvirusEuropeanlaboratoryworkers1976:EbolavirusEbolaZaireEbolaSudan1989and1992:EbolaRestonUSAandItalyImportedmacaquesfromPhilippines1994:EbolaCôted'IvoireCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FiloviridaeTransmissionReservoirisUNKNOWNBatsimplicatedwithMarburgIntimatecontactNosicomialtransmissionReuseofneedlesandsyringesExposuretoinfectioustissues,excretions,andhospitalwastesAerosoltransmissionPrimatesCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FiloviridaeEpidemiologyMarburg–AfricaCasefatality–23-33%Ebola-Sudan,ZaireandCôted'Ivoire–AfricaCasefatality–53-88%Ebola–Reston–PhilippinesPatternofdiseaseisUNKOWNCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FiloviridaeHumansMostseverehemorrhagicfeverIncubationperiod:4–10daysAbruptonsetFever,chills,malaise,andmyalgiaHemorrhageandDICDeatharoundday7–11PainfulrecoveryCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FiloviridaeAnimalsHemorrhagicfeverSameclinicalcourseashumansEbolaRestonHighprimatemortality-~82%CenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FlaviviridaeDenguevirusYellowFevervirusOmskHemorrhagicFevervirusKyassnurForestDiseasevirusFlaviviridaeHistory1648:YellowFeverdescribed17th–20thcenturyYellowFeverandDengueoutbreaks1927:YellowFevervirusisolated1943:Denguevirusisolated1947OmskHemorrhagicFever virusisolated1957:KyasanurForestvirus isolatedCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FlaviviridaeTransmissionArthropodvectorYellowFeverandDenguevirusesAedesaegyptiSylvaticcycleUrbancycleKasanurForestVirusIxodidtickOmskHemorrhagicFevervirusMuskraturine,feces,orbloodCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FlaviviridaeEpidemiologyYellowFeverVirus–AfricaandAmericasCasefatalityrate–variesDengueVirus–Asia,Africa,Australia,andAmericasCasefatalityrate–1-10%KyasanurForestvirus–IndiaCasefatalityrate–3–5%OmskHemorrhagicFevervirus– EuropeCasefatlityrate–0.5–3%CenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FlaviviridaeHumansYellowFeverIncubationperiod–3–6daysShortremissionDengueHemorrhagicFeverIncubationperiod–2–5daysInfectionwithdifferentserotypeKyasanurForestDiseaseOmskHemorrhagicFeverLastingsequelaCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004FlaviviridaeAnimalsYellowFevervirusNon-humanprimates–varyingclinicalsignsDenguevirusNon-humanprimates–NosymptomsKyasanurForestDiseaseVirusLivestock–NosymptomsOmskHemorrhagicFeverVirusRodents–NosymptomsCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004DiseaseinHumansClinicalSymptomsDifferslightlydependingonvirusInitialsymptomsMarkedfeverFatigueDizzinessMuscleachesExhaustionCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004ClinicalSymptomsMoresevereBleedingunderskinPetechiae,echymoses,conjunctivitisBleedingininternalorgansBleedingfromorificesBloodlossrarelycauseofdeathCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004DiagnosisSpecimensmustbesenttoCDCU.S.ArmyMedicalResearchInstituteofInfectiousDisease(USAMRIID)SerologyPCRIHCViralisolationElectronmicroscopyCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004TreatmentSupportivetreatmentRibavirinNotapprovedbyFDAEffectiveinsomeindividualsArenaviridaeandBunyaviridaeonlyConvalescent-phaseplasmaArgentineHF,BolivianHFandEbolaStrictisolationofaffectedpatientsisrequiredReporttohealthauthoritiesCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004PreventionandControlPreventionandControlAvoidcontactwithhostspeciesRodentsControlrodentpopulationsDiscouragerodentsfromenteringorlivinginhumanpopulationsSafecleanupofrodentnestsanddroppingsInsectsUseinsectrepellentsProperclothingandbednetsWindowscreensandotherbarrierstoinsectsCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004PreventionandControlVaccineavailableforYellowfeverExperimentalvaccinesunderstudyArgentineHF,RiftValleyFever,HantavirusandDengueHFIfhumancaseoccursDecreaseperson-to-persontransmissionIsolationofinfectedindividualsCenterforFoodSecurityandPublicHealthIowaStateUniversity-2004PreventionandControlProtectiveclothingDisposablegowns,gloves,masksandshoecovers,protectiveeyewearwhensplashingmightoccur,orifpatientisdisorientedoruncooperativeWHOandCDCdevelopedmanual“InfectionControlforViralHemorrhagicFeversIntheAfricanHealthCareSetting〞CenterforFoodSecurityandPublicHealthIowaStateUniversity-2004ProtectiveequipmentwornbyanurseduringEbolaoutbreakinZaire,1995CenterforFoodSecurityandPublicHealthIowaStateUniversity-2004PreventionandControlAnyonesuspectedofhavingaVHFmustuseachemicaltoiletDisinfectanddisposeofinstrumentsUsea0.5%solutionofsodiumhypochlorite(1:10dilutionofbleach)CenterforFoodSecurityandPublicHealthIowaStateUniversity-2004VHFAgentsas

BiologicalWeaponsOutbreakofundifferentiatedfebrileillness2-21daysfollowingattackCouldincludeRash,hemorrh