Venezuelan hemorrhagic fever

Venezuelan Hemorrhagic Fever (VHF) Description

Venezuelan hemorrhagic fever, caused by the Guanarito virus, is a viral hemorrhagic disease characterized by:

• Fever: High fever is one of the primary symptoms, often accompanied by chills and malaise [7].
• Headache and muscle pain: Patients typically experience headache and muscle pain, which can be severe [8].
• Arthralgia and sore throat: Joint pain (arthralgia) and a sore throat are also common symptoms [5, 9].
• Vomiting, abdominal pain, diarrhea: Some patients may experience vomiting, abdominal pain, and diarrhea [8, 9].
• Convulsions and hemorrhagic manifestations: In severe cases, convulsions and hemorrhagic manifestations such as bleeding gums can occur [9].

The disease is often preceded by an incubation period of 1-4 weeks, after which the symptoms abruptly onset. The Guanarito virus is primarily spread through inhalation of aerosolized particles from infected rodents, specifically the short-tailed cane mouse (Zygodontomys brevicauda) [2].

References:

[2] Context result 1 [5] Context result 3 [7] Context result 8 [9] Context results 8 and 9

Early Clinical Signs

Venezuelan hemorrhagic fever (VHF) typically begins with flu-like symptoms, which can progress to more severe signs and symptoms. According to various sources [2, 3, 7], early clinical signs include:

• Fever
• Mild hemorrhagic signs
• Nonspecific symptoms such as headache, arthralgia, sore throat, vomiting, abdominal pain, diarrhea, convulsions
• Thrombocytopenia (low platelet count)
• Leukopenia (low white blood cell count)

Progression of Symptoms

As the disease progresses [4, 6], symptoms may include:

• Low blood pressure
• Sustained fever
• Sweats
• Rash
• Diarrhea
• Swelling around the eyes
• Flushing and redness of the eyes

Common Initial Symptoms

According to a study published in December 2023 [7], initial symptoms (day 0 to 4) are mild and may include:

• Fever (93%)
• Malaise (75%)
• Headache (58%)
• Sore throat (36%)
• Vomiting (34%)

Severe Symptoms

In severe cases, symptoms can become life-threatening and may include:

• Bleeding under the skin, inside the body or from the mouth, eyes or ears [11]

It's essential to note that these symptoms can vary by disease, but in general, patients with VHF present with abrupt onset of fever, headache, myalgias, and prostration, followed by more severe signs and symptoms [8].

Diagnostic Tests for Venezuelan Hemorrhagic Fever

Venezuelan hemorrhagic fever (VHF) can be diagnosed through various tests, including:

• Reverse transcription PCR (RT-PCR): This test detects the genetic material of the Guanarito virus in a patient's blood or serum. RT-PCR is a sensitive and specific method for diagnosing VHF [4].
• Antigen detection: This test detects the presence of viral antigens in a patient's blood or serum, which can indicate an active infection.
• Virus isolation: This test involves growing the virus from a patient's sample in a laboratory, which can confirm the diagnosis.
• Serological tests: These tests detect the presence of specific antibodies against the Guanarito virus in a patient's blood. Serological tests can be used to confirm a diagnosis or rule out VHF [9].

Additional Diagnostic Methods

In addition to these tests, diagnostic teams for Venezuelan hemorrhagic fever may include infectious disease specialists who can provide guidance on diagnosis and treatment [10]. It is essential to note that the diagnosis of VHF can be challenging, and a combination of clinical features, travel history, and laboratory results should be considered when making a diagnosis.

References

• RT-PCR tests have been validated for some diseases, including Lassa fever, which is caused by another arenavirus [7].
• The Guanarito virus, responsible for VHF, can be detected using RT-PCR assays that have proved to be specific and sensitive [2].
• Serological tests can detect the presence of specific IgM antibodies against the Guanarito virus, which can confirm a diagnosis [9].

Venezuelan Hemorrhagic Fever (VHF) Drug Treatment

Venezuelan hemorrhagic fever, also known as Guanarito virus disease, is a severe and potentially life-threatening viral infection. While there are no specific antiviral therapies available for VHF, treatment typically focuses on supportive care to manage symptoms and prevent complications.

• Supportive Care: The primary goal of treatment is to provide supportive care, including analgesia (pain relief) and fluids, to help manage symptoms such as fever, headache, and muscle pain [1].
• Ribavirin: However, once infected with VHF, ribavirin, an anti-viral drug given intravenously, can be used as a treatment option. Ribavirin has been shown to reduce mortality from Lassa fever, another type of viral hemorrhagic fever [5].

It's essential to note that the availability and effectiveness of these treatments may vary depending on the specific circumstances and location.

References:

[1] CR Silva-Ramos · 2022 · Cited by 15 — No antiviral therapies are available; thus, treatment includes only supportive analgesia and fluids. GTOV is transmitted by contact with the excreta of its ...

[5] by BB Gowen · 2011 · Cited by 46 — The broad-spectrum antiviral drug ribavirin was shown to reduce mortality from Lassa fever, and has been tested against Argentine HF, but it is not an approved ...

Differential Diagnosis of Venezuelan Hemorrhagic Fever (VHF)

Venezuelan hemorrhagic fever (VHF) is a viral disease caused by the Guanarito virus, which can be challenging to diagnose due to its similarities with other febrile illnesses. The differential diagnosis for VHF includes several conditions that present with similar symptoms.

Similar Conditions:

• Lassa Fever: A viral hemorrhagic fever caused by the Lassa virus, which is also an arenavirus. Like VHF, it presents with fever, mild hemorrhagic signs, nonspecific symptoms, thrombocytopenia, and leukopenia [2].
• Argentine Hemorrhagic Fever: Caused by the Junin virus, this disease shares similarities with Lassa fever and VHF in terms of its clinical presentation [6].
• Bolivian Hemorrhagic Fever: Another arenaviral hemorrhagic fever caused by the Machupo virus, which presents with similar symptoms to VHF [1].

Other Conditions:

• Icterohaemorrhagic Fevers: These fevers can be caused by other pathogens and present with overlapping areas of endemism with VHF. The differential diagnosis in Venezuela includes other clinically relevant conditions such as yellow fever and dengue fever [4].
• Systemic Infections: GTOV, the causative agent of Venezuelan hemorrhagic fever, can cause systemic infection with hemorrhagic features. Initial symptoms may include fever, which can