17973 Viral Hemorrhagic Fevers

Overview

Viral hemorrhagic fevers (say: VY-rul heh-MOR-aj-ik FEE-vers) are a group of rare but serious infections caused by viruses. They can cause fever, tiredness, and sometimes bleeding inside or outside the body. These viruses are usually passed to people by mosquitoes, ticks, or rodents, or through contact with the blood or body fluids of an infected person or animal. Good medical care helps many people recover.

No. Viral hemorrhagic fevers are very rare in most countries. Common infections such as flu, malaria, or urine infections are far more likely to cause a fever. Doctors may think about a viral hemorrhagic fever if someone has a high fever and bleeding after travelling to an affected area.

Anyone can catch one of these viruses if they are exposed to it, but it usually happens in regions where the virus is present, especially parts of Africa, South America, and Asia. Travellers, healthcare workers, and people caring for an infected person have the highest chance of exposure.

Symptoms

Common symptoms

• Fever and chills
• Headache and muscle aches
• Feeling extremely tired and weak
• Nausea, vomiting, or belly pain
• Red eyes, flushed face, or a red rash
• Bruising or tiny red spots on the skin
• Bleeding from the nose, gums, in vomit, urine, or stool

Symptoms in children

• Fever with fussiness or unusual sleepiness
• Drinking less than usual or refusing feeds
• Tiny red spots or bruises on the skin
• Nosebleeds or bleeding gums
• Vomiting or diarrhoea with trouble keeping fluids down

Symptoms in older adults

• High fever with confusion or drowsiness
• Feeling dizzy or faint when standing
• Breathing faster than usual
• Unusual bruising or bleeding
• Severe weakness, poor appetite, or not drinking enough

Causes

Main causes

• Infection with a virus from the hemorrhagic fever group, such as Ebola, Marburg, Lassa, dengue, yellow fever, or Crimean-Congo hemorrhagic fever virus
• Being bitten by an infected mosquito or tick
• Touching infected rodents, or their droppings and urine
• Contact with the blood, saliva, vomit, urine, or other body fluids of a person or animal infected with the virus

Risk factors

• Living in or travelling to areas where these viruses are found
• Working in healthcare or a laboratory without proper protective gear
• Caring for someone who is infected with a viral hemorrhagic fever
• Hunting or handling wild animals in affected regions
• Being bitten by mosquitoes or ticks in affected regions

When to see a doctor

See a doctor urgently if:

• Fever plus bleeding, bruising, or tiny red spots on the skin
• Fever plus confusion, a severe headache, or a stiff neck
• Fever with a rash after travelling to a high-risk area
• Bleeding that you cannot explain or that is slow to stop

Book a routine appointment if:

• Mild fever or flu-like symptoms that do not improve after a few days
• Fever and muscle aches after travelling to an area with hemorrhagic fevers
• Need advice before travelling, so you can plan how to prevent infections

Diagnosis

A doctor will ask about your symptoms, travel history, and any contact with sick people or animals. They will examine you carefully. Because the illness is rare, they will usually test for more common causes of fever first, such as flu or malaria. If a viral hemorrhagic fever is possible, the doctor will arrange specialist tests through a laboratory that can handle the samples safely.

Tests that may be done

• Blood tests to look for viruses or for how the body is responding to infection
• Tests for malaria, dengue, and other common causes of fever
• Blood tests to check liver, kidney, and blood clotting function
• Urine or saliva samples, if needed, collected and tested in a specialist laboratory

What to expect at your appointment

You may be asked to wear a face mask and stay in a separate room. Staff caring for you will wear protective clothing. This is standard safety practice, and it helps protect both you and others from possible spread. You may need to stay in hospital while test results come back. If the diagnosis is confirmed, a specialist infection team will guide your care.

Treatment

There is no single medicine that treats every viral hemorrhagic fever. Treatment is mainly supportive — helping your body stay strong while it fights the virus. This may include fluids through a drip, oxygen, fever and pain relief, and medicines to support blood pressure or organ function. For some of these viruses, specialist antiviral treatments are available. The care team will personalise the approach to your exact illness.

Self-care at home

• Rest and sleep as much as possible
• Drink plenty of clear fluids, unless a doctor tells you otherwise
• Use a cool cloth or fan to help with fever if this makes you more comfortable
• Only take medicines for fever or pain if a pharmacist or doctor says it is safe, and follow their advice — some painkillers can increase bleeding risk
• Wash your hands often and follow local advice about avoiding close contact with others while you recover

Medical treatments

In hospital, treatment may include fluids given through a small tube in your vein, medicines to lower fever and pain, blood pressure support, and blood products if you are bleeding heavily. Some people need oxygen or breathing support in an intensive care unit. For certain viruses, approved antiviral treatments can be used, and specialists will decide whether these are right for you.

When is surgery considered?

Surgery is not used for the infection itself. In rare cases of very severe internal bleeding, a specialist may perform a procedure to help stop the bleeding, but this would be decided by the medical team based on your situation.

Living with this condition

Recovery can take weeks or months. You may feel weak, tired, and lose your appetite. Follow your healthcare team's advice about rest, fluids, and returning to work or school. Do not travel again until your doctor says it is safe, and attend every follow-up appointment.

Lifestyle tips

• Build up your strength slowly with light daily activities
• Keep soap or hand sanitiser nearby and use it regularly
• Avoid close contact with unwell people until your doctor says it is safe
• Tell your healthcare team about any new or worrying symptoms

Diet and exercise

Eat small, nutritious meals when you feel hungry. Sip fluids regularly. Once the fever has gone and your doctor agrees, gentle activity such as short walks can help you regain strength. Don't push yourself too hard, especially in the first few weeks.

Mental health and emotional wellbeing

Going through a serious infection can be frightening. You may feel anxious, low, or stressed, and that is normal. Talk to your healthcare team if you are struggling emotionally, and ask about counselling or support services. If you ever have thoughts of harming yourself, call your local emergency number immediately.

Prevention

Yes, many viral hemorrhagic fevers can be prevented. In affected areas, use insect repellent, wear long sleeves and trousers, sleep under mosquito nets, and avoid contact with rodents and wild animals. Healthcare workers should always follow infection control guidance, including wearing protective clothing and handling needles and waste safely.

Vaccines

Vaccines are available for a few viral hemorrhagic fevers, such as yellow fever, and some countries use an Ebola vaccine to protect people at high risk. Ask your travel clinic or doctor whether any vaccination is recommended for your destination.

Screening programmes

Routine screening is not offered to the general public. During an outbreak, local health authorities may test people who have had close contact with an infected person so they can get care quickly. If you are travelling to an area with these viruses, a travel clinic can discuss whether extra checks are useful.

Complications

If left untreated

• Severe dehydration and electrolyte imbalances
• Damage to the liver, kidneys, or other organs
• Dangerous internal bleeding
• Shock, when vital organs do not get enough blood flow
• In the most severe cases, death

Long-term outlook

With early and good medical care, many people recover from viral hemorrhagic fevers. Some viruses are more serious than others, and recovery can be slow. The chances of a good outcome are much higher when the infection is found quickly and the person is treated by an experienced healthcare team. Your team will support you throughout your recovery.

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