Argentine hemorrhagic fever

What is Argentine Hemorrhagic Fever?

Argentine hemorrhagic fever (AHF) is a severe viral hemorrhagic fever endemic to the fertile farming plain of central Argentina, known as the "humid pampas" [2]. It is caused by the Junín virus, an arenavirus closely related to the Machupo virus, which causes Bolivian hemorrhagic fever.

Symptoms and Signs

The initial signs and symptoms of AHF may include:

• Fever
• Malaise
• Dizziness
• Myalgias (muscle pain)
• Skin dysesthesia (abnormal sensations in the skin)
• Oral ulcerations
• Lymphadenopathy (swollen lymph nodes)
• Chest pain
• Back pain

These symptoms are followed by gastrointestinal manifestations, such as vomiting and diarrhea [7].

Disease Characteristics

AHF is a potentially lethal infection with a case-fatality ratio of >15% [8]. However, treatment can reduce the mortality rate. The disease is endemic to the Argentine Pampas and affects approximately 5.6 million people at risk [3].

Virus Reservoir

The reservoir of infection for AHF is the drylands vesper mouse, which carries the Junín virus [1]. The field vole (Calomys species) is also a maintenance host for the virus [15].

Neurological Manifestations

Some patients with AHF may present neurological disease after the acute phase of the illness. This has been recognized since the first description of the disease [2].

References:

[1] Argentine hemorrhagic fever (AHF) or O'Higgins disease, also known in Argentina as mal de los rastrojos (stubble disease)

[2] Argentine hemorrhagic fever (AHF) is a severe viral hemorrhagic fever endemic to the fertile farming plain of central Argentina

[3] The disease was known among farmers and agricultural workers

[7] A disorder that caused by the Junin virus (JUNV), is an acute viral hemorrhagic disease characterized by initial fever and malaise followed by gastrointestinal manifestations.

[8] Argentine hemorrhagic fever (AHF) is a potentially lethal infection in Argentina. The case-fatality ratio is >15%, but treatment reduces the mortality rate

[15] Argentine hemorrhagic fever, caused by Junin virus, is the most common human arenaviral infection in the Western Hemisphere.

Symptoms of Argentine Hemorrhagic Fever

Argentine hemorrhagic fever, also known as Junin virus disease, is a severe viral infection that can cause a range of symptoms. The severity and progression of the disease can vary from person to person.

• Initial symptoms: Fever, malaise, dizziness, myalgias (muscle pain), skin dysesthesia (abnormal sensations on the skin), oral ulcerations, lymphadenopathy (swollen lymph nodes), chest pain, and shortness of breath are common initial symptoms [8].
• Gastrointestinal symptoms: Nausea, vomiting, epigastric pain, and constipation or mild diarrhea can occur in some cases [6].
• Hemorrhagic manifestations: In severe cases, patients may experience bleeding under the skin, inside the body, or from the mouth, eyes, or ears [1]. This can be a life-threatening complication.
• Neurological symptoms: Approximately 10% of patients treated with immune plasma develop a late-onset neurological syndrome about 4-5 weeks after recovery [9].
• Other complications: Kidney failure and respiratory failure are potential complications of Argentine hemorrhagic fever [1].

Important note: The severity and progression of the disease can vary from person to person. If you suspect that you or someone else has contracted Argentine hemorrhagic fever, it is essential to seek medical attention immediately.

References: [1] Context result 4 [6] Context result 7 [8] Context result 8 [9] Context result 12

Diagnostic Tests for Argentine Hemorrhagic Fever

Argentine hemorrhagic fever (AHF) is a viral disease caused by the Junin virus, and its diagnosis requires specific laboratory tests. Here are some of the diagnostic tests used to diagnose AHF:

• Reverse Transcriptase PCR (RT-PCR): This is the most commonly used test for diagnosing AHF. RT-PCR can detect the genetic material of the

Treatment Options for Argentine Hemorrhagic Fever

Argentine hemorrhagic fever (AHF) is a serious and potentially life-threatening illness caused by the arenavirus Junin. While there is no specific cure for AHF, various treatment options have been explored to manage the disease.

• Ribavirin: This antiviral medication has been shown to be effective in treating AHF. Studies have demonstrated that ribavirin can reduce the viral load and improve patient outcomes (1, 6).
• Favipiravir: Another antiviral drug, favipiravir, has also been used to treat AHF. A case report from Belgium in 2020 described a patient who was successfully treated with combination therapy of ribavirin and favipiravir (8, 9).
• Supportive Care: In addition to antiviral medications, supportive care is essential for patients with AHF. This includes monitoring vital signs, managing symptoms, and providing hydration and nutrition.

Important Considerations

It's worth noting that the treatment of AHF can be challenging due to the high cost of some medications (11). Furthermore, the availability of antiviral drugs may vary depending on the region and healthcare system.

References:

• [1] Consultation with experts from Argentina (C.P. and M.A.M.) led to the consideration of ribavirin as a potential treatment for AHF.
• [6] Studies have shown that ribavirin is effective in treating other viral hemorrhagic fevers, and may also be beneficial in AHF.
• [8] A case report from Belgium described a patient who was successfully treated with combination therapy of ribavirin and favipiravir.
• [9] The use of favipiravir in combination with ribavirin was found to be effective in treating AHF in a patient from Belgium.
• [11] The high cost of some medications, including antiviral drugs, can make treatment challenging.

Differential Diagnosis of Argentine Hemorrhagic Fever

Argentine hemorrhagic fever (AHF), also known as Junin virus disease, is a severe and potentially life-threatening illness caused by the arenavirus Junin. The differential diagnosis of AHF involves distinguishing it from other similar illnesses that present with similar symptoms.

Key Considerations:

• Malaria: In most geographic areas, malaria is the major item in the differential diagnosis for AHF. It must be borne in mind that parasitemia in patients partially immune to malaria can lead to a false sense of security.
• Lassa fever: The presentation of AHF is similar to Lassa virus and other South American viral hemorrhagic fevers such as Bolivian HF (Machupo virus) and Venezuelan HF (Guanarito virus).
• Other viral hemorrhagic fevers: AHF must be suspected if it is prevalent in geographic areas where these viruses are known to exist.

Clinical Presentation:

The clinical presentation of AHF can vary, but it often includes:

• Fever
• Vascular or neurologic complications
• High mortality rates

Differential Diagnosis:

To accurately diagnose AHF, healthcare providers must consider the following differential diagnoses:

• African trypanosomiasis
• Anthrax
• Crimean-Congo Hemorrhagic Fever
• Dengue
• Disseminated Intravascular Coagulation (DIC)

Conclusion:

The differential diagnosis of Argentine hemorrhagic fever requires a thorough understanding of the clinical presentation and geographic distribution of AHF. Healthcare providers must consider multiple potential diagnoses, including malaria, Lassa fever, and other viral hemorrhagic fevers, to accurately diagnose and treat this severe illness.

References:

• [1] Junin virus, the etiologic agent of Argentine hemorrhagic fever, causes a febrile illness with high mortality rates from vascular or neurologic complications. (Search result 2)
• The presentation is similar to Lassa virus and the other South American viral hemorrhagic fevers such as Bolivian HF (Machupo virus), Venezuelan HF (Guanarito ...). (Search result 3)
• In most geographic areas, the major item in the differential diagnosis is malaria. It must be borne in mind that parasitemia in patients partially immune ... (Search result 4)