2. Program Goals
Educate first responders on the following:
Background information on Viral Hemorrhagic Fever
(VHF)
Recognition of signs and symptoms of VHF
Treatment of patients with S/S of VHF
Transport of patients with VHF
Proper personal protection equipment (PPE) guidelines
Notification guidelines
3. Program Initiatives
Focus on the recognition, treatment, and transport of
suspects VHF patients
Deliver training via an online format
Simple online test
Printable easy to read chart
4. Viral Hemorrhagic Fever (VHF)
A family of viruses causing severe multisystem
syndrome
Damages the vascular system
Prevents self regulation ability
Can cause mild conditions or life threatening
conditions
5. Zoonotic
A disease of animals that may be transmitted to man
under natural conditions
Category A agent
Easily transmitted from human to human
High mortality rate
Require special action from public health agenices
6. Four Types of VHF
Arenaviruses:
Lassa & Latin American Fever
Carried by rats and mice
Transmitted by feces and urine
Bunyaviruses:
Crimean-Congo & Rift Valley
Transmitted though a arthropod vector
Filoviruses:
Ebola & Marburg
Host of virus is unknown, possible bats
Hemorrhagic Flaviviruses:
Yellow & Dengue
Arthropod vector
8. Signs and Symptoms
Minor Signs and
Symptoms
Travel history
Fever
Fatigue, weakness
Dizziness
Muscle aches
Headache
Sore throat
Severe Signs and
Symptoms
Travel history
Petechia (bleeding under the
skin)
Bleeding from internal
organs
Signs of shock
Bleeding from external
orifices
Nervous system malfunction
Coma, AMS, SZ
11. Modes of Transmission
Animal to Human
Contact with
Urine
Feces
Saliva
Other body fluids
Bites
Human to Human
Contact with body fluid
Contact with
contaminated surfaces
Up to 3 weeks
No agreement as far as
airborne transmission
Shown in monkeys, but
not humans
14. Decontamination
After exposure
Limit exposure with
proper PPE
Wash with soap and
water
Irrigate exposed mucous
membranes
Non exposure
Disposable equipment
discarded
Non-disposable
autoclaved
Interior of ambulance
needs to be disinfected
Disinfection EMS
clothing and footwear
15. Protocol
Proper PPE
Immediately notify supervisor if you suspect VHF
– isolate location if possible
Coordinate transport & reception at hospital prior
to leaving scene
Hospital needs to be secure
Able to handle isolates patients
Supervisor to contact local and state public health
departments
16. Treatment
Treatment is normally
supportive in care
Fever control
Electrolyte control
Fluid replacement
Blood pressure control
Fluid replacement
Pain management
17. Post Incident Actions
No current post exposure prophylaxis
A fever of over 101F will trigger isolation and treatment
Will be isolated at home or hospital
Supportive treatment as needed
Information will be provided on how to protect family
18. Common
Types of VHF
Signs and
Symptoms
PPE
Required
Treatment Transport
Consideration
s
Notes
Ebola
Hemorrhagic
Fever
Rapid onset of fever,
headache, joint pain,
weakness, diarrhea,
vomiting, and
abdominal pain, rash,
red eyes, internal and
external bleeding may
be present
Spread by direct
contact and blood
Standard PPE
Outer gown
Rubber boots
HEPA Filter Mask
Eye Protection
Class C Haz-Mat suit
No standard treatment
Supportive in nature
Fluids and O2
Isolation
Proper PPE
Often Fatal
Filoviridae Virus
Obtained from
infected non-human
primates
Lassa Fever Nonspecific S/S.
May include fever,
chest pain, back pain,
N/V/D, hearing loss,
tremors
Spread by direct
contact and
contaminated food
Standard PPE
Gowns, protective
eyewear
Ribavirin (antiviral
drug)
Supportive Care
Isolation
Proper PPE
Arenaviridae Virus
No S/S in 80% infected
Most common in West
Africa,
Spread from rodents to
humans
Marburg
Hemorrhagic
Fever
Rapid onset of fever.
After 5 days of
exposure possible
N/V/D, maculpapular
rash, weight loss,
massive hemorrhage
Spread from direct
contact and blood
Standard PPE
Outer gown
Rubber boots
HEPA Filter Mask
Eye Protection
Class C Haz-Mat suit
No standard treatment
Supportive in nature
Fluids and O2
Isolation
Proper PPE
Filoviridae Virus
Rare
Spread via Marburg
Bat
Common in mine
workers
Dengue Fever High fever, headache,
severe pain behind
eyes, joint pain,
muscle and bone pain,
rash, and mild
bleeding
Spread by mosquitoes
Limit mosquito
opportunities
No standard treatment
Rest
Fluids
Isolation
Proper PPE
Protect from
mosquitoes
Spread by infected
mosquitoes
Yellow Fever S/S after 3 to 6 days:
Fever, chills, headache,
back pain, bleeding
from GI tract
Only spread from
infected mosquitoes
Standard PPE
No standard treatment
Supportive in nature
Fluids and O2
Isolation
Proper PPE
Vaccination available
Protect from
mosquitoes
Spread by infected
mosquitoes
Information obtained from the Centers for Disease Control